In the second week of February, I returned from a golden alumni meet in Kerala attended by classmates from all corners of the world. Murmurs about a virus infection in distant China did not worry us then. In the next few days, three medical students arrived from Wuhan and tested positive for the novel coronavirus. Travel was restricted, and those of us from outside Kerala were relieved to have reached home before the virus made its presence felt.
As the infection appeared in other States and in many countries, hospitals geared up to deal with COVID-19 patients. Elective surgeries were cancelled and routine OPDs were scaled down. We the alumni in the vulnerable age of 67-plus stopped our medical practice. Young doctors in hospital emergency rooms were trained to focus on COVID. Fortunately, the usual rush of traffic accidents had come down to a trickle. Strangely, hospitals everywhere noted a marked reduction in the number of heart attack patients. Whether heart attacks became less prevalent because of the lockdown or heart attack patients were suffering at home is a puzzle.
Heart attacks are often triggered by physical and mental strain in patients with diabetes, hypertension or tobacco habits. One out of five Indian adults has diabetes, hypertension or both and many are not aware of these silent risk factors in them. If heart attacks had truly become less during lockdown, the benefit must have accrued from: staying at home, eating home-cooked food, spending more time with family members, playing with children, resuming hobbies, working from home, less stress from job pressure and deadlines and breathing cleaner air.
The stresses caused by the pandemic affected everyone and probably no one felt like a lone victim of the circumstances. Post-COVID analysis may provide the answers but it is worthwhile to recalibrate from a stressed, unhealthy lifestyle to a healthy one. It could mean a better work-life balance, realistic goal setting, nurturing family relationships and pursuing hobbies. In addition, early detection and better control of diabetes and hypertension will help to control the risk factors for heart attack in young Indians. Since we need to live with COVID for the next several months, diabetics and hypertensive patients should learn to self-monitor their blood sugar and blood pressure at home. Many doctors have started online consultation which can be availed to get opinion and maintain social distancing.
If the lockdown had no effect on the prevalence of heart attack and patients were staying away from hospitals out of fear of catching corona or due to lack of access, the consequences need to be understood. While heart attacks spell death in some, those who survive without any effective treatment lead a poor quality of life due to permanent damage to their heart muscle. Early arrival in a hospital and prompt treatment can stop heart attack in its track and salvage heart muscle. Warning signs of a heart attack such as chest pain with sweating, breathlessness or giddiness should not be ignored. Cardiologists have deliberated extensively on dealing with heart attack during the pandemic and developed effective protocols that would benefit the patient as well as prevent the spread of virus infection. The guidelines have been shared through webinars organised by professional bodies these past few weeks.
The lockdown has probably given a serendipitous lesson to prevent heart attacks by modifying lifestyle. If anyone feels the symptoms of a heart attack, COVID or no COVID, the nearest hospital is the right place to go and get it treated. It is an emergency that should not be endured at home. Cardiologists have recalibrated their approach to treat patients with efficacy and safety. The onus is now on the public to take responsibility for their health.
