Bracing for the Second Pandemic: PTSD, Cognitive Difficulties and Other Possible Mental and Physical Impacts of the Coronavirus

Even though most of us are still sheltering in place in an attempt to lessen the immediate spread and most severe health consequences of COVID-19, it is not too soon to start considering possible long-term health impacts that may arise in the wake of the coronavirus pandemic.

Because the virus affects many organs and systems within the body – from the lungs and cardiovascular system to the liver, kidneys and likely the brain – it now appears likely that at least some patients will suffer long-term physical symptoms.  These long-term and even permanent problems may result from the virus itself, the body’s own immune response or even medical interventions, especially respirators, or a combination of all these factors.  But whatever the cause, doctors are already seeing heart damage, kidney and liver damage and, unsurprisingly, lung scarring and damage in a number of COVID-19 patients who are no longer actively infected.

And these are still early days. Some patients present during the illness with serious neurologic problems such as strokes and encephalitis, as well as other more mild neurologic symptoms such as dizziness, headache and loss of smell.  There have been reports of some patients suffering from Guillain-Barré Syndrome, an auto-immune disease where the immune system responds to an infection by mistakenly attacking the body’s own nerve cells.  It seems possible that at least some of these patients may continue to suffer neurologic and autoimmune issues, and related pain, fatigue and cognitive difficulties for at least some time.

As serious as some of these physical impacts may be, mental health providers are already warning that the long-term physical consequences of the virus may be dwarfed by psychological and mental health impacts that are likely to arise among an even larger group of individuals.

First, the severe stress suffered by COVID-19 survivors and front line healthcare workers, particularly in hard-hit nursing homes and hospital emergency rooms and intensive care units, could trigger anxiety, depression and even post-traumatic stress disorder (PTSD).  Studies of hospital workers who dealt with the SARS outbreak in 2003, found high levels of PTSD symptoms three years later.  Likewise, for many COVID-19 survivors who make it out of ICU, their stay is likely to be the most traumatic event in their lives, particularly if they have been intubated.  This trauma is likely compounded by the fact that they are completely isolated from their loved ones.  The first very preliminary studies of such survivors from China suggest that upwards of 90% of such patients are suffering PTSD symptoms at least in the short-term.

Second, a much larger group of people may also suffer mental health effects stemming from loss, isolation and social distancing.  Those who lost a loved one to COVID-19 or become financially crippled are believed to be the most likely to suffer long-term effects.  But even those who have not suffered these kinds of losses may be vulnerable. Nearly all studies of people who have been quarantined, even for relatively short periods of time, show high levels of high levels of psychological distress and disorder, including some symptoms of PTSD.  And regardless of the source of the stress and trauma, the effects are greatest on vulnerable individuals who already suffer from mental health disorders, such as depression, anxiety and addiction.

The extent of the problem can only be guessed at this point.  But it is not too soon to start preparing for an increased need for intensive mental health and medical treatment and an increase in those who become disabled by the physical and psychological consequences of the virus.  To date, insurance companies have done a good job covering the costs of COVID-19 testing and treatment.  But as the numbers of people affected and their long-term needs increase, this is not, in my humble opinion, likely to remain the case.  We will continue to cover these topics as more information becomes available.

If you are being denied benefits by your insurance, please call Kantor & Kantor for a free consultation at 800-446-7529 or use our online contact formWe understand, and we can help.

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