Along with stroke admissions, there is a decline in post-stroke rehabilitation, of three to six months, which could lead to stroke recurrences, the study states. (Photo: Getty Images/Thinkstock)
Thirteen neurology departments in top public and private hospitals in the country have highlighted coronavirus’s impact on non-Covid healthcare, documenting a 61% reduction in reporting of strokes, as well as a significant shortage of essential medicines. They have also highlighted the lack of personal protective equipment at their centres.
Published in the Annals of the New York Academy of Sciences, the research, covering centres that get a high volume of stroke cases both in the US and India, states that governments have not taken appropriate measures to “deal with the developing atmosphere of fear of going to hospitals”.
The survey cautions that a lack of “stroke risk control” during the pandemic may “eventually” lead to increased stroke-related mortality “across the country” in the coming days. “In virtually all stroke cases…,” the survey adds, “timely care in hospitals supersedes the risk of possible exposure to (Covid-19)”.
AIIMS neurology head M V Padma Srivastava, who was involved with the study, says she is getting just 30-40% of her usual daily patients, as well as fewer cases in emergency. “Now that we have got the data, we are saying (lesser reporting) is not because strokes are happening less,” she said. “Along with geographical barriers, people are taking more chances with perceived minor events, such as numbness, which might actually be the harbinger of a major event. It’s a risk they are willing to take instead of contracting Covid-19 outside.”
The US has seen a similar drop in reporting of strokes during the pandemic, the study states, adding, “The magnitude of decrease in India is deeply troubling, as India has a higher incidence of stroke compared with the United States.”
Along with stroke admissions, there is a decline in post-stroke rehabilitation, of three to six months, which could lead to stroke recurrences, the study states.
Calling this period a “learning curve”, Dr Srivastava says, “I think the ICMR, DHR (Department of Health Research), we are all gearing up for new numbers as the scenario changes. Even in Europe, as proper non-Covid pathways have been established, they are seeing strokes come back in an even bigger way.”
At the same time, Dr Srivastava says she has had cases of patients of stroke who have ended up getting coronavirus, highlighting the difficulty of completely separating corridors for treatment of Covid and non-Covid patients.
As per the study, it is reasonable to assume that peripheral Covid designated centres far away from larger establishments are now taking on extra burden.
The research, covering eight government and five private hospitals, also found an impact of coronavirus on other blood-vessel-related treatments. “Procedures for intravenous thrombolysis (blood clots) and endovascular (cases) have also been severely affected, with an overall reduction of 64.76% and 67.21%, respectively, the latter coming to a complete halt in five centres that had regularly provided this service,” says the study.
On the shortage of PPE, the study says the risk of infection among healthcare workers “can lead to a reduced workforce available for stroke services”. Only five of the centres had full PPE equipment for their healthcare workers, it says. Highlighting the shortage of medicines, it says “political action is required to ensure resumption of drug manufacturing”.
It seeks awareness campaigns on “the high morbidity and mortality of non-communicable diseases, including stroke, and the high risk of a second wave of mortality due to these illnesses”, and suggests that the government employ special ambulances and other emergency services for such cases.