WHAT YOU NEED TO KNOW

​Long after the symptoms of COVID-19 finally fade away, many people who were hospitalized with the virus will face a long road to recovery from the virus—not just physically, but mentally. The most severe cases end up in the intensive care unit (ICU) on ventilators for days or even weeks, but intubating a patient—inserting a breathing tube in their mouth, deep into their lungs—can cause other problems down the road. While intubated, patients must be heavily medicated to prevent them from yanking out the tube and catheters; the long-term, debilitating consequences of this life-saving treatment can include scarred and damaged lungs, weakness, memory loss, depression, hallucinations. Patients may not be able to walk or talk or think as well as they used to, or they’re haunted by nightmares and endure sleepless, anxiety-filled nights. For many people, life after the ICU and COVID-19 will feature months of rehabilitation in the hospital or another facility, apart from their families. And there will be other hardships too: lost income, reduced ability to work, medical bills. Feelings of depression, by them and the loved ones who care for them. Part of the solution, writes Dhruv Khullar, MD, may be special COVID-19 survivor clinics like one at his hospital, NewYork–Presbyterian Hospital, which provides holistic, follow-up care for patients suffering from post-ICU syndrome.

 

The COVID-19 lockdown has had a profound impact on many businesses and industries, one of the unexpected casualties being the illegal drug trade. With trafficking routes disrupted, the supply of opioids has dried up in many areas around the country, but this may not be as positive as it sounds. Fewer drug dealers on the streets and a dwindling supply, as well as the lack of money to buy drugs, have prompted some opioid addicts to seek treatment to avoid suffering from withdrawal. This has resulted in fewer relapses and overdoses; however, on the flip side, some regions actually have seen an uptick in overdoses and related deaths—because new drug sources often provide them at a different strength, which users then take in the wrong amounts. And as states start to reopen, the risk of an overdose could be even worse, if people who have reduced their usage suddenly increase again. To prepare for this eventuality, the Substance Abuse and Mental Health Services Administration supports increasing distribution of naloxone, which is used to treat narcotic overdoses, and they are training first responders in the community to administer it while minimizing their risk of exposure to COVID-19.

Social media is not an adequate substitute for face-to-face, personal interactions, and that’s no less true while practicing social distancing. But there are still ways to virtually, yet meaningfully, stay in touch with others to fulfill our need for human contact. In this article, Allison Aubrey offers some suggestions and resources that can help you overcome loneliness while also helping others cope in this extended period of isolation. Try picking up a new hobby or skill with real-time online classes— the pandemic has created many new opportunities for live streaming activities with groups of people, friends and strangers alike. If you are interested in volunteering, digital platforms make it possible to provide companionship and assistance to the elderly, become a “citizen scholar,” for example as part of crowd-sourced efforts to transcribe historical documents for the Smithsonian; or help people with low vision. Finding joy, even alone, is possible with a little creativity, resourcefulness—and a good internet connection.

During a period of pandemic-related unemployment in the United States, some people are landing jobs in a new market created in response to the virus: COVID-19 contact tracing. Contact tracers make cold calls to people who have been in close contact with someone who has been diagnosed with the virus, to find out whom else they have been in contact with. Tracers also offer assistance to those they call, tell- ing tell them where to get tested for the virus themselves, recommending self-isola- tion if they have symptoms, and connecting them to resources for food and financial support. Naturally with many people now seeking employment, especially work that can be done from home, there’s a lot of competition for a small number of available positions. But as more state health departments establish and expand contact tracing programs, more opportunities may open, and it turns out the most important require- ments to be considered a strong candidate are empathy and cultural literacy.

 

Residents of long-term care facilities are in the high-risk group for COVID-19, so it’s especially concerning when it begins spreading throughout a nursing home or assist- ed living community. The problem is, it seems that the arrival of COVID-19 isn’t a mat- ter of if, but when; even when managers do everything possible to protect their staff and seniors from infection—following all the federal and state guidelines, restricting visitor access, investing in personal protective equipment like N95 masks and rapid testing—the virus still finds its way in. Here are three LTC facilities in Camden, New Jersey, that had different experiences with COVID-19, and some of the lessons they’ve learned about preparing for the worst-case scenario and then managing it when it becom

es a sobering reality.

The unusual demands of living in lockdown during the pandemic are introducing— and exacerbating—equally unusual challenges in managing the physical and emotion- al health of kids, not to mention their parents. Being cooped up indoors all day, every day and the lack of a comforting routine create the perfect storm of boredom, sad- ness, anger, and stress. Some cope with that heavy emotional burden by overeating, although much of the literature suggests that kids follow their parents’ lead when it comes to food and exercise. One solution is to engage your kids more to alleviate their boredom, but of course parents are already busy and under added stress themselves; it’s just as important to forgive yourself a little as well as accept some compromises when it comes to managing your expectations. In this article, experts advise trying to be more aware of your own eating habits and those of your children (especially teenagers); communicating about their feelings; and encouraging healthy activities that promote positive emotions, like finding creative ways to stay in touch with their friends. Establishing and sticking to basic routines can also help, like standard snack and mealtimes, especially if they follow the school schedules your kids are already used to. Everyone’s response to the pandemic is different and there’s no one right way to deal with it—but being aware of the pitfalls of emotional eating, whether overin- dulging or undereating, is the first step to getting it under control.

With everyone’s attention on COVID-19, restrictions on nonessential medical pro- cedures, and people staying home and away from hospitals as much as possible, a disease we can prevent may make an even bigger comeback: measles. The Centers for Disease Control and Prevention (CDC) warns that a decline in routine vaccinations for children during the pandemic could eventually result in measles outbreaks. A cover- age of 90 to 95% measles vaccination is needed in communities to maintain herd im- munity, but immunization data from Michigan shows vaccinations for 16-month-olds dropped from 76.1 percent in May 2019 to 70.9 percent in May 2020, and is currently below the herd immunity threshold. Even before COVID-19, in recent years measles outbreaks have been cropping up around the country, after the disease was effective- ly eliminated in 2000. Thus, it is vital that parents keep up with well-child visits and scheduled vaccinations, even during the pandemic.

 

The pandemic has interrupted everyone’s plans and schedules, forcing the world to hit the pause button. Something like this is a nightmare for events planners like Marisa Sullivan, a 40-year-old Los Angeles woman who recently had to cancel a trip to Paris with her husband. But that was the least of her worries, because among the multitude of things COVID-19 lockdown has put on hold are critical medical proce- dures—and she’s been preparing to undergo surgery to remove a malignant tumor for months now. Despite all this, Marisa, who was diagnosed with triple-negative breast cancer in November, counts herself one of the lucky ones: Her operation was scheduled for May 18, just as restrictions were easing up at Cedars-Sinai Medical Cen- ter. Even though non-COVID-19 care is resuming, the facility has been taking extra precautions to protect their staff and patients like with underlying conditions like Marisa, whose chemo-compromised immune system makes her even more at risk for contracting the virus. Two days before surgery, she was tested for COVID-19—nega- tive—and her surgery was done in an annex building separate from the main campus where COVID-19 patients are hospitalized. If Marisa’s luck holds, the cancer will be completely gone and all she’ll need is follow-up radiation treatments, which she plans to receive in Tampa, Florida, while recovering at her mom’s house—the closest she can get to Paris for now.​