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Covid guidelines have also curbed transmission of other viruses: Doctors

25 Aug 2021

  • Reduction noticed in hospital admissions for common respiratory infections
By Ruwan Laknath Jayakody Public health-related measures, such as wearing a face mask and maintaining social distancing practised at the community level with a view to preventing the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the virus that causes Covid-19, can also reduce the community-based transmission of common respiratory virus infections, thus leading to the decrease in the exacerbation of asthma and related hospitalisations as well as the lessening of the resultant financial burden, doctors have noted. This finding was made by R.M.M. Seelarathna and T. Kumanan (attached to the Jaffna Teaching Hospital) and N. Rajeshkannan (attached to Australia’s Civic Park Medical Centre) in an original article titled “Impact of non-Covid-19 respiratory disease-related hospital admissions: A single centre experience”, which was published in the Jaffna Medical Journal’s 33rd Volume’s First Issue on 11 August 2021. With regard to non-Covid-19 respiratory illnesses such as asthma and the exacerbation of chronic obstructive pulmonary disease (a chronic inflammatory lung disease where the airflow from the lungs is obstructed), Seelarathna et al. cited England’s National Health Service in their Monthly Hospital Activity up to early July 2020, the United Kingdom Government’s Emergency Department Weekly Bulletins during 2020, and L.E. Wee, E.P. Conceicao, J.Y. Tan, J.X.Y. Sim, and I. Venkatachalam’s “Reduction in asthma admissions during the Covid-19 pandemic: Consequence of public health measures in Singapore”, which found that there was a reduction in hospital admissions associated with such health conditions since the implementation of the maintenance of social distancing (one to two metres). In Australia, M. Woodley’s “Physical distancing and good hand hygiene: Australian cases drop by more than 99%”, an analysis of the routine surveillance system, had shown a drop in cases of flu by 99%, which was attributed to the maintenance of social distancing and maintaining good hand-related hygiene. Therefore, Seelarathna et al. extracted data from records of the Jaffna Teaching Hospital, which is collected routinely for audit purposes, for the period from March 2019 to September 2019 and for the same duration in the course of 2020, and compared the monthly admissions during the said time frame. When the total number of monthly hospital admissions to its Professorial Medical Unit due to non-Covid-19-related respiratory diseases was compared during the said period for the two years, it was found that the monthly admissions in 2020 was less than during 2019 for the majority of the months during the period, except in August 2020. Figuratively, the total hospital admissions during the study period reduced from 6,180 in 2019 to 4,781 in 2020 – a reduction of 1,399 patients. The median for monthly admissions in 2019 was 898 and 779 for 2020, which was deemed statistically significant. In terms of biological sex, with regard to the total number of hospital admissions, in both years, females marginally constituted the majority (in 2019, there were 3,197 or 51.73% females and in 2020, there were 2,446 or 51.6% females, while in 2019 there were 2,983 or 48.27% males and in 2020, there were 2,335 or 48.83% males). This result was, however, not considered to be statistically significant. Concerning the total number of admissions due to respiratory conditions during the two years, it was found that it reduced from 306 (4.95%) in 2019 to 201 (4.2%) in 2020. The study also did a breakdown of the admissions in terms of the disease – namely, chronic obstructive pulmonary disease (in 2019, 53 or 96.36% males and two or 3.64% females, and in 2020, 40 or 90.9% males and four or 9.1% females), bronchial asthma (a condition which causes the airway path of the lungs to swell and narrow, thus leading to the air path producing excess mucus, in turn making it hard to breathe, and the results being coughing, shortness of breath, and wheezing) (in 2019, 42 or 42% males and 58 or 58% females, and in 2020, 24 or 29.63% males and 57 or 70.37% females), non-specified respiratory tract infections (in 2019, 108 or 83.7% males and 21 or 16.28% females, and in 2020, 34 or 54.84% males and 28 or 45.16% females), and bronchiectasis (a long-term condition where the airways of the lungs become widened, leading to a buildup of excess mucus that can make the lungs vulnerable to infection) (in 2019, 22 or 100% males, and in 2020, 14 or 100% males). In 2019, there were a total of 225 males and 81 females who were admitted with respiratory diseases, while in 2020, there were 112 males and 89 females for the same. It was seen that non-specified respiratory infections reduced from 64.18% in 2019 to 30.84% in 2020. Also, there was a significant reduction noted in terms of the total respiratory diseases-related admissions among males from 2019 to 2020 from 225 to 112, while the same was the case when it came to non-specified respiratory tract infections (48% in 2019 to 30.36% in 2020). Discussing the findings, Seelarathna et al. pointed out that the slight increase in the number of admissions seen during August 2020 corresponds with the date of reopening cities which were under lockdown. However, they cited J.L. Izquierdo, C. Almonacid, Y. Gonzalez, C.D. Rio-Bermudez, J. Ancochea, R. Cardenas, and J.B. Soriano, who found in “The impact of Covid-19 on patients with asthma” that compared to patients with other chronic diseases, that there was a lower percentage of patients with concurrent asthma and Covid-19. Additionally, they noted that the reduction in hospital admissions owing to the exacerbation of bronchial asthma and the exacerbation of chronic obstructive pulmonary disease corresponded with findings made by Wee et al.; D.L. Sykes, S. Faruqi, L. Holdsworth, and M.G. Crooks in “Impact of Covid-19 on chronic obstructive pulmonary disease and asthma admissions and the pandemic from a patient’s perspective”; K.P.F. Chan, T.F. Ma, W.C. Kwok, J.K.C. Leung, K.Y. Chiang, J.C.M. Ho, D.C.L. Lam, T.C.C. Tam, M.S.M. Ip, and P.L. Ho’s “Significant reduction in hospital admissions for acute exacerbation of chronic obstructive pulmonary disease in Hong Kong during the Covid-19 pandemic”; J.Y. Tan, E.P. Conceicao, L.E. Wee, X.Y.J. Sim, and I. Venkatachalam’s “Covid-19 public health measures: A reduction in hospital admissions for chronic obstructive pulmonary disease exacerbations”; and L.D. Nolen, S. Seeman, D. Bruden, J. Klejka, C. Desnoyers, J. Tiesinga, and R. Singleton’s “Impact of social distancing and travel restrictions on non-Covid-19 respiratory hospital admissions in young children in rural Alaska”. However, Seelarathna et al. found no statistical significance. Moreover, Seelarathna et al. ventured an explanation for the reductions in admissions to the effect that patients had altered their health-related behaviour due to the Covid-19 pandemic, thus making them less likely to seek treatment. According to Seelarathna et al., another perhaps alternative explanation concerning the reduction in the rates of commonly circulating respiratory viral infections is most likely due to a significant reduction in non-specified respiratory infections, a phenomenon that has also been recorded in J.Y. Tan, E.P. Conceicao, X.Y.J. Sim, L.E.I. Wee, M.K. Aung, and I. Venkatachalam’s “Public health measures during the Covid-19 pandemic reduced hospital admissions for community respiratory viral infections”.


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