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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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Yellow Eyes and Skin Symptoms: Causes, Warning Signs and When to Seek Care

Yellowing of the eyes and skin is one of the most noticeable physical changes a person can experience. Often referred to as jaundice, this symptom is not a disease by itself but a sign of underlying health conditions. Understanding yellow eyes and skin symptoms is essential because they frequently indicate problems involving the liver, blood or bile ducts and may require urgent medical attention.

In India, jaundice is a common presentation across age groups due to infections, liver disease and metabolic disorders.

What Does Yellowing of Eyes and Skin Mean?

The yellow colour appears due to excess bilirubin in the blood.

Bilirubin is:

a yellow pigment
produced from the breakdown of red blood cells
processed and removed by the liver

When bilirubin builds up, it deposits in tissues, causing yellow discoloration.

Why the Eyes Turn Yellow First

The sclera, or white part of the eyes, contains elastic tissue that binds bilirubin easily.

This makes yellowing:

more visible in eyes
detectable before skin changes

Yellow eyes are often the earliest sign of jaundice.

Common Causes of Yellow Eyes and Skin

Liver-Related Causes

The liver plays a central role in bilirubin metabolism.

Common liver causes include:

viral hepatitis (A, B, C, E)
fatty liver disease
alcoholic liver disease
liver cirrhosis
drug-induced liver injury

ICMR reports viral hepatitis as a major cause of jaundice in India.

Bile Duct Obstruction

Blocked bile flow prevents bilirubin excretion.

Causes include:

gallstones
bile duct strictures
pancreatic or bile duct tumours

This type of jaundice is often associated with itching and pale stools.

Blood Disorders

Excess breakdown of red blood cells increases bilirubin production.

Conditions include:

hemolytic anemia
malaria
inherited blood disorders

The liver may be overwhelmed despite being healthy.

Infections

Certain infections directly affect liver function.

Examples include:

hepatitis viruses
leptospirosis
severe sepsis

WHO data highlights hepatitis as a leading infectious cause of jaundice globally.

Newborn and Pregnancy-Related Causes

While common in newborns, jaundice in adults always needs evaluation.

Pregnancy-related liver disorders can also cause yellowing.

Associated Symptoms That Provide Clues

Yellow eyes and skin are often accompanied by:

dark yellow or tea-coloured urine
pale or clay-coloured stools
itching
fatigue
abdominal pain
loss of appetite

These symptoms help identify the underlying cause.

When Yellowing Becomes Dangerous

Seek urgent medical care if yellowing is accompanied by:

high fever
severe abdominal pain
confusion or drowsiness
vomiting
rapid worsening of colour

These signs suggest severe liver or systemic disease.

Jaundice and Liver Function

The liver normally:

conjugates bilirubin
excretes it into bile

When liver cells are damaged, bilirubin accumulates.

Lancet studies confirm jaundice as a key marker of liver dysfunction.

Diagnostic Evaluation

Doctors evaluate jaundice using:

blood tests for bilirubin levels
liver function tests
viral markers
ultrasound or CT scans
additional tests based on findings

Early testing identifies reversible causes.

Impact on Daily Life

Persistent jaundice can affect:

energy levels
digestion
mental clarity
work performance

Untreated liver disease can progress silently.

Treatment Depends on the Cause

There is no single treatment for jaundice.

Management focuses on:

treating infection
relieving bile obstruction
stopping harmful medications
managing chronic liver disease

Self-medication can worsen liver injury.

Role of Preventive Healthcare

Preventive measures include:

hepatitis vaccination
safe drinking water
limiting alcohol intake
regular health checkups

NITI Aayog emphasises liver health in preventive care strategies.

Lifestyle Factors That Affect Liver Health

Risk factors include:

excessive alcohol
obesity
high-fat diets
unsafe injections

Addressing these reduces jaundice risk.

Importance of Early Detection

Early diagnosis:

prevents complications
improves recovery
reduces hospitalisation

Delays increase the risk of liver failure.

Jaundice Is a Symptom, Not a Diagnosis

Understanding this distinction is crucial.

Treating the symptom alone:

does not resolve the disease
may mask serious conditions

Medical evaluation is essential.

Conclusion

Yellow eyes and skin symptoms are visible warning signs that should never be ignored. Most often linked to jaundice, they reflect underlying problems involving the liver, bile ducts or blood. Early medical evaluation, accurate diagnosis and timely treatment are critical to prevent serious complications. Recognising these symptoms and seeking care promptly can protect liver health and save lives.

References

Indian Council of Medical Research (ICMR) – Hepatitis and Liver Disease Reports
World Health Organization (WHO) – Jaundice and Hepatitis Guidelines
National Family Health Survey (NFHS-5) – Liver and Metabolic Health Indicators
Lancet – Liver Function and Bilirubin Research
NITI Aayog – Non-Communicable Diseases and Liver Health
Statista – Liver Disease and Hepatitis Trends

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