13th February 2021
UK COVID Deaths – Daily 621 / 7-Day average 718
Total UK COVID Deaths within 28 days – 116,908
Total UK Deaths with COVID-19 on the death certificate – 121,674 (up to 29th Jan)
James Cook Hospital – Total COVID deaths – 569
All COVID cases within South Tees Hospitals Trust – 128
James Cook Critical Care
COVID cases – 26 (15 ventilated)
Non-COVID cases – 33 (15 ventilated)
Across the country, the number of COVID patients currently occupying hospital beds continues to fall. The R number has fallen below 1 for the first time since July meaning that the pandemic is shrinking. The UK has now vaccinated over 14 million people and should have offered the first dose of a vaccine to all the over 70’s by Monday. At the hospital, the total number of COVID patients continues to fall and we now have one less COVID ward on the James Cook site.
The Prime Minister visited Teesside today to inspect the plant in Billingham where the Novavax vaccine will be produced. Boris appeared optimistic that he will be able to announce his plans to ease the current restrictions later this month. The newspapers are full of stories claiming that something approaching normal service may be resumed by the summer. In fact, were it not for the news that the South African variant continues to be isolated in various areas, including Middlesbrough, you could be forgiven for thinking that it was blue sky as far as the eye could see.
Things remain pretty busy within Critical Care and whilst we are still operating out of seven ICUs rather than our usual three, I will attempt to keep the mood upbeat by using the rest of this post to update you on my friend Gary’s recovery from COVID-19.
Gary became very unwell with COVID-19 at the end of March. He became breathless and was admitted to hospital where he received oxygen and CPAP. Within three days he had been transferred to the ICU and had been intubated and ventilated. He spent the next five weeks unconscious. He was unlucky enough to experience many of the complications associated with severe COVID pneumonitis; he developed a pneumothorax, was repeatedly ventilated prone and required dialysis for kidney failure on his birthday. Thanks to the ICU team at Barnet Hospital in London, he survived and, after undergoing a tracheostomy, was finally able to be woken up.
Gary, being the determined individual he is, made good progress in weaning from the ventilator. He was eventually discharged to the ward after spending a total of seven weeks on the ICU. However, his time on the ventilator had taken its toll and he was left with speech, swallowing and neurological problems as well as the profound muscle weakness that is common to all long-stay ICU patients. With the help of the physiotherapy team he slowly began to regain his strength and I remember him sending me a video of the first time he was able to walk the length of the ward at the beginning of June.
Gary spent a total of three months in hospital but many aspects of his recovery were only just beginning. He had left hospital with severe swallowing problems which meant he was unable to eat anything. He was, therefore, fed through his abdominal wall using a Percutaneous Endoscopic Gastrostomy (PEG) feeding tube. He had also been left with a weak, hoarse voice as a result of damage to his vocal cords and nearby nerves. More nerve damage had occurred to his lower limbs and he had a marked foot drop which necessitated him having to wear a special foot brace.
Gary threw himself into his rehabilitation programme and slowly began to improve. I can imagine him being a rehab physiotherapist’s dream. He will have done everything they asked of him and more, spending as much time on exercises to improve his swallowing as he did on the ones to strengthen his leg muscles. He spent hours each and every day repeating these exercises, despite an overwhelming feeling of fatigue.
Nicky and I met up with Gary and his wife Jenni, back when you were still allowed to meet people outdoors in October. He was looking much better than I had imagined he would and we took a three mile walk around Codbeck Reservoir. Gary had stopped needing his feeding tube months before and by now, his swallow had returned to normal and he could eat whatever he liked. Whilst still thin, he no longer looked gaunt or unhealthy and his voice had recovered to the point where if you didn’t know him, you wouldn’t have thought anything was wrong. His foot drop was still present and he found it tricky to walk without his brace but he was surprisingly sure-footed with it. I had inadvertently picked a rather uneven, slippery path to finish our walk and I was pleasantly surprised when Gary stayed upright and I didn’t have to pull him out of any gorse bushes.
I had thought that his foot-drop might be a lasting legacy of COVID but I’m pleased to report that the other day Gary sent me a photo of him throwing his brace in the bin. Whilst he still has some weakness, he is able to function well without it and has been signed off by his rehab physiotherapist. I did wonder whether the NHS might insist on him returning the brace, but I guess that after being on his foot for months on end, it’s probably rather ripe and best incinerated.
Gary has been back on his bike for a few months now. He swiftly graduated from using his indoor trainer to riding outdoors and has been able to ride distances of up to 50 miles. He has found that he is riding at a much slower pace than he used to and is limited by breathlessness when trying to climb hills. This seems especially true when the air is cold and so the current winter weather has been rather inconvenient. Gary’s breathlessness is perhaps not surprising, given that many COVID-survivors are reporting similar problems. Both the timescale and the extent of any recovery are unclear, especially in patients like Gary, who have spent a significant period of time ventilated on the ICU.
Gary’s ability to cope with these problems, whilst still remaining optimistic is truly a testament to his tenacious resolve. He seems determined to make the most of his narrow escape from COVID’s clutches. I would imagine it would be all too easy to resent what the disease had done to your health, to feel angry and frustrated and grudgingly accept that your recovery might well be limited. However, I have never heard so much of a hint of this kind of thinking from Gary, just a steadfast determination to make the most of the situation.
In all honesty, you could splice together video clips of Gary at various stages of his recovery, lay a thumping 70’s soundtrack over the top and you’d have yourself a Hollywood rehab/training montage that was the equal of anything Rocky Balboa could muster.
Gary has ordered an electric mountain bike so he can continue to ride high altitude trails. Our group of friends have been floating the idea of an overseas mountain-biking trip at some point in the future when this is allowed. The e-bike will mean that Gary will be able to join us. Over the years, beating Gary to the top of any hill has always been a challenge. Whilst not quite the same, I suspect that his motor-assisted advantage will ensure that this continues to be the case for some time to come!