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With the onset of winter, recurrent coughs and breathing troubles become more common among people living in most Indian cities. Symptoms of people with chronic respiratory diseases, including asthma, chronic obstructive pulmonary disease (COPD) and other lung diseases, may also worsen with falling temperature and rising pollution.
Together with the reality of pandemic fatigue, the government and health authorities must launch COVID-19 prevention campaigns aimed at people with chronic respiratory ailments, as they stand a high risk of getting seriously ill with the disease.
India has a disproportionately high burden of chronic respiratory diseases, so targeted campaigns that address the specific concerns of people with respiratory illnesses could go a long way in promoting compliance with COVID-19 prevention guidelines.
One of the more important concerns that COVID-19 campaigns need to address is the fact that people with chronic respiratory ailments may find it uncomfortable to wear masks, especially for long durations. In these situations, a person with a respiratory illness may also be tempted to lower the mask below her nose in an attempt to breathe easier, if not take the mask off altogether.
However, medical experts have emphasised the importance of wearing masks for such people as well. According to Dr Samir Sahu, a pulmonologist with more than 30 years of experience who practices in Bhubaneswar, “Everyone should wear masks unless their doctor certifies against it, due to medical reasons.”
The US Centres for Disease Control and Prevention (CDC) has also said the same thing. While emphasising that people with asthma can wear masks, it advises people with respiratory illnesses to proactively discuss their concerns with their doctors and healthcare providers.
For those who find wearing masks to be uncomfortable, the European Lung Foundation recommends a gradual process of getting used to the habit. It recommends that people first practice breathing through the mask while at home. Once they’re comfortable, they can practice breathing through the mask while taking a short walk near their homes. Finally, they can try wearing it outside for longer periods.
Using breathable fabrics
The WHO recommends medical masks (or surgical masks) for people who are at higher risk of becoming seriously ill with COVID-19 – including people older than 60 years and those of any age with chronic respiratory disease, cardiovascular disease, cancer, obesity and diabetes mellitus, and immunocompromised patients. In a video, experts with the WHO also clarified that while wearing medical masks may be uncomfortable, they don’t lead to oxygen deficiency if they’re worn properly.
For other people, the WHO recommends non-medical fabric masks. A study published in May 2020 claims that while N95 masks offer the most protection, “wearing a universal cloth face mask in combination with meticulous hand hygiene and social distancing can provide a complementary protection and can significantly block the spread of infection.”
In this context, Dr Sahu also said, “Not everyone has to wear masks that are used by healthcare workers in an infectious environment. You can wear masks you are comfortable in.”
People with respiratory ailments need to take special care while exercising or performing other intense activities. The WHO asks people to not wear masks while exercising, as the accumulated sweat could make the mask wet and make breathing more difficult. While exercising, it’s also important to maintain a physical distance of at least 1 m from others.
Many people use the same mask for a whole day, leaving it wet with moisture, sweat and saliva. Health authorities need to spread awareness about replacing masks that are wet with clean, dry ones. According to the CDC, wet masks are a major health hazard plus they may not be as effective either. So for those people with breathing difficulties, ensuring the mask is clean and dry at all times becomes even more critical.
Working from home
Travelling in crowded public-transport vehicles or working in poorly ventilated office rooms poses additional risks for people with respiratory ailments. The government should not only instruct but also ensure that both public and private sector organisations sector allow their vulnerable employees to work from home as much as possible. Indeed, a person with a limiting respiratory illness should be able to work from home without worrying about job loss and other repercussions.
In cases where the nature of work requires a person to be present at the work site, measures must be taken to ensure flexibility for the employee.
Finally, COVID-19 prevention campaigns that have been designed for people with chronic respiratory ailments must feature people who experience such symptoms as well. This will help make the campaign more credible and relatable. Studies have shown that ensuring compliance to a health-related regimen is more likely to be effective when enforced by peers, not just by experts.
As more people grow weary of pandemic-related restrictions, it becomes even more important to renew emphasis on prevention measures, especially for vulnerable people who may get seriously – yet avoidably – ill with COVID-19.
Smeeta Mishra is an associate professor at Xavier Institute of Management, Bhubaneswar, and researches health communication, digital cultures and media representation.