Extract from ABC News
During the depths of his months-long fight to survive COVID-19, Sergio Fredes had little idea his body had been ravaged by the virus.
Instead, the 59-year-old Melbourne man spent the months in intensive care mentally transported back to the military dictatorship of his childhood in Chile.
His lungs had failed, and as a machine pumped his blood out, oxygenated it, and then funnelled it back into his body to keep him alive, Sergio says he had vivid nightmares he had been kidnapped.
He dreamed of his father, who was jailed as a political prisoner decades ago.
When Sergio eventually regained consciousness as he recovered, he realised that instead of the horror in his mind, he had been kept alive and cared for by medical staff at Melbourne's Alfred Hospital.
"[They are] a truly amazing bunch of people, some of them just incredible, who helped me so much in my recovery," Sergio said.
"I am so grateful."
Sergio's brothers came to visit him, nurses took him into the hospital courtyard in his bed for some sunshine and when he was well enough to be discharged from the ICU, he was cheered on by the medical staff.
Throughout the COVID pandemic, the use of ventilators for the most seriously ill patients has been prominent, but the machine that Sergio was hooked up to for more than 100 days — called ECMO — hasn't garnered as much attention.
'Last-ditch' treatment buys time for the gravely ill
Alfred Hospital intensive care specialist David Pilcher said the treatment known as ECMO, which stands for extracorporeal membrane oxygenation, was generally only used if a ventilator had failed to provide a patient with enough oxygen.
He said the treatment was a "last-ditch" option for treating COVID patients who were very seriously ill.
"It can be used for patients whose lungs are very damaged, but it can also be used to support people whose heart isn't working properly," Dr Pilcher said.
ECMO is already used to treat patients whose lungs have been severely damaged by other conditions such as pneumonia, and it was refined for such use after the swine flu pandemic in 2009.
In Victoria in 2020, 10 people with COVID-19 were treated at the Alfred using ECMO. Less than half of those people, including Sergio, survived.
The treatment itself is high-risk, because patients who are treated using ECMO usually need to spend a month or more on it, which can lead to other conditions like blood clots and infection setting in.
Dr Pilcher said essentially the treatment was "buying time" and it was more likely to be used on a younger patient whose body had a better chance of making a recovery.
"What you're trying to do is get them to the point where the lungs can recover before some kind of complication kicks in," he said.
"We've had patients who have spent months on ECMO who have made a pretty good recovery who come back to having almost normal lungs, even when they've been really, really damaged."
Given the starkly younger age profile of this year's major outbreak in Victoria, compared with 2020, Dr Pilcher said ECMO machines were more likely to be used.
At the moment, there are nine people with COVID-19 in Victoria on ECMO machines, and they range in age from their 60s down to their 20s.
Despite the number of active COVID-19 cases in Victoria passing 8,500 and dozens of those people in hospital requiring intensive care, Dr Pilcher said there were enough ECMO machines to cater to COVID-19 patients.
He said if the worst-case scenarios that had been modelled played out, running short of staff to monitor the machines was more likely to become a problem than running out of machines.
"People like the disaster stories, but I actually think it's realistic to think that the people that will need it and can benefit from it will be able to get ECMO, because people will pull out all the stops to make it happen," Dr Pilcher said.
From a tingling throat to seven months in hospital
Sergio still isn't sure how he and his mother, who's in her 90s, caught COVID-19 in June last year, but he believes they may have picked it up going to a medical appointment at a hospital.
His life-threatening ordeal started with a tingling in his throat. He did the right thing and got tested, received his positive result and a few days later ended up in hospital.
"I was concerned, but I thought I'd got through the worst of it," he said.
Despite also needing to be hospitalised with COVID-19, Sergio's elderly mother was not as sick as he was and did not require intensive care.
One of the last things he remembers before ending up in ICU was getting dizzy while showering at the hospital and calling for help.
He does not remember much of his experience in ICU, but said he felt as if he had "lived another life".
"It was absolutely horrible, it went on forever," he said.
Sergio came to Australia from Chile with his family in the 1975 when he was 13, and while he was ill with COVID-19, he was gripped by some traumatic memories from that time.
Nine months after being discharged from hospital, he is able to walk around unaided, but he experiences ongoing effects of his illness including a chronic cough and nerve damage causing constant pain in his right foot.
Sergio has been fully vaccinated, but he is still fearful about the prospect of becoming ill again with the Delta strain.
"I've been sort of trapped in my house because I don't think I'll survive this again," he said.
"I've been very, very paranoid, especially when I see the people who don't believe that it's true, like the anti-vaxxers."
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