The experience of surviving Covid-19 has been harrowing and physically and mentally draining for many Indians. Media reports suggest that several Covid-19 patients have experienced neurological changes and slipped into depression, or had repeated nightmares post-recovery.

Social media first-person accounts claim that many show sensitivities to light and experience extreme body pain and headaches. In fact, several studies outline the lasting impact of Covid-19 on the human brain and people’s overall well-being.

A study conducted by Oxford University on more than 2,30,000 American patients found that one in three Covid-19 survivors were diagnosed with brain or psychiatric disorder within six months of their recovery. However, in India, where accessing basic health infrastructure to survive Covid-19 is a struggle, post-Covid care seems to be an afterthought.

As more fall prey to this deadly virus, workplaces are functioning with skeleton staffing. So they have little room for compassion and want their employees back on the job as soon as they show any sign of recovery. Thousands, who are struggling economically to keep their family afloat, do not even have the basic time or space to process the life-altering experience they underwent with Covid-19. For many, processing the trauma of being in ICU, and or losing loved ones have not even begun.

Dr Harish Shetty, a social psychiatrist at Dr LH Hiranandani Hospital, Mumbai, pointed out, “Dementia and strokes are also common among Covid-19 survivors. The patients, who had been in the most critical conditions during the infection, struggle more with mental health. After a near-death experience, and the overall uncertainty of the pandemic, it is also not uncommon for patients to have an existential dilemma; and they often tend to re-evaluate their lives.”

“Another phenomenon that is being noticed in Covid-19 patients is the survivor guilt, especially among those who have lost their parents or partners due to Covid. They cannot fathom what has hit their lives and are in dire need of support and counselling,” he added.

Shetty explained that even patients who had mild symptoms and were, therefore, self-isolating at home had shown signs of mental health sequelae. Approximately one-fourth of Covid-19 patients, in general, have experienced emotional disturbances.

“Lack of sleep and total insomnia are the obvious common signs. However, palpitations, a sense of impending doom, fear of dropping dead at any moment have also been observed. I know of a teacher who believed that her Covid infection had not been cured and insisted on extending her stay at the hospital, although her reports were negative. But this is just one example. Fear has been an overarching emotion during this pandemic,” explained the doctor.

Mumbai-based psychologist Priyanka Varma pointed out that the ICU has been a very triggering place for many patients.

“The sounds of monitor beeping, the noise of doctors walking through corridors can be very stressful. Things get worse when others around you pass away from the same disease. These patients also have minimal contact with family members, and the isolation and loneliness push them to confront their own mortality, question the meaning of the life they had built, and acknowledge the finiteness of their time,” said Varma.

“It can be very overwhelming and can induce anxiety and depression. One of the most comforting things to us is the physical touch. But those struggling with Covid cannot even reach out for a hug from the loved ones. Therefore, there is a significant amount of physical isolation, and that can be very difficult for many people to go through,” she added.

Varma pointed out that care and support are also required for the family and friends. “They are dealing with Covid positive patients every day and that can be overwhelming. They might need help but may not think of asking for it because they prioritise the health and well-being of the patient above their own,” she explained.

Varma said that while it is necessary for Covid-19 survivors to do some introspecting, instead of going down the vortex of fear, if they can manage to focus on finding the purpose of their lives, especially after such a life-altering experience, it might thrust them into a new direction.

“I think the best way to make sense of your thoughts during this time is to journal. Journaling is almost a kind of self-therapy because it enables you to rationalise and work through your thoughts and identify which one is an endless spiral and which one is based in reality. So, journaling is a very useful technique to cope. However, if you, or your immediate family or friend think that you need professional help, it is important to be open to it; seek that out,” she added.

Most mental health experts, as well as physicians, agree that going back to work has to happen at a slow pace for Covid-19 survivors, and all workplaces should offer an employee assistance programme that will help their staff deal with a crisis of such unprecedented scale.

Dr Charu Goel Sachdeva, HOD and Consultant -Internal Medicine, Manipal Hospitals, Dwarka, New Delhi told News18, “After leaving work for a prolonged period due to Covid-19, it’s possible that a patient may deal with anxiety and stress owing to workload. However, it will do no good because the body is in recovery even after it stabilises. Therefore, we recommend engaging in stress-relieving activities like yoga or light workout and consumption of light and nutritious diet.”

Sachdeva pointed out that the patients should continue to monitor their oxygen level, do regular exercise, and give their body enough rest so that their organs can recover completely. They should also minimise their screen time and alcohol consumption.

Dr Tushar Tayal, Department of Internal Medicine, CK Birla Hospital, said, “Generally, the recovered patients should avoid going out immediately after recovery as the body is still getting back to its healthy state and needs proper care. But still, if one has to step out, then the patient must take certain precautions while doing so. For instance, they should wear a double mask, always keep a hand sanitizer, maintain six feet distance in public places and last and the most important thing is to get yourself vaccinated (as per the doctor’s recommendation).”

Personal and social hygiene is of utmost importance for full recovery. So, soon after a patient stops showing signs of Covid and tests negative, he should clean his surroundings, especially if he was self-isolating in that room, and clean all his personal belongings like clothes, and utensils. Apart from them sanitizing often-touched surfaces like door knobs, switches etc, post recovery is also essential.

Tayal added, “If the patient is still in the recovering stage and the doctor has prescribed medication, then the patient must complete the course of medicine without failing to lead a healthy life again. Completing the course will help them build their immunity and at the same time keep them active.”

Deeksha Ahalawat, Consultant – Nutrition and Dietetics, Manipal Hospitals, told News18 that nutrition plays a significant role in the recovery path. During Covid-19, the body gets weakened, and it continues for days even after recovering from the symptoms. Thus, it becomes essential to consume the right kind of diet.

“The main diet focus for Covid patients is to consume foods that would help rebuild muscle, immunity and energy levels. One should have small frequent meals. Most Covid patients experience loss of smell and taste or difficulty in swallowing. Therefore, it is important to eat soft foods at small intervals. Drinking plenty of fluids, like warm water with Tulsi leaves to manage Covid symptoms, like cough and itchy throat, is also recommended. Avoid sugary drinks, alcohol, coffee as it leads to dehydration. Inhale steam with the tongue out at least 2-3 times a day,” said Ahalawat.

Ahalawat pointed out that food shouldn’t be over-cooked since it causes loss of essential vitamins. Ideally, canned food should be avoided, but if one has to opt for it, a good option is to go for those without added sugar or salt.

Immunity boosting is a long-term, and continuous process, said Dr Prachi Jain, Department of Dietetics, at the CK Birla Hospital. “One can boost their immunity by including Vitamin A, C, D and E, minerals like zinc, selenium, and magnesium in their diet. It is also important to consume enough protein in your diet and include prebiotics, probiotics and fibre. Indian spices and herbs have anti-inflammatory and anti-viral properties to boost the immune system as well,” she explained.

“To manage heart health post Covid recovery, one should consume low fat, low cholesterol and high fibre diet with a combination of complex carbohydrates and Omega 3 and 6. Those patients who had experienced severe breathing issues, and had lung-related damage should consume a complex carbohydrate and a high protein diet; fat should be unsaturated with the combination of Omega 3 and 6,” she added.

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