For many people, surviving a life-threatening event may lead not only to long-term physical consequences, but significant psychological difficulties as well. Past research has found that among survivors of medical conditions including stroke and heart attacks, posttraumatic stress disorder (PTSD) symptoms were seen in almost one out of eight survivors of heart attacks and nearly one in four survivors of stroke. Now we have emerging data for people who have survived covid-19.

Outlined in a new research letter in JAMA Psychiatry, researchers followed a group of 381 patients who were diagnosed with covid-19 between April and October 2020 at a hospital in Italy. The researchers found that over 30 percent of the participants met criteria for PTSD, and approximately another 17 percent were noted to have developed other mental health conditions including depression. 

While this finding is certainly concerning for clinicians and patients alike, the authors' conclusions are tempered by several methodological issues. First, this was a study conducted at a single site, as opposed to multiple hospitals. In addition, the researchers used a cross sectional design, meaning that the post-covid-19 patients were not compared to a non-covid-19 control group and that the data captured a single snapshot of the patients, but not over time. Based on knowledge from past pandemics, it's likely that many recovered individuals would be expected to exhibit psychological symptoms in the wake of an acute event, but that a significant number will recover or have only minimal long-term effects. Furthermore, the participants in this study had a number of pre-existing individual factors such as a past history of mental health conditions that could also significantly influence the odds that PTSD would develop after infection. 

Nevertheless, this study contributes to our understanding of the short and long-term mental health effects of the pandemic, and adds to information from other studies on the "long haul" effects. Future work looking at the longitudinal mental health of recovered patients may help us identify at-risk persons and develop targeted interventions that support patients in their psychological recovery.

In the wake of the winter storm that plowed through Texas, power outages have plagued the state. An unexpected consequence is that Texas could now be facing another covid-19 spike. With hundreds of thousands losing heat and electricity, many Texans have flocked to crowded hotels and shelters, or have been forced to seek heat and shelter in the homes of friends and relatives that still have power. 

Conditions favoring spread of SARS-CoV-2 are only worsening. Grocery store lines are longer than ever. Many hotels are full—with reported instances of price gouging given the growing demand, driving people into increasingly crowded conditions. It is unlikely that physical distancing can be reasonably maintained amid these crowded conditions, making it a matter of time before the risk of viral transmission rises to dangerous levels. Moreover, Texas has pushed back against mask mandates and physical distancing measures despite the gravity of the covid-19 pandemic, which means a surge now stands to be all that much worse.

This deteriorating situation clearly has far reaching implications, and Texas' leaders have not taken effective action—more inclined to blame the situation on the Green New Deal (which has yet to be implemented) than enacting policies that could actually help the immediate situation. To make matters worse, the delivery of hundreds of thousands of vaccines will be delayed by the storm. 

The Texas crisis is just the latest example of our country's need to invest in infrastructure, disaster preparedness, and to take climate change seriously. Preventing emergencies like this takes foresight, time, and effort. But once they've occurred, gaining immediate control of the consequences becomes impossible.