Dear Doctor/ Dr Vivek Nangia, interventional pulmonologist, principal director and head, Max Super Speciality hospital, Saket
It seems that some of the gains of the lockdown may have been reversed in Delhi-NCR, thanks to the rising air pollution. There is a sudden spurt in cases of allergy, cough, cold, breathlessness, asthma and chronic obstructive pulmonary disease (COPD).
The other chunk of patients these days is those suffering from post-Covid-19 syndrome. The most common after-effect of Covid-19 is fatigue, which afflicts about 20 to 30 per cent of those who have recovered from moderate to severe Covid-19. Intermittent fever is also one of the complaints. Some patients (10 to 15 per cent) also have breathlessness due to lung fibrosis. As the lung tissue is damaged and scarred, the thickened, stiff tissue makes it difficult for the lungs to work, causing breathlessness. In one or two (of about 300 patients) we have also noticed pulmonary embolism, caused by a blocked artery in the lungs. This can lead to low blood pressure, respiratory distress, pain in the limbs and weakness, and can be life-threatening. Such patients require oxygen therapy.
Use N-95, not cloth masks
With festivals and the wedding season in the offing, there are concerns of a spike in respiratory diseases. People are moving out and a certain fatigue has set in. It is important for people to understand that cloth/fabric masks are not enough anymore. There was a time when N-95 masks were not being recommended because of cost and availability issues, but those issues are past us. Regardless of whether one is in a low or high incidence area for Covid-19, the N-95 mask is a must. Masks have to be worn and physical distancing has to be observed in indoor settings, too.
Do not miss the flu shot
Both seasonal influenza and Covid-19 may present with similar symptoms—breathlessness, cough and cold—making it tricky for doctors to handle them. Which is why we are recommending the flu vaccine. Even though the protection offered is less (about 65 per cent), for those in the high-risk group (elderly, those with co-morbidities), it is a must. Affordability might be an issue with the vaccine, and so the government should subsidise the vaccine at least this year, in the same way that it subsidises vaccines for children.
Do not burn incense
My advice to people for the next couple of months is to stay indoors, keep your hands clean, avoid smoking and preferably be in an area with plants. Avoid exposure to household fumes, including agarbattis (incense sticks). The smoke from incense sticks has been documented to cause COPD.
People ought to have a healthy diet high in antioxidants, and a lot of fresh fruits and vegetables. Keeping yourself hydrated is a must.
—As told to Namita Kohli