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

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

Following the start of the pandemic in March 2020, many regions around the world reported a dramatic reduction in demand for acute health services, including urgent care visits and hospitalizations in emergency departments. Initially, this was probably driven by stringent lockdown measures, patients escaping health care settings due to fears 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 subsequent months, there was a rapid return to health care services for conditions such as heart disease and appendicitis. Meanwhile, shortages persisted for respiratory diseases attributed to non-COVID-19 viruses.

In Canada, there has not been a normal annual increase in influenza infections during the two winters since the start of the pandemic.

Our research group – all front-line health care workers – analyzed admissions data nationwide. Our analysis showed that hospitalizations for major respiratory illnesses declined sharply in the year following the start of the first lockdown.

In particular, following the implementation of NPIs such as masking in outbreaks of chronic obstructive pulmonary disease (COPD), a chronic lung disease related to long-term smoking, and community-acquired non-COVID-19 pneumonia, across Canada has decreased by about 40 percent. and physical distance.

These findings were supported by another study of 15,677 patients from nine countries. That study reported a 50 percent reduction in hospital admissions for COPD after the start of the epidemic.

This isn’t entirely surprising because both COPD and non-COVID-19 pneumonia are often triggered by the common cold virus. If you’re like most Canadians, you haven’t caught a cold in almost two years.

So, what’s the big fuss about some runny noses and colds? While a viral infection such as the common cold or influenza is unlikely to cause significant harm to a healthy person, it can be debilitating and sometimes fatal for someone who is elderly, immunocompromised or has lung disease. . This can result in the need for acute care in hospital, or even in the ICU in severe cases, and some patients may not survive.

In Canada, acute and chronic respiratory disease is the third leading cause of death, behind only cancer and heart disease. It also means that viral-associated respiratory diseases place a considerable burden on limited health care resources.

There were times during the pandemic when our health care system was exceeding capacity, and there was a fear that hospitals would need to reduce resources and deny ICU care to some critically ill patients.

Thankfully, this did not pass, and it seems likely that the cause was the significant excess capacity that became available due to hospitalization, which was avoided by other virally associated respiratory diseases.

As the pandemic continues to grow, people are getting tired of the ongoing public health restrictions. The vaccination rate in Canada is among the highest in the world and is expected to reach even higher with vaccination approval for the pediatric population, many looking forward to a time when the NPI may no longer be needed.

However, before eliminating measures entirely, it is important to consider whether their demonstrated benefits warrant continued use. The fact that hospitalizations for non-COVID-19 respiratory illnesses have remained low, despite the easing of stringent lockdown measures, suggests that these benefits can be reaped through practices such as masking and frequent hand-washing. can be maintained with the use of

Even before the pandemic, wearing a mask in public was a common practice in many Asian countries. This is now the norm in Canada as well, there may be significant merit in continuing these practices and providing protection to the most vulnerable demographics of our society.

This will certainly be challenging given the opposition from vocal minorities and the lack of awareness among the general public about the benefits of continued use of NPI. Currently, most of the available evidence is largely observational, as no randomized trial has yet evaluated the efficacy of NPIs for reducing non-COVID-19 viral respiratory diseases at the population level. .

Additionally, there is no consensus on which specific NPIs may be most effective in preventing disease spread. It is also unknown whether the reduction in access to acute care has translated into a reduction in mortality for specific conditions.

These limitations are currently being addressed in a large-scale Albertan study of over 500,000 patients. Preliminary results – which will be published in the Proceedings of the 2022 American Thoracic Society International Conference – suggest that NPIs are an effective strategy for preventing both acute care visits and mortality related to respiratory illnesses.

However, in the interim, public policy-makers should consider this compelling evidence and consider whether there is a need for continued use of masking and other NPI measures, particularly in the high risk of severe illness from viral respiratory infections. For persons at risk and those close to them. them.

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

by Rutwij A. Khanolkar Medical Student, University of Calgary and Eddie S. Lang Professor, Cumming School of Medicine, University of Calgary

This story has been published without modification in text from a wire agency feed. Only the title has been changed.