People still have diabetes, high blood pressure, cholesterol, and other issues as well that they don’t need to neglect
These are the testing times. We doctors, most of us, have not encountered this kind of situation before. The population on the whole is distressed. Even a minor cough or a common cold brings anxiety in us. I never advocate anxiety but being aware and cautious should be the plan. We all have the same concern for our patients; people with underlying conditions are not visiting doctors’ offices as often due to the fear of corona virus. By not going to doctors’ offices, many are ignoring other serious health conditions. People still have diabetes, high blood pressure, cholesterol, and other issues as well that they don’t need to neglect. It is a dreadful trend. Worldwide we have witnessed 30 to 35 percent decrease in the visits of chronic patients in our hospitals. Personally I have seen drastic decrease in the patient ratio vis-a-vis emergency and chronic patients.
Two theories circulate
One, due to COVID-19 fear, many chronic patients are taking extra precautions and having their medications on time, which in itself is a blessing in disguise. Especially during lockdown period we had a very few cases of Road Traffic Accidents.
The second one is worrisome and has a greater impact over the patient inflow than the first one explained above.
It could be best explained by two examples. The fear of contracting corona virus infection even keeps patients who require immediate intervention away from the hospitals and clinics.
The most important rule to remember, other diseases too are as real as the pandemic. If people stay home, which is a necessity, doesn't mean all of them are safe inside.
We have a huge number of chronic cases like hypertension, diabetes, Bronchial asthma, COPD, anxiety and depression, cancer patients who require chemo and radiotherapies, Chronic Kidney disease patients who require dialysis on regular basis, etc. The list goes long, so does the worries.
One of the CKD patients requires three haemodialysis from the Kidney unit. For the last two months he has not been punctual at all, visiting only twice or once a week. He could easily visit us wearing a facemask and taking other precautions. But, the fear factor of COVID19 is the culprit.
Remember, too much fear of anything land us in trouble. That's what leads patient's condition to go from bad to worse. It took doctors a good couple of sessions counseling with a patient and his attendants, hence they finally decided to visit the kidney unit regularly as pre-corona times.
Tuberculosis is another neglected disease. According to the World Health Organization, about 10 million people globally were infected with tuberculosis in 2018 including over one million children. India, China, Indonesia, the Philippines, Pakistan, Nigeria, Bangladesh and South Africa accounted for two thirds of all the cases. The families of these patients, NGOs who are handling them and the hospitals should keep the track of these patients. Let's hope we are not neglecting them while being busy with the pandemic.
In many countries Polio Eradication is at risk. All the hard work could go in vain. Countries like Pakistan and Afghanistan could be the prime sufferers. The rapid emergence of multiple strains of Polio virus in several countries is unprecedented and very concerning, and not yet fully understood.
When we talk of ignoring diseases due to covid-19, we should not forget refugees in Bangladesh. Especially Cholera has been a source of concern in the Rohingya refugee camps in Bangladesh. Previous years the cholera vaccination was on a full swing. Let's hope Covid-19 doesn't affect their already existing health conditions, especially cholera breakouts.
Talking of Kashmir, the problem is no different from the rest of the world. In fact due to other prevailing conditions as well alongside pandemic our chronic patients' sufferings are doubled.
A phone call received a week ago where the Fasting Blood Sugar of the patient, checked on glucometer at home, was around 250 mg/dl. It is alarming. They weren't able to see the doctor because he closed the clinic because of COVID19 and was in touch with the patients on Whats app only. When I asked them to visit any government hospital, they feared the patient might catch the virus.
Two things to be understood here
One, our hospitals and clinics back home should continue operating for these chronic and other emergency patients. These are the life threatening cases and need to be dealt on the emergency and regular basis. Under proper covid-19 guidelines all should follow, staff and patients, the move could be made accordingly.
Second, patients and their caretakers or family members must not delay. A high or a sudden low blood pressure or high blood glucose have the greater chances of a patient ending up on the death bed rather than contracting covid-19.
Do not ignore the symptoms like chest pain, dizziness, severe headaches, shortness of breath, severe vomits, slurred speech, blurred vision, etc. Any symptoms or signs ignored of a heart attack, stroke or acute exacerbations of COPD or Asthma, etc, only because of fear of visiting the hospital is a blunder. Wear the mask and one attendant is enough, follow other guidelines and see a doctor in an Emergency unit. It could save your life.
Even in pandemic, continue with a routine healthcare and don't ignore a medical emergency. Some people living with chronic conditions such as heart failure, lung or Renal disease may be more concerned about contracting COVID-19. This is justified. But it should not be at the cost of your routine care.
The apprehensions are if people delay seeking care for chronic illnesses, we may see an increase in preventable deaths. It's also possible if a large number of people avoid seeking treatment now, hospitals will find themselves overwhelmed when the pandemic is over.
This pandemic might take another year or two to see this world again as a Covid free home. May be like AIDS and other viral diseases it will stay with us forever. Nothing could be predicted. While the global public health messaging urges people to stay home to save lives, it's important to understand one of the key exemptions is medical treatment. And this doesn't apply only to people with COVID-19 symptoms only.
Advice for chronic patients
(1) Your life is precious. Seek medical help.
(2) Stay connected with your doctor.
(3) Eat a healthy diet.
(4) Sleep well.
(5) Wear masks and maintain physical distance.
(6) Wash your hands regularly with soap water.
(7) Do not change the medication or alter the doses without consulting your doctor.
(8) Google is not your doctor.
(9) Don't miss your annual flu vaccine.
(10) Don't ignore a medical emergency.
(11) Don't miss your blood investigations.
(12) For those on dialysis, don't skip the sessions.
(13) Say no to anxiety.
(14) Keep yourself busy with various activities you like.
(15) Keep praying.