As if on cue, just when we had started patting ourselves on the back for a marvellous handling of the Corona pandemic in India, it has come back to us with vengeance to celebrate its first anniversary.
The new surge is taking most states by storm.
While reams have been written about Covid 19, not much was known so far about its impact on the changing pattern of other diseases affecting the populace.
Until the lockdown was in place, there was subnormal reporting of the other diseases for obvious reasons of lack of access to the healthcare facilities, including the friendly neighbourhood clinic.
But soon after the lockdown was lifted, we realized that in effect, the incidence of several other non-communicable diseases (NCDs) shot upwards not only because of accumulated unreported cases, but also because it increased in actuality.
For example, the incidence of diabetes, a lifestyle ailment, which affects millions of lives every year, increased because of several reasons including physical inactivity and Covid affecting immunity in general.
Patterns emerging from COVID cases across countries indicate that people with co-morbidities of NCDs have a higher mortality rate than those who do not.
A review of eleven studies from India has revealed that diet, physical activity and sleep patterns etc. have been altered and mental stress levels increased during this pandemic.
Dietary habits changed for the worse, in terms of overeating. Mental stress, particularly high levels of anxiety, fear and depression were found across the cross-section of society.
All these factors, indeed interrelated, led to abnormal weight gain and increased incidence of obesity which further propagated other diseases like high blood pressure, heart disease, increased blood lipids and diabetes itself.
Work from home, even across time zones has forced several lifestyle changes including those in the sleep pattern affecting the four Biological rhythms we have in our body.
These are the natural cycle of change in our body’s functions brought about by various chemicals including certain hormones. Of the four rhythms, circadian rhythms are the 24-hour cycle that includes physiological and behavioral rhythms like sleeping.
Diurnal rhythms are the circadian rhythm which sync with day and night.
The circadian clock plays a role in maintaining physical, mental, and behavioral health and responds to light and dark.
This clock helps regulate among other things, functions like sleep, alertness, reaction times, appetite and other vital parameters like body temperature, blood pressure and hormone levels etc.
It is easy to understand that factors, such as exposure to daylight or lack of it, affect these rhythms, bringing about several undesirable changes in the normal physiological metabolism of the body giving rise to aberrations leading to various diseases.
Common diseases that we come across because of changes in diurnal rhythm are obesity, irritable bowel syndrome, high blood pressure and menstrual irregularities and PCOS (polycystic ovarian syndrome) in women etc. Incidence of all these syndromes has increased appreciably in the Covid year.
Fortunately, these can be set right with relative ease. All that is required, is to have a disciplined lifestyle comprising of regular meals with a predominantly vegetarian diet rich in fibre, regular exercise and most importantly adequate sleep and regular hours. Yogasanas and ‘Yog Nidra’ are strongly advisable.
What has really taken a beating because of this pandemic, is diseases like cancer, Chronic NCDs like diabetes and consequential complications affecting almost all other organ systems causing diseases like Chronic Kidney Disease (CKD), Ischemic Heart Disease etc.
Because of restricted mobility, fear and reduced access to the direly needed treatment facilities, the cold cases of chronic diseases which were pushed aside, advanced to an unsalvageable state.
Despite a fear associated with the surge in the Covid 19 cases, possibly with newer more infectious mutants, it is eminently advisable to all patients suffering from such diseases to have their regular assessment done by their physicians, of course, taking the mandatory precautions and observing Covid Appropriate Behaviour (CAB).
Reproductive health and Mental health have been probably the worst affected in the past one year. Confinement to home and fears of contracting the virus on going to a healthcare facility, appear to have led to several unwanted child births as also reduced access to safe abortion care.
As a result, many women took to a rather unsafe way to abort, by taking oral abortion pill from the chemists in the vicinity without actually knowing when and how to take it. Several of them had severe complications requiring major surgeries, at times resulting in the removal of the uterus jeopardizing their capacity to conceive ever again.
Many others, on the other hand waited without realising the period of gestation and went past the period to carry out safe medical termination of pregnancy.
Anxiety Neurosis, fear psychosis and Depression were probably the most frequently occurring mental health disorders encountered in this year of the pandemic.
In the review cited above, it was found that more than 80% of participants felt the need for counselling. However, only 2.2% took psychiatry help and 2% of those were started on anti-depressant or anti-anxiety drugs.
Such mental health issues can not just be wished away as they tend to become chronic and run a prolonged course.
Telemedicine has been accorded a legal status in India now. Especially for patients grappling with abnormal mental health this may prove to be a boon as in most cases examination of the patient is not required.
In fact, utilizing tele-medicine facilities fully for expanded and faster reach for most other diseases is the need of the hour.
(Dr Ashwini Setya is a Gastroenterologist and Programme Director in Delhi’s Max Super Speciality Hospital. His endeavor is to help people lead a healthy life without medication. He can be reached at ashwini.setya@gmail.com)
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