John
When his wife fell ill with and was hospitalised with Covid in late December 2020, John fell ill shortly after. He was in hospital for 30 days, including 12 days in ICU. After 5 months he had recovered at home and returned to work full-time.
Time of interview May 2021
John (60) works in the electrical distribution business. He is husband and carer to his wife and has two adult children and six grandchildren. White British.
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Onset
As John’s wife was at risk for becoming severely ill with Covid due to a pre-existing respiratory condition, they were particularly careful not to contract it from the beginning of the pandemic onwards: they shielded through the whole year. His wife often spends time in the hospital, so the staff there knows both her and John from these visits and stays.
In late December 2020, John’s wife was in hospital with pneumonia, where she contracted Covid. He then tested positive too, just before Christmas Day. Up until that point, John had not thought that he would become critically ill with Covid as he had no underlying health conditions and had always been fit. His admission to hospital impacted both him and his family, within which he plays a central role in the care for his wife. His illness also had a ripple effect on friends and colleagues, many of whom re-evaluated their risk of Covid and made lifestyle changes following his admission to hospital.
Symptoms
John experienced flu-like symptoms: a temperature, body aching, loss of appetite and a cough, but nothing too severe. On day three or four his respiratory issues became worse. On Boxing Day John’s wife was admitted to hospital. He was then at home alone, as public health restrictions in place did not permit household mixing. When in the evening he started to feel particularly short of breath, John called his daughter, who lives far away from him. He also called his son, who lives close by, who came over to help John down the stairs and into the ambulance.
Admission to hospital
John was admitted the high dependency unit (HDU). He remembers little of the 17 days after that. John later learned that he was admitted to ICU on New Year’s Eve.
Communication between the hospital and John’s family
Communication between the hospital and John’s family involved regular updates on how he was doing. The ICU communicated with John’s two adult children, and they, in turn, communicated with others, including their mother, wider family and John’s colleagues. When there was a conversation about possible ventilation, doctors tried to get more of an understanding of who John was. As John understands this process now, it is part of assessing whether his body would be strong enough to withstand treatment in ICU. As part of this, doctors screened him for cancer and did a health check.
Intensive care
John’s treatment on ICU involved receiving oxygen: first through a mask, then through a mechanical ventilator. He was also given various medications and was proned. A member of the Church of England, friends and acquaintances prayed for his survival.
John remembers a feeling of being trapped in a bed with pipes coming out from everywhere. His last day in ICU, when he was extremely thirsty, and was given water – but he could not drink this due to the various tubes and he almost choked. That night he asked the nurse on shift for water, and she gave him a sponge to put in his mouth and suck the water out of, which worked.
After waking up from ventilation, John needed to relearn how to swallow, drink and eat again. He had no strength to walk or stand. Even moving in bed was difficult. Being weaned off oxygen was difficult and had to be restarted a number of times.
Two people died in the beds opposite him in ICU, and one patient died when he was in the respiratory ward later on. John said about this: “This really focuses your mind on what you’ve been through.”
The respiratory ward
When he had been given water in a sponge, he felt like staying in ICU – his recovery had finally started, he liked the nurse who had had a positive impact on him. Yet, it was decided he was to be moved to the respiratory ward. For this, John needed to be disconnected from the various tubes – a process that was followed by 30 minutes observation. After this, it took five hours for him to be transferred to the respiratory ward. When he was finally moved his oxygen levels had dropped significantly. A nurse on the respiratory ward indicated that she was not happy with how he was currently doing, and that the level of care she would be able to provide for him on the low dependency side of the ward would not suffice. John was therefore moved to a high dependency bay of the respiratory ward instead. Here, John was placed on the CPAP – Continuous Positive Airway Pressure (for 1 hour) and then given oxygen via a nasal cannula.
On the ward, a number of therapists (language and speech therapy on the respiratory ward, and occupational and physiotherapy including after discharge home) came to see him. John knew many of the staff on the respiratory ward due to his wife’s stay there over the past 5 years. He felt that the care there was good. Some patients around him were very distressed; one was screaming, another refused treatment. John found it hard to witness this, and to deal with the screaming, which affected his sleep.
