Nothing in the past 100 years has impacted public health as much as the Covid-19 pandemic. Its effects have mainly been adverse in India due to the large population, constantly rising AQIs and limited resources. To top it all, India has one of the highest prevalence of COPD (Chronic Obstructive Pulmonary Disease) globally. According to the Lancet Respiratory Medicine report, the number had increased from 28.1 million in the 1990s to 55.3 million in 2016. India contributes significantly to the morbidity and mortality of COPD in the world, with 3% of India’s disability-adjusted life years (DALYs) is recorded due to chronic respiratory diseases (CRDs), according to Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults (INSEARCH). It is important to note and understand that COPD is the biggest contributor to CRDs. According to several studies, COPD’s economic burden is over 48,000 crores annually, which is far more than the annual budget of the Ministry of Health and Family Welfare (MOHFW) for the year 2010-2011.
The global pandemic has brought respiratory ailments to the forefront of public health. Along with state authorities, the Government of India is continuously investing in efforts to advance the adoption of digital technologies for diagnosis and treatment, resulting in the growing adoption of telemedicine and teleconsultation. The government of India has also launched the Ayushman Bharat Digital Health Mission to further the adoption of digital technologies for the treatment of chronic diseases. Though progress has been made, there is still a long way to address the burden of COPD in India.
What is COPD, and why it is even more critical?
Chronic Obstructive Pulmonary Disease, commonly known as COPD, is an umbrella term used to describe progressive lung diseases. They are called progressive because they significantly worsen over time and cause damage to the lungs. It consists of two main respiratory problems, chronic bronchitis, and emphysema, both obstructing airflow in the patient.
The most common risk factors for COPD are tobacco smoking and exposure to biomass fuel in our country. Individuals with COPD are also likely to experience episodes called exacerbations which may be triggered by adverse environmental factors such as air pollution. The symptoms include chest tightness, fatigue, shortness of breath, wheezing and frequent respiratory infections.
COPD hamper the health and productivity of the patient and impacts their surroundings and close family, thus impacting the quality of life of a vast number of individuals. Given the enormous health burden COPD imposes, there is a need for an awareness campaign to educate people about the causes and consequences of COPD. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) collaborates with health care professionals and COPD patient groups and observes World COPD Day every year to increase conversations and awareness around COPD ailments. This year’s theme, ‘Healthy Lungs – Never More Important’, highlights that there is never a more critical time to focus on our respiratory health.
What can be done?
Although COPD is irreversible, with proper management of the symptoms and timely medical intervention, the quality of life can be improved and can also reduce the risk of other associated diseases, such as cardiovascular ailments and lung cancer. COPD, can be managed by proper medications like bronchodilators, oxygen therapy, breathing exercises, quitting alcohol and tobacco consumption and a good diet. Acute exacerbations of COPD cases (AECOPD) need medical intervention and can be controlled by using Non-Invasive Ventilation (NIV) therapy and Long term Oxygen Therapy (LTOT) after oxygen therapy during hospitalization is conducted.
According to the Indian Chest Society guidelines, NIVs should be used early in the management of respiratory failure and AECOPD cases. Even as per the American Thoracic Society 2020 guidelines and the European Respiratory Society guidelines, NIVs should be implemented shortly after hospitalization in AECOPD cases in addition to the usual care of patients. COPD is a rising public health concern in India. Its use is associated with reduced intubation rates, reduced length of hospital stay, and a decline in mortality.
Several devices comes with telemonitoring technology and NIV devices for home ventilation is also in the foray. These connected devices can monitor patient parameters remotely and in certain circumstances remote clinical intervention is also possible. Devices like ResMed’s Lumis is one such example with inbuilt remote monitoring technology.
For a country like India, there is an ever-growing need for accessible, proper diagnostic and monitoring technologies to enable the early diagnosis of COPD. Hence, it’s becoming equally critical to increase awareness and call for action.
Dr. Sibasish Dey, Head, Medical Affairs, Asia and Latin America, ResMed
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