As Wuhan lifted coronavirus lockdown on April 8th, all cities in China have entered the stage of resuming work and prodution.
Through comparative analysis, we found that the outpatient visits of common respiratory diseases were affected by COVID-19 pandemic,especially for acute infectious diseases.The substantial decline of the outpatient visits of common respiratory diseases mainly due to the following reasons:
1. Lockdown strategy
Human-to-human transmission of COVID-19 has been confirmed.The people most at risk of the infection are those who are in close contact with a COVID-19 patient or who care for COVID-19-infected person[3].
Since the COVID-19 epidemic outbreak, Chinese government responded quickly and has taken powerful measures to combat the disease.The lockdown strategy,which is considered as the most effective way to stop the spread of the corona virus within a short time,worked well in China’s battle against the pandemic.Since Wuhan government announced that all forms of the city's public transport stopped operation and the residents were not allowed to leave the city on January 23,2020,other cities entered the lockdown state in succession.Residents were required to stay at home as much as possible and restrict close contact with other people. The inconvenient traffic hindered the patients from going to the hospital.
The risk for getting those diseases is highest for people who are in close contact with those who have COVID-19, or other respiratory tract infectious diseases such as pulmonary tuberculosis(TB)[4] and influenza[5]. Lockdown strategy limited the spread of COVID-19,as well as TB and influenza.
Lockdown strategy also brings opportunity to rationalize human impact on the environment[6]. During the lockdown period, the improvement of air quality reduces the irritation of air pollutants to the respiratory tract,which is one of the most important causes of cough.
Although the cities had gradually lifted the blockade in China, respiratory tract infectious diseases were not severe. Flu season,which tends to hit in the winter and spring,had almost over,earlier than before. National response strategies and public health interventions applied to control COVID-19 may serve as useful strategies for the prevention and control of influenza[7].
2. Mask usage
It is generally considered that the main mode of transmission of COVID-19 is through contact and in the form of droplets[8].The experimental results show that household masks have some filtration capacity in the relevant droplet size range, as well as efficacy in blocking droplets and particles from the wearer[9]. Masks are effective as both preventing asymptomatic transmission and preventing COVID-19 in healthy persons[10].So the routine use of a face mask in daily life has been incorporated into pandemic control plans[11].
Meanwhile,using of mask reduced the incidence of other respiratory tract diseases to some extent.Face masks are used as a protective barrier to reduce the risk of transmission of microorganisms between patients, healthcare workers, and the environment[12].Population-wide use of face masks could make a remarkable contribution in delaying an influenza pandemic[13].
Wearing a face mask properly decreases the risk of acute episodes of chronic obstructive pulmonary disease, bronchial asthma, and several other respiratory diseases caused by particulate matter (PM) exposure[14].Mask also provide protection from common allergy triggers such as pet dander,dust mites,and pollen in the air,which are the main cause of acute asthma attacks and allergic rhinitis[15,16].
3. Fear of going to the hospital
Avoiding crowded places, social gatherings, and the use of public transport is helpful to limit cross-infection.The Chinese authorities recommended that people avoid crowded places as much as possible. As a public place,hospitals are always full of people.For worrying about nosocomial infection,many patients choose to wait at home to see if they can get better on their own, or take drug by themselves,or get help from online medical treatment system.
4. Cancelation of non-emergent operations
Medical thoracoscope and bronchoscopy play an important role in the diagnosis and treatment of respiratory department.Non-emergent operations were canceled or postponed to prevent the spread of the highly contagious novel coronavirus.
5. Temporary adjustment of medical insurance policy
China has established a universal health care security system, the scope of its payment including long-term control medicines for many chronic pulmonary disease such as asthma and COPD. In order to ensure the standard and reasonable use of social medical security fund, many drugs had been prescribed as one-month doses.
The government adopted a temporary relaxed policy of increasing the amount of the long-term control medicines that could be prescribed at one time during the time of coronavirus.This strategy reduced the outpatient visits of many chronic diseases.
In addition to the decrease in the incidence of diseases,the decline of the outpatient visit rate may reflect some negative situations.The effect of COVID-19 on the management of other illnesses cannot been ignored.A patient may miss the golden hour of rescue for serious medical conditions like heart attack and stroke only because of he or she isn’t willing to go to the emergency room out of fear of corona virus.
Correct first aid measures need to be known by the general public.It is incredibly helpful to strengthen the health education of common and acute diseases by various means.
The applications of digital technology in the healthcare field are well known.Since the outbreak of COVID-19,online pharmaceutical stores and teleconsultation systems,which are easily accessible from desktop system or mobile device,have been used by more people.However, several shortcomings have emerged including drug shortage, lack of relevant legal protection, and many prescription drugs aren’t covered by insurance.It is a pressing issue to standardize and professionaliza the digital platforms to ensure patients are receiving high-quality online medical service.