The column will be written by Dr. Chandrakant Lahariya (MBBS, MD), a Physician-Epidemiologist and a leading expert on COVID-19 disease and vaccines. In this fortnightly column, Dr. Lahariya will pick up one topic and give you tailored solutions, catering to the health needs of your entire family — kids, adolescents, adults, and senior citizens and all the other members of your family.
This week’s column focuses on ‘Monsoon and COVID-19’ and gives you all the essential information required during this rainy season to keep your family safe from covid.
What kind of precautions should one take during monsoon season to prevent COVID-19 and other infectious diseases?
The rains increase the risk of vector-borne diseases such as malaria, dengue, and chikungunya. In addition, there is also the fear of fungal, food, and water-borne diseases and other skin infections. Therefore, apart from following COVID-appropriate behaviour (like wearing masks, washing hands, etc.), and getting vaccinated as soon as possible, focusing on personal hygiene is a must during monsoons.
Always consume clean, preferably boiled or filtered water, and wash vegetables and fruits thoroughly in it before cooking. Avoid eating raw or pre-peeled fruits or juices from outside. And, try to eat fresh vegetables.
While COVID-19 prevention involves improving ventilation, this provides an ideal opportunity for mosquitos to enter homes. Therefore, the use of insecticide-lined bed nets, insect repellents, and meshes placed over windows and doors is essential. Keeping the surroundings clean and avoiding water stagnation and decaying matters in close vicinity also reduces risks of malaria and dengue.
The first rains raise the risk of increased pollutant load washed from the atmosphere and augments flu risk due to sudden weather change. But such cases of flu shouldn’t be taken lightly in COVID times. Report early to a health care provider in cases of fever.
As the pandemic continues, what precautions should one take while stepping out in the rains?
People should try to wear clothes that are full-sleeved and offer maximum body cover; apply mosquito repellent on the exposed parts of the body before stepping out. Another thing to keep in mind while venturing out is to carry extra masks. If you get drenched in the rains, and your mask gets wet, it will not protect you from germs and bacteria. So, change it immediately.
Also, carry a water bottle with you to avoid drinking unclean water from the outside. A good hygiene practice is to clean feet, dry them completely, and avoid the risks of fungal infection that rises during monsoons.
How can one differentiate between season flu and COVID 19 symptoms?
Common COVID-19 and Seasonal Fever symptoms include fever or feeling feverish/ having chills, cough, shortness of breath, fatigue (tiredness), sore throat, runny or stuffy nose, muscle pain or body aches, and headache. Therefore, any person displaying such symptoms should immediately do a Rapid Antigen Test or RTPCR test to rule out COVID-19.
During the pandemic, nearly every such case, especially those with a history of contact with someone who has recently developed COVID-19, should be considered seriously.
However, there are a few specific COVID-19 related symptoms such as a change in or loss of taste or smell (often early symptom without a runny or stuffy nose) or Dip in Oxygen Saturation, Shortness of breath (more common) that can directly indicate towards COVID-19.
How are malaria and dengue patients affected by COVID-19? Are they more prone to the virus?
These diseases share symptoms with COVID like fever, malaise, headache, and breathing difficulties. They can both lead to complications ranging from mild upper respiratory symptoms to severe disease. In addition, these patients are at increased risk of COVID-19 as pre-existing malarial anaemia can result in insufficient tissue oxygen with the slightest decrease in oxygen coping capacity in an individual with Covid co-infection.
Both diseases cause a blood clotting state in the body, leading to an increased risk of pulmonary thrombosis. Both the disorders also cause inflammatory cytokines and pose a risk of poor outcome in COVID-19. Malaria-induced immunosuppression inhibits the immune response hence there can be severe manifestations of respiratory viruses.
Dengue patients exhibit a dysfunctional immune response and make the physiological setting favourable for a secondary infection. Hence despite the low prevalence of Covid disease in malaria-endemic regions, the severity of co-infections is higher and warrants extra precaution in management.
Recent studies have shown that dengue patients can show the false-positive result for COVID serology, and reciprocally, COVID patients show positive dengue serology. These overlapping laboratory investigations and false positivity make diagnosis a challenge.
Will the third wave have a more significant impact on children? How should parents protect them?
There is no scientific evidence that any subsequent wave of COVID-19 would affect children disproportionately. So far, we have seen that children are not severely affected by the virus, probably because they do not have the specific receptors, the ACE-2, which SARS CoV2 needs to bind to the lungs. Thankfully, the situation has not changed so far, despite the new variants.
However, special care should be taken of those children who have pre-existing disease conditions because they are at a relatively higher risk of severe disease. Also, although Multi-system inflammatory syndrome of Children (MIS-C) has been a dreadful development in some children with COVID but it has to be remembered that such cases are rare.
Parents should be careful that kids above 5-year-old wear mask, avoid crowded spaces, stay hydrated and consume healthy, nourishing meals. Routine vaccination of all children should be continued to prevent any other health issues.
Should children wear a mask? Which age group can wear masks?
Everyone above five years should wear a mask in public places and they should be supervised while wearing it. However, according to WHO and the Indian health ministry advisory, children younger than five years should not wear masks.
Young children, especially below two years old, have smaller airways, so breathing through a mask is harder. Babies also can’t tell anyone about breathing difficulty or take the masks off, so they cannot convey it if they feel suffocated wearing it. Another reason is that some homemade masks might have pieces that a baby could choke on, such as strings or elastic bands. As a result, they will likely try to remove the mask, causing them to touch their face a lot. Again, this can increase their risk of catching and spreading the virus.
Are women more prone to vector-borne diseases? If so, how will monsoon season affect women’s health?
Pregnant women represent the single largest vulnerable group for some diseases. This is due to both immune suppression in pregnancy and the gravity of an individual infection to impact not just one but two human lives. As pregnancy progresses, rising oestradiol/progesterone, reducing CD4/CD8 cells, decreasing cytotoxic T cells, and a shift from Th1 to Th2 have all been proposed to be essential for susceptibility to infections. This makes women more susceptible to vector-borne diseases.
Please remember that COVID-19 is now reported to cause severe disease at a higher rate in pregnant women. Therefore, the Federation of Obstetrician and Gynaecologists in India (FOGSI) has recommended that pregnant women get COVID-19 vaccination on priority. Those who have not been vaccinated should be very mindful of following precautions.
Senior citizens are more likely to get affected in the rainy weather with joint pains, respiratory disorders, and digestive problems. Can these issues aggravate COVID-19?
The population aged 60 years or higher has poor health status, weak immune function, lowered organ function, increased probability of multiple underlying diseases, and poor attention to personal health. All of this can increase the susceptibility to various diseases in this population. The 60+ population is at higher risk of moderate to severe COVID-19. Respiratory difficulties, diabetes, and other comorbidities increase their risk of hospitalization and death.
Furthermore, an additional illness during the rainy season may make them further vulnerable to COVID-19. Therefore, every effort should be made to protect from season diseases. It is important that this age group complete their COVID-19 vaccination on priority.
Can COVID infection lead to patients having typhoid fever? What precautions should one take to decrease risks?
Typhoid is a bacterial infection caused by Salmonella typhi characterized by fever, malaise, headache, diarrhoea and abdominal discomfort. COVID-19 patients are now presenting with gastrointestinal symptoms, which mimics typhoid clinically and makes clinical diagnosis confusing. In addition, false-positive Widal tests in COVID patients have made diagnosis a challenge. This warrants usage of RT-PCR for confirmation of Covid infection and blood culture for confirmation of typhoid in the acute phase of illness. In the case of chronic carriers of typhoid, stool culture is preferable for confirmatory diagnosis.
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