As Jammu Kashmir is under the grip of the second wave of COVID-19, hundreds of people with non-communicable diseases are facing neglect as they are unable to get the necessary treatment or visit the hospital due to the pandemic.
Major hospitals of the region have witnessed a partial or complete disruption of routine services which has affected the specialized care for diabetes, hypertension, cancer, and lung ailments.
However, experts say persons with Non-communicable diseases (NCDs) can be managed at home in a better way by taking extra care and caution due to the pandemic.
Self-care of persons with DIABETES
As per doctors, the pandemic situation can take a heavy toll on persons with diabetes (PWDs) and those who are at risk of developing it. However, they say self-management or self-education tools are effective in controlling its impact.
Kashmir’s leading endocrinologist Dr Shariq Masoodi suggests that PWDs should take a healthy diet and keep active.
“This pandemic has transformed the routine of most of the people but I think it has allowed us also to change our lifestyle and control the controllables,” he said.
He said that PWDs and those who are at risk of getting it should start improving healthy habits in some key areas which will help them to control and manage Type-2 diabetes.
An important lifestyle change can be made in the diet because sugar levels should be maintained in persons with diabetes, he said.
“They should take the right amount and the right type of carbs to maintain healthy blood sugar levels throughout the day,” he said.
“PWDs should take fibre rich and protein-rich diets like green leafy vegetables, fruits and lentils. They must avoid sweets, like candy and cookies, chips and salty snacks, juice and soda, sugary tea, white bread, processed cereals and white rice,” he said.
According to him, patients with Type-2 diabetes are more prone to dehydration. So they should make a habit of sipping sugar-free, caffeine-free beverages throughout the day, he said adding that, “water is the best choice”.
Dr Masoodi said mild exercise such as walking and simple aerobics is important to diabetes management as it can help you achieve a healthy weight, which can improve your blood sugar control.
“Exercise can also reduce risks for other chronic issues such as high cholesterol and high blood pressure,” he said.
Other lifestyle changes like quitting smoking and alcohol, getting adequate sleep and managing stress are also important to control diabetes, he said.
Prioritising HYPERTENSION
Dr Shariq Masoodi says these are challenging times for hypertensive patients as well. However, he says improving overall health in patients is key to preventing this in the pandemics.
“People with high blood pressure or hypertension should continue taking their medications as prescribed by their doctor, especially in the pandemic,” he said.
He said they should self-monitor their blood pressure at home when and if they can.
“During the pandemic, they should adopt telemedicine rather than unnecessary visits to hospital or clinic,” he said.
According to him, a healthy diet and physical activity are a must for these patients.
“They must not stay indoors and avoid activity outside their room. If they cannot go out they can do exercise in their gardens,” he said.
Critical case of Chronic Lung Disease (CSD)
Persons having a chronic lung disease means that they are more susceptible to have complications from Covid-19 which makes it more important than ever for them to follow all the guidelines to minimize their risk of infection.
“In CSD patients we put extra emphasis on staying home and physically distanced from others because for them Covid-19 would be serious complications and even death,” said Dr Parvaiz Koul, former professor and head, of Internal and Pulmonary Medicine, SKIMS Soura.
He said such patients must follow their routine treatment religiously and consult the doctor telephonically or virtually if they are having a flare-up from their lung disease or experiencing new symptoms that trouble them.
“Visiting a hospital or clinic must be avoided unless it’s an emergency. But, it’s important for them to continue their regimen as prescribed whether they take oral or inhaled medication,” Dr Koul said.
Multidisciplinary support for CANCER patients
As per the research published in Nature Reviews Clinical Oncology, Cancer increases the adversity up to 40% in Covid-19 patients which means they have more chances of complications or death due to the infection than others. Experts believe that cancer patients should take extra care in the pandemic.
Dr Gul Muhammad Bhat, professor and head of the medical oncology department at SKIMS Soura said cancer patients need multi-disciplinary support and multiple medical and ethical considerations to best manage them during the pandemic.
“Cancer is not like other non-communicable diseases so it requires a different plan. We can only manage only a small percentage of cancer patients at home for a limited period which is why we have kept the Oncology department open,” he said.
“Those who are on curative care cannot be managed at home. They must visit the hospital after taking necessary precautions during the pandemic,” he said
SKIMS’s Medical Oncology Department had also seen a decline of patients up to 25 per cent, Dr Bhat said. However, he said, those who are on palliative care or follow up treatment can be managed at home.
“They can consult the oncologists through the phone and delay their visit to the hospital to prevent them from getting infected from COVID-19. Some of them can also go on Chemo Holiday after due permission from the oncologist and if they are not critical,” he said.
He said modern communication tools like telemedicine must be adopted to optimise cancer care during pandemics.
“We must adapt quickly so that we keep the control and support cancer patients in a better way,” he said.
As per the World Health Organisation (WHO), reducing the major risk factors for noncommunicable diseases (NCDs) – tobacco use, physical inactivity, unhealthy diet and the harmful use of alcohol – should be the focus to prevent death from NCDs.
“NCDs – primarily heart and lung diseases, cancers and diabetes – are the world’s largest killers, with an estimated 38 million deaths annually. Of these deaths, 16 million are premature (under 70 years of age). If we reduce the global impact of risk factors, we can go a long way to reducing the number of deaths worldwide,” WHO said.
It said prevention of NCDs is a growing issue: the burden of NCDs falls mainly on developing countries, where 82% of premature deaths from these diseases occur. Tackling the risk factors will therefore not only save lives; it will also provide a huge boost for the economic development of countries.
