Many of those who have been to Covid hell and back are unable to shake off the memories of their days in hospitals, leading to worries about post-traumatic stress disorder and other anxiety related problems, including insomnia.
Crowded wards with scarcely a doctor or an attendant in sight, patients holding on to each other to go to washrooms so filthy they gagged and, most agonising, people around them dying. For Covid patients now back home, harrowing images from their hospital stay are the hurdles on their road to recovery.
Over a year after the pandemic began and deeper into the second, deadlier wave, many of those who have been to Covid hell and back are unable to shake off the memories of their days in hospitals, leading to worries about post-traumatic stress disorder and other anxiety related problems, including insomnia.
It's a "numbing experience" for many COVID-19 survivors who come out from hospital, observed Dr Samir Parikh, director, Department of Mental Health and Behavioural Sciences, Fortis Healthcare, Gurgaon.
Their days in hospital are seared into the memories of Covid patients who seem to be healing, but maybe only from the outside.
"Hardly any doctor attended to us for the first two days. There were six of us -- women and men -- in the same COVID-19 ward. We had to throw empty plastic bottles out of the door to catch the staff's attention. I watched at least three people die on the bed right across from mine," a Delhi homemaker said, requesting anonymity.
The 57-year-old, who is slowly regaining her strength, spent five days at a government hospital in the city.
Cases were spiking in the national capital and hospital beds were hard to come by when she was taken ill last month. With oxygen saturation levels falling, high fever and deteriorating HRCT chest values, she needed urgent hospitalisation and the family managed that with some difficulty.
She recalled her hospital stay with a shudder.
“There was no one to take us to the washroom and we, the patients, would hold each other's hands and go to that very unhygienic toilet, which was down the hall and unisex.”
The attendants, overburdened, exhausted and frustrated themselves, were often unhelpful.
"When the old man right across from my bed would take off his oxygen mask repeatedly, the ward boy would shout at him and say 'Uncle ji, this won't affect us. So you can keep doing this'," she recalled.
Almost a month later, she still wonders what happened to the woman who was on the bed next to hers.
As cases continue to rise and hospitals stay overburdened, sociologist Sanjay Srivastava said this is a pandemic that seems to have no answers, causing a general rise in ‘social anxiety, distrust and psychological instability’.
There has also been a realisation about the fragile nature of what in India was always believed to be a strong idea, the state, the London-based academic added.
"There is also a feeling of extreme psychological distress due to the seemingly mysterious nature of the virus, a mystery that none of the usual authorities -- doctors, hospitals, the government -- has any answers for," Srivastava said.
The stories of continuing patient distress are many.
Several patients said they couldn't bathe for days in hospital because there was no water or use toilets that were clogged and dirty.
Siva Shakthi, a student in Puducherry, sought an early discharge for her 57-year-old mother Alamelu from the Puducherry-based Indira Gandhi Medical College because of its unhygienic conditions. Her mother has co-morbidities such as heart issues and high blood pressure and she didn't want to take a chance.
"The hygiene was pretty bad. That's why she had to come back in just three-four days. Both men and women had to use the same toilet. It was very disturbing,” Shakthi said.
"Medication was given but drips weren't. You had to take care of yourself which is the case with a lot of hospitals in the country today," she added.
According to Parikh, the patient may experience a range of emotions while in treatment for multiple complications that may arise.
“They are isolated so they might feel loneliness, being around sick people and perhaps seeing death around, anguish, pain, grief their family may also go through the same," he explained.
Some of these patients can get PTSD, Parikh said.
“What can be done is to have a support system in place and ask them to express themselves openly every time they get worried. Be connected with people through messages, calls and video calls. When you're back, don't rush to work, or be over busy. Give time to self care," he added.
According to Parikh, some people will feel vulnerable for a few weeks after being discharged and expert intervention might be required.
Distress cannot be quantified and should not be correlated with illness, Parikh emphasised.
He also stressed on the need for support systems.
"The difference between what we will be as a society six months down the lane post the wave is going to be in the nature of our support systems. "If you've not felt isolated socially and felt supported by family, friends and colleagues, then on the other side of the pandemic, you will be standing comfortably," Parikh said.
Former Allahabad University chemistry professor Arun Srivastava is an example of ‘self care’ and holistic healing. Srivastava, who had also tested positive for Covid, lost his wife Hemlata, also an academic, to the infection. But he has begun the process of picking up the threads of his life and has decided to complete a book series on the university's Science department.
“Both of us got admitted to a private hospital in Allahabad's United Medicity on April 6. On the evening of April 8, they said they will refer her to SRM Hospital. We reached there the next day. I didn't have any such symptoms then, but they kept my wife on oxygen (support) there were some severe complications due to which she couldn't make it," Srivastava said.
"She was the driving force behind this series. I thought I won't be able to write anymore. Then I decided I must complete the series to honour her memory," he said.
A Jaipur-based physician said frontline workers are also "worn out and frustrated" from working 24X7 for the past one year, but admitted to the many problems of an overburdened healthcare infrastructure.
"No one attends you for hours. This includes both general and resourceful patients who have been admitted for COVID-19 treatment, be it in a government or a private hospital. Even if they do, the senior doctor seldom comes to see them.
"Many deaths occurred because patients were not attended on time. There is also a possibility the doctors will never examine the patients and only treat them on the basis of their reports."
The condition of toilets is often horrible, he added.
Clearly, the trauma of Covid is not just about the infection. The mental scars also have to heal for patients to get back on their feet, and resume life as it was before the pandemic struck.
