At the bottom
The first day in the intensive care unit was the low point for Florian Namuth. The doctors had placed a central catheter on him, administered medication and connected him to a Hyper Flow ventilator. That forced liters of oxygen into his lungs, but he couldn’t really get any more air. Instead, he felt puffed up. So he concentrated all the remaining strength on exhaling so that the machine could press in the oxygen again. But his strength was almost exhausted and he expected to die. His own death, which usually seemed far away to him, had come to his bedside.
When Namuth remembers today, it is not the fear of death that was most memorable to him, but the experience of being dependent on strangers in his distress.
On the fourth day, the medication and treatment finally worked. His lungs finally processed the incoming air again and the oxygen level in the blood stabilized, albeit at a low level. Fear gave way to confidence: “I can do it.”
But then his recovery stagnated. He had been able to avert death, but for the next ten days in the hospital his condition barely improved. Namuth was able to move again, but after a few meters on foot he was at the end of his strength. A new fear spread: “Will I ever be able to breathe normally again? Is there anything left behind? That is why my thoughts circled.”
“Recovery “does not mean healthy: What is Long Covid?
Like Florian Namuth, many hospitalized Covid-19 patients are doing. When they are discharged from the hospital they are formally “recovered”, but in fact they are far from healthy. If this condition persists for more than four weeks, medicine speaks of Long Covid Syndrome. A British study, to which the RKI also refers, shows that around 40 percent of people with severe Covid 19 disease still have long-term health problems. Even with slight gradients, one in ten retains an impairment in health.
This roughly coincides with the experience in Thuringia. “We see that about half of all patients with a severe Covid 19 illness continue to have symptoms after overcoming the acute illness,” says Professor Andreas Stallmach, who heads the Post Covid outpatient clinic, which is unique in Thuringia, at the Jena University Hospital. What is particularly tricky about Covid-19 is that, as a multi-system disease, it can cause a wide variety of long-term damage. “Today we no longer understand Covid-19 as pure pneumonia, but as blood poisoning with viruses […] This can damage all organs, “explains Stallmach.
So far it has been known that Covid-19 causes tissue damage in organs with ACE cell receptors such as the lungs, liver and kidneys. The virus can also cause myocarditis or damage to the neurological area. This results in various symptoms of Long Covid patients, some weeks and months after the illness, still complaining of palpitations, shortness of breath, depression, massive dizziness, persistent loss of taste, permanent fatigue, and difficulty concentrating and sleeping.
Rehabilitation in Bad Salzungen
In mid-November Florian Namuth received a rehabilitation place in the Asklepios Parkklinik in Bad Salzungen, which specializes in lung diseases. He spent four weeks here with movement therapy, breathing exercises, brine inhalation, equipment training for muscle building and walks. “In the second and third week, the changes were no longer just measurable, they were finally noticeable. I was even able to breathe into the tips of the lungs again,” says Namuth. But not all patients make such good progress.
In rehab I met Covid patients who fell ill in the first wave in April and are still unable to work. This is a topic that has not yet reached the public enough.
Professor Andreas Dösch, chief physician at the Park Clinic in Bad Salzungen, has a similar assessment. Many of his patients still complain of limitations months later. Irreversible damage cannot therefore be ruled out, in particular the pulmonary fibrosis caused by the acute disease and some neurological damage are difficult to restore. “ The re will definitely be patients who have permanent damage,” says Dösch.
From a social perspective, Dösch considers the long-term consequences of Covid-19 to be too little considered. “This is definitely an issue that needs a certain amount of attention.” He calls for structured follow-up care for recovered Covid-19 patients in order to be able to collect data on the long-term consequences in as many cases as possible.
Slow new beginning
Florian Namuth is now in the process of reintegration. He works as an administrative manager in an outpatient nursing service in Erfurt. His wife is the manager here. If she thinks back to the last three months, she realizes once more:
You’re just not prepared for something like that. We have to deal with death and illness every day at work, but even we were caught off guard. It can happen so quickly and I’m happy that Florian is still here.
Namuth currently works up to six hours a day. Even if it’s “just” desk work, his lungs are still a problem. The re are also headaches and concentration problems. It will probably take a while until he is fully recovered. And yet Florian Namuth is happy about this new beginning after three lost months.