A Swansea University Medical School led study is the first national level analysis of the impact of the COVID-19 lockdown on COPD (chronic obstructive pulmonary disease) attacks and deaths.
The study was undertaken in partnership with researchers at Edinburgh University’s Usher Institute, and colleagues in the EAVE II study; a real-time monitoring project of COVID-19 in Scotland.
Comparing with data from the last 5 years, the study found a 39% reduction in GP consultations and a 48% reduction in hospital admissions for COPD following the introduction of the first national lockdown. The study also found no evidence that deaths due to COPD have increased during lockdown. This is important since reductions in health care utilisation on this scale for other conditions have corresponded with higher mortality.
COPD is a common condition that mainly, but not exclusively, affects smokers and ex-smokers as they get older, leading to breathlessness and other respiratory problems.1 COPD is an incurable condition that can severely limit sufferer’s activity levels and quality of life, with many people not knowing that they have it.1 1.2 million people are estimated to be living with diagnosed COPD; around 2% of the UK population.2
Funded by the Medical Research Council with the support of BREATHE – The Health Data Research Hub for Respiratory Health – the study’s authors used population-based data with near complete geographical coverage across Scotland and Wales held by Public Health Scotland and Wales’s SAIL Databank.
The authors advise future investigation to fully understand the underlying reasons behind these results.
First author and Clinical Data Scientist, Dr Mohammad Alsallakh, said, “Lockdown was associated with the largest reductions in COPD attacks we have ever seen in Scotland and Wales. We think this is due to a combination of factors including lower circulation of non-COVID-19 respiratory infections and improved outdoor air quality during lockdown, and improvements in COPD self-management through smoking less or by those at risk making other behavioural changes.”
Professor of Respiratory Medicine at Swansea University, Professor Gwyneth Davies, said, “Lockdown measures to reduce COVID-19 seem also to have led to a dramatic drop in COPD attacks and we need to understand the reasons behind this better. These findings have important implications in preventing COPD attacks. Public health strategies need to capture the positive elements here that could reduce COPD attacks in the future. These are likely to include hygiene measures, effective self-management and improved air quality.”
Professor Aziz Sheikh, Director of Usher Institute, The University of Edinburgh, and BREATHE, said, “Amidst all the havoc that COVID-19 has heaped on our lives and the NHS, it is encouraging to see that lockdown measures have been associated with important improvements in some health outcomes. Our study, drawing on data from across Scotland and Wales, found that lockdown was associated an almost 50% reduction in hospital admissions for acute exacerbations of chronic obstructive pulmonary disease (COPD). These are the most substantial reductions in COPD ever seen across the UK and are likely to be the result of improved hygiene measures and curtailed social mixing leading to a reduction in the circulating viruses that trigger many COPD exacerbations.”
“These findings build on our work earlier this year also showing substantial reductions in serious asthma exacerbations. Our focus is now on identifying the transferable lessons from this body of work that can hopefully be taken forward into the post-COVID era to improve outcomes for the millions of people living with chronic respiratory disorders in the UK and globally.”
These findings have far-reaching implications because a reduction in COPD-related attendances increases health care capacity and resources to treat people with COVID-19. Further investigation based on these results could also support the drive to reduce pollution levels.
It’s also hoped that these findings will help to harness the learnings from COVID-19 lockdowns to support an improved public health message beyond the pandemic. For example, to facilitate effective self-management and reduce the transmission of respiratory infections through better hygiene and other precautionary measures.
Read the full paper here: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-021-02000-w
References.
1 https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/
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