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Published on: Apr 04, 2020
2 minute read
By: Dr Rajan Choudhary

COVID-19 LOCKDOWN !

As the cases continue to increase worldwide more and more countries have begun to take drastic measures to prevent the spread of COVID-19. In some places it is clear containment is no longer achievable, as too many people have become infected and the natural exponential increase in number of cases is inevitable. Now the focus switches to damage mitigation.

We first saw this in Wuhan, with city wide quarantine measures. Then Italy enacted similar measures, now extending across the country with all non-essential services and businesses closed for the foreseeable future. The Italian health service has become strained with the rising patient load, with reports of drastic measures taken in hospitals including conversion of operating theatres into intensive care bays. We have previously discussed the effect this has had on the Italian economy.

A NEW EPICENTRE

With Europe now seen as the “epicentre” of the pandemic, other countries have begun following suit. Spain is the second hardest hit country in Europe, with 6,000 infections and nearly 200 deaths. After a lengthy meeting of the government cabinet, the Spanish PM has enacted a partial lockdown of the country, with the use of armed forces on standby to assist. This includes closure of all shops except those selling food and basic necessities, reduction in medium-distance rail traffic to stem the spread of people around the country, and economic measures to support business workers.

France has also shut down all non-essential businesses, with food shops, chemists, banks and petrol stations remaining unaffected. The PM urged a reduction in travel amongst the population, and to enact “social distancing”. Germany has 3,800 cases but remarkably has only had 8 deaths so far. Berlin has banned all public and private events with more than 50 participants, with similar bans occurring in other cities across the countries.

So what do they hope to achieve with such measures? At first people were advised to take measures to wash hands, practice basic hygiene, self-quarantine if developing symptoms. But it became apparent this was not enough. Social distancing and lockdowns further reduce the spread of the virus by drastically reducing the number of people out in public, the number of interactions they can have. Schools and universities act as breeding grounds for infections, large congregations amongst which respiratory infections can spread like wildfire.

SHUT DOWN EVERYTHING

Lockdown also carries great political power. People respond well to drastic action, rather than soft recommendations to slightly change their daily habit with washing hands and increased hygiene. This is why masks have been so popular amongst the populous. It is decisive, it is visible. It is however NOT recommended by the WHO and most governments to wear as it is unnecessary unless around infected patients, and increased demands is straining supply for medical professionals and those who truly need it.

Similarly, Lockdown is a decisive action. It reassures the population that something is being done, that the government is taking the IT seriously. But it is not a cure to COVID. It is a plaster, a temporary stopping measure, one that cannot continue indefinitely. Shutting businesses can seriously affect the economy, affect people’s income and subsequently prevent them from paying off mortgages or loans. Forcing children to stay at home can affect their education, parents have to choose whether to work or look after their unsupervised kids.

It’s true that lockdown is now a necessity in some countries, and the lockdown of the Hubei province and parts of China was credited with significantly slowing down the spread of COVID. But it will not stop the viral spread completely. For this reason the UK has adopted an alternate strategy, one that we will discuss in our next blog.

Dr Rajan Choudhary, London UK

Head Of Products, Second Medic Inc

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Shortness of Breath Causes: From Common Triggers to Serious Health Conditions

Shortness of breath, medically known as dyspnea, is a symptom that ranges from mild discomfort during exertion to a distressing sensation of not getting enough air. In India, increasing air pollution, lifestyle diseases and respiratory infections have made breathlessness a frequent complaint across age groups. Understanding shortness of breath causes is essential to identify when it is harmless and when it signals a medical emergency.

What Is Shortness of Breath?

Shortness of breath refers to difficulty breathing or a feeling of air hunger.

It may present as:

rapid breathing
shallow breathing
tightness in the chest
inability to take a deep breath

The sensation can develop suddenly or gradually.

Common and Benign Causes of Shortness of Breath

Physical Exertion

During exercise, the body demands more oxygen.

Temporary breathlessness during:

climbing stairs
running
heavy physical work

is normal and resolves with rest.

