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Long walk to recovery for virus coma patients in Belgium

Patients coming out of comas need help relearning the basics like walking, reading and writing
Patients coming out of comas need help relearning the basics like walking, reading and writing Kenzo TRIBOUILLARD AFP
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Brussels (AFP)

Some of them have been in a coma for days. Some are too weak to call for help. All need support even after they have been released from intensive care.

The global coronavirus epidemic had threatened to overwhelm critical care facilities in Europe's hospitals.

That risk is receding but, just as societies and economies will take time to heal, COVID-19's shattered survivors will carry the burden of the disease.

"These are patients who have been in a coma for a long time, so they need to express their fears, their worries, their emotions, and we need to be there for them," nurse Agnes Lambert said.

Lambert works in the post-intensive care recovery unit in Brussels' Erasmus Hospital in Belgium, one of the countries with the highest per capita rate of COVID-19 infection.

Belgium massively stepped up its specialist ICU treatment to cope with the outbreak, and is tentatively preparing to begin exiting social and economic lockdown next week.

But, while new case numbers are falling, those who have been treated and cured still need care, especially those who wake up scared and scarred.

"For people in my state, and so for me too, what is painful is to have to recover reflexes and actions that are completely natural," says 74-year-old Pierre Fonteyne.

"Walking, basically, walking, reading, writing,"

Two health workers in full face plastic visors help him sit up painfully, a third gives him an anti-inflammatory painkiller which he sips gingerly. Then he stands for a brief assisted walk and some knee flexes.

"After a month, the pathogen has healed, but not the rest," he tells AFP, explaining how he had come in to the hospital for another condition, only to be diagnosed with novel coronavirus.

"That is what saved my life and that of my wife. Because I didn't know I had the coronavirus. But I had it, very strongly," he said, explaining how the couple came to be admitted.

"Having remained motionless for a month, everything has to be re-educated, of course. And my wife too, even if it's a little less strong. And that's where I am now."

- 'Escaped death' -

Fonteyne may be well into retirement, but for the doctors in Erasmus he is one of a younger generation of patients after a first wave of the very elderly -- not all of whom pulled through.

"Here in Belgium, the first cases appeared at the end of February, or early February if I remember correctly, and the first severe cases followed in early March," said respiratory specialist Olivier Taton.

"So the first severe cases are now in the process of healing and, at the Belgian level at least, we haven't yet had the experience of patients who have completely recovered.

"And, as I say, if they recover completely, it will only be in several months."

There are ten beds in the recovery unit, allowing the hospital to move patients on from the under-pressure ICU, even when they still need much care and attention.

There are monitors to record heart rate, oxygen levels and blood pressure constantly.

"There are also cameras in each room to see if patients have a problem," Taton said.

"If, for example, some patients have lost so much muscle that they can't call for help, then you can see it directly on the screens and come and help them."

But the patients do not just have to lie there and wait for help. There is some work to do to begin the recovery process after the bruising process of assisted breathing.

"These are patients who have, for most of them, been intubated for a really long time, several weeks," explained physiotherapist Julien Dutrieux.

"You need to walk, you need to move, you need to stimulate the patient, who must get back the muscular strength, the lung volume that they had before, so that they get better."

For nurse Lambert, working in a unit where the patients have a forward trajectory after such an ordeal is rewarding. "Day by day these patients are getting better," she said.

Fonteyne is grateful, but philosophical: "I'm not a serious case. I just escaped death."

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