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Michael J. Salamon

What about the wounded?

Those who don't die from COVID-19 may suffer confusion, clumsiness, overwhelming lethargy, painful tingling, visual issues, a cough, blood clotting, brain swelling, or brain damage
Johnny, the bus driver from East Jerusalem who recovered from the coronavirus, is released from hospital, March 30, 2020. More than two months later, after being discharged from the hospital, Johnny's health is still deeply affected. 'He can't work, he can't walk. He walks two minutes and he gets tired,' his father told Channel 12. (Maya Tzaben/Baruch Padeh Medical Center)
Johnny, the bus driver from East Jerusalem who recovered from the coronavirus, is released from hospital, March 30, 2020. More than two months later, after being discharged from the hospital, Johnny's health is still deeply affected. 'He can't work, he can't walk. He walks two minutes and he gets tired,' his father told Channel 12. (Maya Tzaben/Baruch Padeh Medical Center)

Today the mortality rate for COVID-19 is hovering around 4.5 percent in the US. Perhaps as low as 1% in Israel. It is both lower and higher in other countries. It is far too early to know just how meaningful these percentages are for two primary reasons. Mortality or death percentages are tied to the number of accurately reported cases, so if there are cases of individuals with COVID-19 who died from the disease but were not documented as such on their death certificate, or there is a higher number for people with the disease that were never tested but had all the symptoms of COVID-19 then the mortality rate may dip or rise. Epidemiologists are working to get better insight on these numbers, but likely will not have more solid data for quite some time. While mortality rates are of critical significance there is an aspect to this pandemic that is getting short shrift.

The rate of illness in the population, known as morbidity, is also in question due to the same issues of testing and reporting. But these numbers too are being calculated to the best of the abilities of the scientific community and, at some point, we may get them.

What is not being calculated is the sequelae of this disease, which is defined as any condition or state that follows a disease.

Well, that may not be fair. It is highly likely that there are researchers tabulating the medical complications that COVID-19 is causing. We just do not have any solid data on these consequences yet.

What we do have is some especially important and significant anecdotes. COVID-19 has been referred to as a tornado in the body. We know of the breathing, coughing and smell and taste complications caused by this disease. We know that, for some, the pain of this illness can last a few days to many weeks, and, while, in some cases, Corona leads to death, in many more there is recovery.

In those who recover from Corona, the healing is often sidetracked by a variety of serious sequelae. The erroneous perception among those not afflicted is that COVID-19 is an illness of the respiratory tract and that is where it does the most damage. It turns out, however, that it is also causes widespread threat to other major bodily organs.

People who have been infected by COVID-19 and survive are reporting symptoms that last for a long time. Confusion, unsteady gait, clumsiness, overwhelming lethargy, painful tingling on one side of the body or in discrete areas, significant visual problems with focusing and differing levels of blindness and a persistent cough are all a result of this disease. What most of these secondary symptoms indicate is that COVID-19 causes blood clotting and brain swelling and brain damage. In patients with these symptoms who have been medically followed, MRI scans of the brain indicate the swelling that apparently results from Corona. Perhaps the most frightening aspect of these anecdotal reports is that some of these symptoms do not resolve with medical intervention. And the doctors who treat the patients with these secondary after-effects have no idea whether they will resolve or not. (As I have noted, prior abuse has been increasing too as people have had to limit their social interactions and been quarantined with their abusers. This too is a serious side effect.)

Someone said that we are in a war against this pandemic. That is true. It is a war against a disease that we are still learning about. In battlefield wars, however, we tally not just the dead but the wounded. It is time to do the same with COVID-19. If not, we risk becoming complacent and believing that only the very vulnerable will likely die and if you are young and relatively healthy, COVID-19 will be no worse than a mild cold. We are becoming increasingly aware that that is not the case. Physical and emotional illnesses secondary to Corona are a real outcome. So please — it bears repeating — do not take this lightly -Wear a mask, keep physically distant, and wash your hands.

About the Author
Dr. Michael Salamon ,a fellow of the American Psychological Association, is an APA Presidential Citation Awardee for his 'transformative work in raising awareness of the prevention and treatment of childhood sexual abuse". He is the founder and director of ADC Psychological Services in New York and Netanya, the author of numerous articles, several psychological tests and books including "The Shidduch Crisis: Causes and Cures" (Urim Publications), "Every Pot Has a Cover" (University Press of America) and "Abuse in the Jewish Community: Religious and Communal Factors that Undermine the Apprehension of Offenders and the Treatment of Victims."
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