Anxiety and Panic Attacks

Stress and anxiety alter breathing patterns.

Symptoms include:

rapid breathing
chest tightness
dizziness

These episodes often resolve with calming techniques.

Respiratory Causes of Shortness of Breath

Asthma

Asthma causes airway narrowing and inflammation.

Symptoms include:

wheezing
chest tightness
breathlessness during exertion or at night

Asthma is a leading cause of chronic breathlessness.

Chronic Obstructive Pulmonary Disease

COPD includes chronic bronchitis and emphysema.

Risk factors include:

smoking
indoor air pollution
occupational exposure

WHO identifies COPD as a major cause of breathlessness in adults.

Respiratory Infections

Infections such as pneumonia and bronchitis reduce lung capacity.

Breathlessness may be accompanied by:

cough
fever
chest pain

Severe infections require urgent treatment.

Heart-Related Causes of Shortness of Breath

Heart Failure

The heart fails to pump blood efficiently.

This leads to:

fluid accumulation in lungs
breathlessness on exertion
breathlessness while lying flat

ICMR data shows heart disease as a major contributor to unexplained breathlessness.

Coronary Artery Disease

Reduced blood supply to the heart can cause:

breathlessness
chest discomfort
fatigue

This may occur even without chest pain in some individuals.

Blood and Metabolic Causes

Anemia

Low hemoglobin reduces oxygen delivery.

Common symptoms include:

fatigue
breathlessness on mild activity
pale skin

NFHS-5 highlights anemia as highly prevalent in India.

Thyroid Disorders

Hyperthyroidism increases metabolic demand, causing breathlessness.

Hypothyroidism may contribute indirectly through weight gain and reduced stamina.

Lung Circulation Disorders

Pulmonary Embolism

A blood clot in the lungs causes sudden, severe breathlessness.

This is a medical emergency and may be accompanied by:

chest pain
coughing blood
fainting

Immediate treatment is critical.

Lifestyle-Related Causes

Obesity

Excess body weight restricts lung expansion.

Breathlessness occurs due to:

increased oxygen demand
reduced lung volumes

Weight management improves breathing efficiency.

Sedentary Lifestyle

Poor physical conditioning reduces respiratory muscle strength.

Even mild exertion may cause breathlessness.

Environmental and Occupational Factors

Air Pollution

Pollutants irritate airways and reduce lung function.

Urban populations experience higher rates of breathlessness.

Workplace Exposure

Dust, chemicals and fumes increase respiratory risk.

Protective measures are essential in high-risk occupations.

When Shortness of Breath Is a Warning Sign

Seek urgent care if breathlessness:

starts suddenly
worsens rapidly
occurs at rest
is associated with chest pain, bluish lips or confusion

These may indicate life-threatening conditions.

How Shortness of Breath Is Diagnosed

Evaluation may include:

physical examination
chest imaging
blood tests
lung function tests
heart evaluation

Diagnosis focuses on identifying the root cause.

Preventive Measures and Lifestyle Care

Prevention includes:

regular physical activity
pollution protection
smoking cessation
weight control
managing chronic conditions

Preventive healthcare reduces long-term risk.

Importance of Early Medical Evaluation

Delayed diagnosis can worsen outcomes, especially in:

heart disease
lung infections
anemia

Early care improves treatment success.

Conclusion

Shortness of breath causes range from temporary exertion and anxiety to serious heart, lung and blood disorders. While occasional breathlessness may be harmless, persistent or sudden symptoms should never be ignored. Understanding the underlying causes and seeking timely medical evaluation can prevent complications and save lives. Paying attention to changes in breathing is an essential step toward protecting overall health and wellbeing.

References

Indian Council of Medical Research (ICMR) – Respiratory and Cardiac Health Reports
World Health Organization (WHO) – Breathlessness and Chronic Disease Guidelines
National Family Health Survey (NFHS-5) – Anemia and Respiratory Health Data
Lancet – Dyspnea Evaluation and Outcomes Research
NITI Aayog – Non-Communicable Disease Prevention Reports
Statista – Respiratory Disease and Air Pollution Trends

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