The first thing Simon Farrell can remember, after being woken from a medically induced coma, is trying to tear off his oxygen mask.
He had been in intensive care for 10 days, reliant on a ventilator just to breathe.
“I was trying to pull the mask off my face, and the nurse kept putting it back on,” he recalls.
When doctors woke him up, his body had fought off the worst of Covid-19 but he still needed oxygen to support his damaged lungs. And the 46-year-old father-of-two was suffering from such severe delirium he was trying to deny himself the oxygen he required.
“Try to stop me,” he remembers saying, when nurses at Birmingham’s Queen Elizabeth Hospital said they would have to put his hands in boxing glove-sized medical mittens unless he relaxed.
“In the end they had to tape my hands up. I was trying to tear the mittens off, I managed to bite through them, and they had to put new mittens on.”
It is not an unfamiliar story for anyone working in intensive care. The assault Covid-19 mounts on the most severely ill means patients are ventilated for longer, and require a deeper level of sedation, than the typical ICU patient.
That has produced “a lot of delirium, confusion and agitation”, explains Dr Kulwant Dhadwal, a consultant who runs the intensive care unit at London’s Royal Free Hospital.
“Usually if you have a surgical procedure, or normal pneumonia patients come to ICU, you wake them up and they’re less confused and less disoriented than this.”