Dr Sudhir Kumar MD DM

Apollo Hospitals, Hyderabad

25th May 2020

COVID-19 caused by SARS CoV2 virus is a pandemic that started from China and rapidly spread to about 200 countries worldwide. In the absence of a vaccine, strict lockdown was imposed in March 2020 to prevent a sudden surge in COVID-19 cases. In India, lockdown has been in force for more than two months, though, a number of relaxations have been given in the past couple of weeks. Lockdown has served its primary purpose of preventing an exponential growth in the number of people with COVID-19 infections. However, lockdown has brought with it, a number of hardships and miseries too. Some of these include- migrant labour crisis, loss of jobs and incomes for a large number of people, a number of people getting stranded away from their homes and families, difficulty in getting access to items of daily needs, and so on. You are well aware of these through media reports. However, the current article’s aim is to highlight the “unexpected benefits” of lockdown.

  1. Reduction in the number of road traffic accidents (RTA) and deaths– Lockdown has resulted in significantly reduced traffic movements on roads. So, a reduction in RTA and accident-related deaths was expected. The reduction in fatalities due to road accidents has been in the range of 30-50% (as compared to the same period last year).
  2. Cleaner and healthier air: Reduction in vehicular traffic and closure of industrial establishments during lockdown has resulted in cleaner air. Reduction in air pollution over the past month has resulted in 11,000 fewer deaths from pollution in UK and Europe. Reduction in death was due to lower incidence of heart failure, chronic obstructive lung diseases, strokes, cancer, infections and diabetes. In the same period, 6000 fewer children developed asthma. Levels of nitrogen dioxide have fallen by 40% and tiny particulate matter (PM2.5) is down by 10% (as compared to same period last year). These two forms of air pollution weaken heart and respiratory system, and are responsible for 4,70,000 deaths in Europe per year.
  3. Reduction in crime rates: Lockdown has had another unintended gain- drastic fall in the crime rates. As per a top police officer in Kerala, there has been a 70% fall in rape cases and 40% fall in cases of murder during lockdown. There has been 100% fall in cases of violence against women and children. Suicides have dropped by 60% and unnatural deaths by 40%. As per Mumbai police, there has been not a single case of chain snatching or dacoity during entire month of April. Cases of thefts and robberies too have significantly declined.
  4. Reduction in hospitalizations due to heart attacks and strokes: Significantly lesser number of hospitalizations from acute myocardial infarction (heart attacks) has been reported during lockdown from many countries. In a recent study from California, admissions due to heart attacks reduced by 48% during COVID-19 period (March-April 2020). In an earlier study from Italy, similar reduction was noted. The daily admission rates of heart attacks reduced from 19 per day (in Feb-Mar 2019) to 13 per day (in Feb-Mar 2020). The admissions due to stroke have also come down by about 50% during the Covid-19 period. Rates of thrombolysis and mechanical thrombectomy (treatments that significantly reduce stroke-related disability) have also halved during the Covid-19 period.

It is possible that the reduction may not be real and just that patients are not reaching hospital- a) Difficulty in transportation facilities, b) Patients may be fearful of contracting Covid-19 and avoiding hospitals, c) Patients may be trying home remedies or self-medication for minor symptoms, d) Patients may be consulting general or family physicians, or taking remote advice via tele-medicine. However, the reduction could be real too on account of following factors- a) Lesser work and travel-related stress, b) Improved sleep quality and duration, c) Regular exercises, d) Better compliance with medicines for diabetes and hypertension, e) Reduction in “eating out” in restaurants, which are often rich in oil and salt. A proper study is needed to confirm these hypotheses.

Lessons learnt from lockdown

More than 2-month lockdown was tough on a majority of Indians leading to unprecedented hardships for them. It would be a great dis-service if we do not gather a few useful insights from it.

  1. Reducing fossil fuel use and stricter pollution control for industries can significantly reduce air pollution, leading to better health and lesser deaths.
  2. Road traffic accidents and crimes can be reduced too.
  3. Reduction in stress, good quality sleep, avoiding outside food and regular exercise can lead to reduction in heart attacks and strokes.
  4. The biggest lesson off course is that a lot still needs to be done for the poor including migrant workers so that our country- India as well as Bharat- can have a bright future.

Published by Dr Sudhir Kumar MD (Medicine) DM (Neurology)

I am a doctor with 25 years experience. I have worked as a neurologist for about 20 years. Educating public and healthcare professionals is very dear to me. This is possible due to my interactions with thousands of patients and their caregivers. I salute the patients who suffer and it is our duty to minimise suffering by preventing diseases and ensuring prompt diagnosis and treatment of those already affected.

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