Why should masking, physical distancing, hand washing continue in the post-Covid world?

These effects are a valuable research finding of the pandemic. It’s a finding that suggests the selective, non-compulsory use of public health measures such as masking, physical distancing and hand washing could play an ongoing role as we enter the endemic phase of COVID-19. . Collectively, these measures are known as non-pharmacological public health interventions (NPIs).

After the onset of the pandemic in March 2020, many parts of the world reported a dramatic decrease in demand for acute healthcare services, including urgent care visits to emergency departments and hospital stays. At first, this was likely due to strict lockdown measures, patients avoiding healthcare facilities for fear of contracting COVID-19, or the perception that hospitals were overwhelmed and unable to accommodate non-emergency cases.

However, as public health measures were eased in the following months, there was a rapid rebound in health care services for conditions such as heart disease and appendicitis. Meanwhile, the decline persists for respiratory illnesses attributed to non-COVID-19 viruses.

In Canada, the usual annual surge of influenza infections has not occurred in the two winters since the start of the pandemic.

Our research group – all front-line healthcare workers – analyzed admission data nationwide. Our analysis revealed that hospital admissions for major respiratory illnesses fell sharply in the year after the first lockdown began.

Specifically, flare-ups of chronic obstructive pulmonary disease (COPD), a serious lung disease linked to long-term smoking, and non-COVID-19 community-acquired pneumonia have decreased by nearly 40% in Canada following implementation. of INM such as masking. and physical distancing.

These findings were backed up by another study involving 15,677 patients from nine countries. This study reported a 50% reduction in hospital admissions for COPD after the onset of the pandemic.

This is not entirely surprising as COPD and non-COVID-19 pneumonia are often triggered by cold viruses. If you’re like most Canadians, you haven’t caught a cold in almost two years.

So what’s the deal with a few runny noses and a few colds? Although a viral infection such as a cold or the flu is not likely to significantly harm a healthy person, it can be debilitating and sometimes fatal for someone who is elderly, immunocompromised, or has lung disease. This may require acute care in hospital, or even intensive care in severe cases, and some patients do not survive.

In Canada, acute and chronic respiratory diseases are the third leading cause of death, just behind cancer and heart disease. It also means that virus-related respiratory illnesses place a huge burden on limited healthcare resources.

There have been several periods during the pandemic when our healthcare systems were over capacity, and there were fears that hospitals would need to triage resources and deny intensive care to some critically ill patients.

Fortunately, that did not happen, and it appears the likely reason for this is the significant extra capacity that has become available due to avoided hospitalizations for other respiratory illnesses linked to the virus.

As the pandemic drags on, people are tired of ongoing public health restrictions. With vaccination rates in Canada among the highest in the world and set to increase further with the approval of vaccines for pediatric populations, many are looking forward to the time when NPIs may no longer be needed.

However, before renouncing the measures altogether, it is important to consider whether their demonstrated benefits warrant continued use. The fact that hospitalizations for respiratory illnesses other than COVID-19 have remained low, despite the easing of strict containment measures, suggests that these benefits can be maintained with mask use and practices such as frequent washing. hands.

Even before the pandemic, public masking was common practice in many Asian countries. As is now the norm in Canada as well, the continuation of these practices can have significant merit and offer protection to the most vulnerable demographic groups in our society.

This will certainly be difficult given the opposition of a vocal minority and the lack of awareness among the general public of the benefits of the continued use of NPIs. Currently, most of the available evidence is largely observational, as no randomized trials have yet assessed the effectiveness of NPIs in reducing non-COVID-19 viral respiratory disease at the population level.

Additionally, there is no consensus on which specific NPIs might be most effective in preventing the spread of disease. It is also unclear whether reductions in acute care use have translated into reduced death rates for specific conditions.

These limitations are currently being addressed in a large Alberta study involving more than 500,000 patients. Preliminary results – to be published in the Proceedings of the American Thoracic Society International Conference 2022 – show that NPIs are an effective strategy for preventing both acute care visits and respiratory disease-related mortality.

However, in the meantime, policy makers should consider this compelling evidence and consider whether the continued use of masking and other NPI measures is warranted, particularly for people at high risk of severe disease from viral respiratory infections and those close to them.

Recommendations, policies or, if deemed necessary, terms of reference may be changed in the future as new evidence emerges. Until then, the use of NPIs, even on an interim basis, can reduce the strain on our healthcare system and help protect the most vulnerable members of our society.

By Rutvij A. KhanolkarMedical student, University of Calgary and Eddy S. LangProfessor, Cumming School of Medicine, University of Calgary

This story was published from a news feed with no text edits. Only the title has been changed.

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