Ten months after the epidemic in the United States, the death rate – the number of people who died from COVID-19 divided by the total number of cases identified – is 1.8%. Fortunately, this is a decrease from the 3.5% in the first few days when unprepared hospitals in the northeast were overwhelmed by a sudden wave of unexpected cases. However, that's more than a dozen times higher than the worst flu in decades, and the fast-filling hospitals mean it's not getting better anytime soon.
The death rate among patients ending up in the intensive care unit has not changed much since the beginning of the pandemic. About 1 in 20 people who go to intensive care with COVID-19 will die. For those who survive, some degree of heart damage is virtually guaranteed. About half of these patients will also have long-term lung damage. These are issues that will affect people throughout their lives. The time to recover from COVID-19 is not measured in months. It will take generations.
It has been clear since August that COVID-19 also leaves lasting neurological damage. This includes possible psychological changes in up to a third of all patients with the disease – even in those with mild or asymptomatic cases. Early analysis from China revealed widespread reports of depression and anxiety that will not go away with the virus. These and other symptoms can last a lifetime.
But, as the New York Times reports, even this long list of misery can be the least thing COVID-19 can do. Because smaller numbers of COVID-19 survivors are going insane with the disease. Patients who have never had psychological problems develop "severe psychotic symptoms" weeks after being infected with the coronavirus.
The damage leads not only to paranoid delusions, but also to actual violence. For example, a 30-year-old construction worker was so convinced his cousin wanted to murder him that he tried to strangle that cousin in his sleep. A 34-year-old woman began loading hand sanitizer onto her food and undressing in front of strangers. A 36-year-old woman was so convinced that someone tried to kidnap her three children that she tried to get them to "safety" by pushing them through the drive-through window of a fast food restaurant.
The exact cause of these problems is not clear as the coronavirus can cause damage in a number of ways. For example, heart damage can be caused by the way the virus causes tiny blood clots to develop. By the way, the virus can put the body into an overactive immune response. Or by the virus itself, which replicates in the heart tissue and damages it. Researchers believe it could be the immune response that triggers persistent psychosis in COVID-19 victims. But they are not sure.
These cases of severe psychosis seem relatively rare, but the fact that they can occur weeks after COVID-19 in people who otherwise appeared to have gone through the disease without harm is terrifying. These people may not have died from the disease, but they have lost an important part of their lives. And with so many people affected by COVID-19, it may be impossible to determine how much the disease will affect the nation in the future, or how it will affect people's actions today.
When people talk about it that only affects a "small percentage" of patients, it may not seem as effective. However, this makes the same mistake as the people who speak of "only 1%" when discussing COVID-19 deaths. COVID-19 has now infected at least 19 million Americans. A small percentage of that number could still lead to a devastating increase in severe mental illness – and a much greater need for mental health improvement.