Reduced pollution levels leave positive impact on asthma admissions; but anxiety remains a worrying trigger

After the lockdown was enforced, there has been a dramatic drop in pollution levels and with it a dramatic reduction in the number of asthma admissions in March, April and May 2020 as compared to the previous year. The factors are thought to be many but the most significant is less air pollution.

Dr Raja Dhar, Director of the Department of Pulmonology at Fortis Anandapur said, “The PM2.5 of the ambient outside air in Kolkata in the last month has consistently been less than 100, which has not been the case in the past 10 years. The PM 2.5 mean in Kolkata in the month of March-April 2019 was about 150, which is extremely polluted. Hence the better control of asthma during this period is understandable at least from the pollution perspective. The other factor is that with people being limited mostly to their homes, they can stay away from triggers and the inciting factors (pollutants, pollen etc) for asthma which result in the worsening of the disease. The chances of cross contamination or cross infection which might trigger asthma are also less because people are wearing masks.” Hence overall the number of asthma attacks in 2020 during the said period of pandemic is five times less as compared to what it has been in 2019. This phenomenon is not true only for Kolkata. The same pattern is repeated throughout the country and even in places like China or the bigger cities like New York and London. However, anxiety remains a cause for worry. Asthma is an anxiety provoking disease because breathlessness is a frightening experience. People who have suffered an attack previously are extremely apprehensive about it happening again. The experience of

breathlessness, chest constriction and tightness begets anxiety. The reverse is also true. If you are anxious, you breathe harder and faster which can aggravate the situation if you are asthmatic. There is a theoretical chance that people who are at home and fearful of an attack might suffer episodes more frequently as compared to others.

The silver lining is, as people are staying at home, triggers are absent and air pollution is less; it compensates for the increased anxiety. Thus the frequency of attacks or admissions have reduced even after taking into account the anxiety people are facing. “If people do get an infection (COVID or not) which makes their asthma more serious, then the anxiety factor kicks in and their chances of ending up in an intensive care increases. This is because the anxiety worsens the attack and that is what we are experiencing while practicing respiratory medicine in the current state that we are in”,

added Dr Raja Dhar.