Why do we need to continue masking, physical distance and hand washing in the post-Covid world?

These effects are valuable research findings from the pandemic. This suggests that the selective and non-mandatory use of public health measures such as masking, physical distance, and hand washing may play an ongoing role as the COVID-19 epidemic begins. am. Collectively, these measures are known as non-pharmacological public health interventions (NPIs).

After the March 2020 pandemic, demand for acute care services, such as emergency medical visits to emergency departments and hospitalization of inpatients, has been reported to have dramatically declined in many parts of the world. Early on, this was caused by strict blockades, fear of being infected with COVID-19, or the patient’s avoidance of the medical environment due to the perception that the hospital was overwhelmed and unable to handle non-urgent cases. It may have been.

However, in the months that followed, public health measures were eased, and medical services for conditions such as heart disease and appendicitis recovered rapidly. On the other hand, respiratory illnesses caused by the non-COVID-19 virus continued to decline.

In Canada, the usual annual surge in influenza infection has not occurred during the two winters since the outbreak of the pandemic.

Our research group (all frontline healthcare professionals) analyzed hospitalization data across the country. According to our analysis, hospitalizations for major respiratory illnesses declined sharply the year after the initial blockade began.

Specifically, chronic obstructive pulmonary disease (COPD), severe lung disease associated with long-term smoking, and relapse of community-acquired non-COVID-19 pneumonia have been reported throughout Canada after NPI implementation such as masking. It decreased by nearly%. And physical distance.

These findings were supported by another study of 15,677 patients from nine countries. The study reported a 50% reduction in COPD hospitalization after the onset of a pandemic.

This is not entirely surprising, as both COPD and non-COVID-19 pneumonia are often caused by the common cold virus. If you’re like most Canadians, you haven’t had a cold for almost two years.

So what’s the big fuss about some runny nose and colds? Viral infections such as colds and flu are unlikely to cause serious harm to healthy people, but can be debilitating and sometimes fatal to the elderly, immunocompromised, or those suffering from lung disease. There is a sex. As a result, hospital acute care may be required, and in severe cases even the ICU may be required, and some patients will not survive.

In Canada, acute and chronic respiratory illness is the third leading cause of death, second only to cancer and heart disease. This also means that virus-related respiratory illnesses place a heavy burden on limited medical resources.

During the pandemic, there are times when our healthcare system has exceeded capacity, and there are concerns that hospitals may need to triage resources and refuse ICU care for some critically ill patients. did.

Thankfully, this didn’t happen. The possible reason seems to have been the significant additional volume available for hospitalizations avoided due to respiratory illnesses associated with other viruses.

As the pandemic prolongs, people are tired of ongoing public health restrictions. Canada’s vaccination rates are among the highest in the world and are expected to be even higher with approval of vaccinations for pediatric populations, and many are looking forward to a time when NPI is no longer needed.

However, it is important to consider whether those proven benefits justify continued use before the measures are completely abolished. The fact that hospitalization for non-COVID-19 respiratory illness remains low despite the relaxation of strict blockade measures may maintain these benefits through practices such as the use of masking and frequent hand washing. It suggests that there is.

Public masking was common in many Asian countries, even before the pandemic. As this is now standard in Canada, continuing these practices has significant benefits and protects the most vulnerable demographics of society.

This is certainly challenging given the opposition from the voice minority and the lack of public awareness of the benefits of continued use of NPI. Most of the available evidence is currently predominantly observational, as there are no randomized trials yet to evaluate the efficacy of NPI to alleviate non-COVID-19 viral respiratory disease at the population level.

Moreover, there is no consensus as to which particular NPI is most effective in preventing the spread of the disease. It is also unclear whether the reduced use of acute care has led to a reduction in mortality in certain conditions.

These limits are currently being addressed in a large Alberta study of more than 500,000 patients. Preliminary results presented in the minutes of the 2022 American Thoracic Society International Conference show that NPI is an effective strategy to prevent both acute visits and respiratory disease-related deaths. I am.

However, tentatively, public policy makers will review this compelling evidence, especially for individuals and them at high risk of serious illness due to viral respiratory infections.

Recommendations, policies, or mandates as needed may be amended in the future as new evidence emerges. In the meantime, provisional use of NPI can reduce the burden on the healthcare system and protect the most vulnerable members of society.

Rutvij A. Khanolkar University of Calgary Medical Student, Professor Eddy S. Lang, University of Calgary Cumming Medicine

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