Yearender 2022: Mumbai doctors highlight how Covid variants and mental health took centrestage

This year started with Omicron and then a spurt in cases of dengue, leptospirosis and hand foot mouth disease. Image for representational purpose only. Photo Courtesy: istock

This year has been quite a mixed bag for people around the city as far as health is concerned. Living amid the Covid-19 pandemic has created a lot of health issues for many people and the many variants starting with Omicron earlier this year haven't helped either. Dr Tanu Singhal consultant, paediatrics and infectious diseases, Kokilaben Dhirubhai Ambani Hospital, believes that while Omicron took over in the first half of the year, there is a particular age group that has been most affected by illnesses this year.

"The biggest burden of illnesses this year has been in children, especially those below the age of 5 years. They have suffered frequent respiratory viral infections almost every two weeks once they started going to school and day care," she adds. This, she says, is due to multiple factors. "One is the circulation of many viruses which took up the niche emptied by the COVID virus. Secondly, children were at home for the past two years and not exposed to infections thus lacked immunity. The increase in allergies due to increasing pollution also contributed to increased infections," she adds.

Hand foot mouth disease and dengue
It did not end there because this year also saw a massive epidemic of the hand foot mouth disease (HFMD) in children. Singhal explains, "While we are seeing HFMD outbreaks every year for the past many years, this time it was different. Children had recurrent attacks in the same season, had a large number of lesions and even adolescents and adults were affected. Fortunately, no serious complications were seen."

There was also an increase in the number of dengue cases, where the severity was higher in some patients and that even resulted in deaths, according to her observations. With dengue came an increase in cases of malaria and leptospirosis too.

Singhal highlights that there was also an increase in vaccine preventable diseases like measles and pertussis, commonly known as whooping cough. She highlights, "The indirect impact of the Covid pandemic has been decline in childhood vaccinations. It is estimated that coverage of infant vaccinations declined from 90-95 per cent to 85-90 per cent. Considering a 25 million birth cohort this translates to a large number of missed vaccination opportunities. In Mumbai alone, only 41 per cent of the eligible population was vaccinated till October 2022. India reported 11,000 cases of measles this year with many deaths."

The effects of Covid were not only seen on people but also on the healthcare system, when it comes to the implementation of programmes for tuberculosis and HIV. "At a personal level, we saw many cases of tuberculosis where the diagnosis was delayed owing to reluctance of caregivers or patients in seeking medical care," she shares.

Uptick in mental health issues
When talking about health, one mustn't forget how the Covid-19 pandemic took a toll on people's mental health, the effects of which are still being seen today. Dr Sonal Anand, city-based psychiatrist with Wockhardt Hospitals in Mira Road, observed a definite increase in stress among people throughout the year. Coupled with financial losses and job insecurities, this has led to an overall increase in mental health issues with anxiety seen as a common factor in people.

She explains, "Post traumatic stress has been a cause of concern after the Covid aftermath due to death of near and dear ones. Depression and sleep disorders have also been mainstay problems this year. Burnout is one more thing that has been on the rise because fewer co-workers at work has prompted an increase in pressure on workers and resultant increase in stress. Rise in irritability has led to increased domestic issues as well, and even marital problems have shown a rise this year."

Mental health problems aren't the only issue that has arisen this year because screen addiction is not far behind. While it has always been a problem, Anand has seen it reach an all-time high this year. "Many parents have brought their kids to doctors for screen addiction and gaming addiction," she explains. However, she has noticed a change. "This year mental health awareness has been on the forefront and many offices and institutes have started taking more steps towards better mental health. Yoga, meditation, exercise, walking, cycling have all been trending towards better mental and physical health." While it is certainly a step in the right direction, there is still a long way to go.

Dealing with Covid variants
Even as the year comes to an end one cannot ignore the new Covid variant, which was a similar situation earlier this year with Omicron. Dr Radhika Banka, consultant physician at PD Hinduja Hospital & MRC in Mahim, says even though China is seeing a rise in cases with the new variant, India is still not seeing an increase in cases.

Banka shares, "Firstly, most of our vulnerable population is vaccinated with more than 2.2 billion doses administered - nearly three-fourth of our population has received one dose. About 70 per cent have received two doses. Secondly, majority of our population has acquired natural immunity (90 per cent estimated)." Lastly, she says the variants XBB and BF.7, which are sub variants of Omicron noted in China and causing this peak, have already been in India since the past few months. Despite the entire country being open and masks not being a compulsory mandate, we have not seen a rise in cases.

However, Banka says it is important that we remain on guard. "We should ramp up the uptake of precautionary Covid dose especially for the elderly and vulnerable group, increase surveillance to identify new strains and encourage masking especially in crowded places," she cautions. At the same time, Singhal believes that one shouldn't forget to focus on other illnesses in 2023.

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