The clinical staff had identified John had a highly resistant hospital bug which meant that he had to be isolated from other patients in a small side room and do exercises (which he called “bed aerobics”). Whilst there was less noise than on the ward, his sleep remained interrupted because of the various tests and measurements that nurses came to do. Being in the side room also meant he sometimes went hours without seeing anybody.
Seeing his wife in hospital
For three days after John was transferred out of ICU, his wife was still in hospital too, on a different ward. This meant that she could visit him on the respiratory ward during those days. John realises that his situation was exceptional, considering that many people were not allowed to have visitors whilst in hospital. When his wife left hospital, she was given a care package to support her at home whilst John was still in hospital.
The rehabilitation unit
For John, it took three weeks to become strong enough to go home during which he was transferred to a rehabilitation unit in order to build up his physical fitness.
Coming home from hospital
Eventually John was discharged with the same care package as his wife. He could wash himself, but not prepare a meal. His son was working from their house to support them and he helped John with his exercises.
John recounts that his mood changed due to Covid. He said that has “never been a good patient” in the sense that he is impatient – he had to give himself a good talking to, to do the positive things one needs to do as part of recovery. He found recovery to be a difficult process. He felt the impact that being in intensive care has on the body, which he felt consisted of the fight against the illness, as well as the fight against the impacts of the treatment.
Looking back
At the time of the interview, 5 months after coming home from hospital, John felt recovered from Covid, but was still recovering from what the machine-dependency did to his body. On the first day at home John could barely walk 100 metres; but through increasing the distance steadily over time (and using an oximeter to check his oxygen levels), he can now walk 8 kilometres at 6km an hour. John feels he is mentally 100% back to the way he was pre-admission, but physically he is at 85%.
Looking back, John feels he should maybe have admitted himself to hospital sooner. Perhaps this would have helped the management of his symptoms. The two things that have helped him get this far are family and exercise. At this point, what helps is knowing that he has somebody to call in case something did happen.
His Covid/ICU experience has been transformative for John – he is now more focused on what matters to him, which is his network (family, friends). “Work is just work” he said. Covid and ICU have also been traumatic, particularly for his family members, who had been told that they could lose their husband and father.
Messages for others
John urges others to be aware of the impact of ICU on the body and on mental health: “Understand that you’ve got a fight on your hands”.
In a brief conversation in August 2021, John said that his follow-up care from ICU had been discontinued in May 2021, although he was told that, should he need to, he can always call the ICU for advice.
John had flu-like symptoms which gradually got worse.
John had flu-like symptoms which gradually got worse.
I remember initially it was quite mild symptoms, the first couple of days. Temperature, just feeling…it's like a flu scenario, your body was just aching and you just didn't want to move or do anything. Loss of appetite. A little cough, not much of a cough. I never lost my sense of taste or smell. So I didn't have all the symptoms which you hear about. And then over the…about day three, four, I then started having difficulty with breathing, so respiratory issues, which is what led to me needing to get myself into hospital at the point where I was really struggling to be able to just breathe. So I'd describe it as a severe case of flu like symptoms.
John and his wife were able to see each other when they were both in hospital.
John and his wife were able to see each other when they were both in hospital.
And when you were on the ward was your wife still in hospital? Had she been discharged by that point?
She was discharged three days after I came up from ICU. So, we were pretty well…we were both on the respiratory ward but in two different parts.
But he doctors allowed her to come and see me on those couple of days we were in there together. And then she went home. And once she went home, she wasn't allowed to see me. So, our contact was through telephone and Facetime…yeah, Facetime for the next few days. Or for the next few weeks because I was in there for the best part of three more weeks before I got fit enough to be able to leave the hospital.
So, what a bizarre situation not being able to visit each other in hospital?
That's right, yeah. The only reason she did see me in hospital was because she was there with me effect. And that was the visit into ICU and the visit between the two wards which were side-by-side and linked together anyway. So yeah, so quite interesting. It was quite interesting, one of the consultants came and saw me one day and she said I've just seen your wife next door, she's just prettying herself to come around and see you because I've given them permission to allow her to pop round to see you. So quite interesting.