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For several such patients, this year’s pollution season has been a double whammy. Barely back on their feet after testing negative for the virus, the harmful air has worsened an already precarious health situation. With the air quality index (AQI) across the NCR cities of Gurugram, Noida and Ghaziabad staying mostly in the ‘poor’ or ‘very poor’ levels in October, several hospitals are witnessing a spike in recovered Covid patients reporting respiratory complications caused by pollution, such as chronic obstructive pulmonary disease (COPD), recurrence of cough and breathlessness.
In Gurugram alone, which has seen relatively better air than the other two cities, more than 75 recovered patients have turned up at hospitals in the last 10 days. Though there is a decline in the number of new Covid patients, there are fears that this figure will increase due to pollution.
“Some patients have returned with breathing difficulty and wheezing. Some of them have acute bronchitis and fresh chest infection. Studies have shown that viral infections tend to occur more frequently from the 38th week of the year. With the rising pollution and the approaching winter season, we should not relax and must take all precautions,” said Dr Manoj Goel, director, pulmonology, Fortis Memorial Research Institute.
In some cases, like that of a 48-year-old resident of Nirvana County who recovered in August and suffered a bout of pneumonia after coming back home, this is the first time they are experiencing respiratory issues. With their lungs weakened by Covid, the poor air quality has only compounded the problem.
“Patients with mild lung infection are witnessing aggravation in their condition. Because of pollutants, recovered Covid patients with other ailments are also facing a bacterial infection and experiencing difficulties in breathing,” said Gurugram chief medical officer Virender Yadav.
Doctors said breathlessness and cough are giving patients ‘reinfection’ worries. “Nearly 4-6% of patients are getting bacterial infections because of the presence of pollen in the air,” said Dr Sanjay Gupta, senior consultant and HOD (internal medicine), Medeor Hospital, Manesar.
Advising caution, Dr Nevin Kishor, head of bronchology and senior consultant, respiratory medicine, at Gurugram’s Max Hospital, said, “Covid patients with allergy and asthma are having more issues. While hospitalised patients are in a controlled environment, others should take their prescribed medication, use inhalers regularly, if needed, and keep as far away as possible from pollution.”
In Noida, meanwhile, about 10-15% of recovered Covid patients have reported allergic symptoms, decreased immunity, fatigue and weakness, said an official from the district health department. Patients currently recovering in hospitals too have started showing the symptoms.
“In several Covid patients, the need for oxygen is disproportionate. This has been observed in about 30 Covid patients at Sharda Hospital,” Dr Devendra Kumar Singh, associate professor, respiratory medicine, School of Medical Sciences and Research and Hospital, said. He added that such patients were being administered inhalation medications and antihistaminic drugs more frequently.
Similarly, at Fortis Hospital in Noida’s Sector 62, Dr Ajay Agarwal, director (internal medicine), said nearly 15 patients are facing problems of breathlessness or cough – all related to pollution. The poor air quality has impacted Covid patients with respiratory difficulties the most, he added. “After recovery, we follow up regularly with Covid patients who may require bronchi dilators, inhalers or antifibrotic agents,” said Dr Aggarwal.
At GIMS in Greater Noida and Noida Covid Hospital (NCH) in Sector 39, while there have been no complications so far in Covid patients due to rising pollution, senior health officials do not rule out a spike in Covid cases in the next two months. “We expect more cases in winter as well as severity in comorbid patients,” said Brigadier RK Gupta (retd), director, GIMS.
Health officials in GB Nagar are also keeping an eye on the 374 Covid patients currently in home isolation, through close monitoring by the integrated control room team. “We have advised them to monitor their oxygen saturation levels every two hours and to call the control room if they have breathlessness, cough or fatigue,” said Dr Akanksha Kanaujia from the home isolation cell.
According to Utsav Sharma, regional officer, Uttar Pradesh Pollution Control Board, the air quality is expected to deteriorate. “Although farm fires started early this year, AQI hasn’t been ‘severe’ yet. But in the coming days, it may be in the ‘very poor’ category. In winter, the ventilation index (used to determine the severity of respiratory illness) also goes down,” he pointed out.
Preparing for the worst, doctors have advised preventive measures, such as strict use of masks, social distancing, hand hygiene, remaining indoors and regular steam inhalation. “Face masks help prevent the impact of particulate matter. Policy measures are also needed, such as checking stubble burning, vehicular pollution and putting construction protocols in place,” said Dr Piyush Goel, pulmonology and critical care, Columbia Asia Hospital, Palam Vihar.