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COVID-19 public health measures: a reduction in hospital admissions for COPD exacerbations
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  • Published on:
    Understanding the differences in impact of public health measures on hospital admissions for COPD exacerbations during the COVID-19 pandemic
    • Jing Yuan Tan, Internal Medicine Resident Singapore General Hospital
    • Other Contributors:
      • Edwin Philip Conceicao, Epidemiologist Executive
      • Liang En Wee, Infectious Disease Registra
      • Xiang Ying Jean Sim, Infectious Disease Consultant
      • Indumathi Venkatachalam, Infectious Disease Consultant

    We thank Brennan et al, for sharing their experiences. In contrast to our observed reduction of more than 50% in AECOPD hospital admissions over a 6-month period, Brennan and colleagues observed a reduction of only 18% over a 4-month period. In addition, while we saw a significant and sustained decrease, Brennan et al. observed a decrease only in the first month following lockdown. At the fundamental level, respiratory viruses can spread either via contact, droplet or aerosols[1] and thus in theory mask wearing, social distancing and increased personal respiratory etiquette and community hygiene would reduce transmission and contribute to reduced incidence of AECOPD. The use of masks has been shown to reduce exposure to acute respiratory viruses by 46%[2].

    We hypothesise that these differences could potentially be due to variations in the degree of adherence to mask wearing/social distancing, as well as nuances in public health measures introduced in various countries during the COVID-19 pandemic.
    For instance, Singapore had mandated face-mask wearing in April 2020. The observations reported by Brennan et al terminated in June 2020 while Ireland only mandated face-mask wearing in August 2020. and hence may not have captured the impact of compulsory mask wearing. The difference in timing of implementation and enforcement of government policies during the COVID-19 pandemic possibly contributed to a different experience in Ireland.

    Aside from early impleme...

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    Conflict of Interest:
    None declared.
  • Published on:
    Reduction in hospital admissions for Acute Exacerbations of COPD during COVID-19- A Different Experience
    • Michelle Brennan, Respiratory Registrar University Hospital Galway
    • Other Contributors:
      • Alicje Straszewicz, Respiratory Senior House Office
      • Dominic Doyle, Respiratory Specialist Registrar
      • Aisling Nolan, Respiratory Intern
      • Jack Rutherford, Medical Student
      • Helen Mulryan, Respiratory Advanced Nurse Practitioner
      • Nicki Byrne, Respiratory Specialist Nurse
      • Anthony O'Regan, Respiratory Consultant
      • Melissa McDonnell, Respiratory Consultant
      • Michael J Harrison, Respiratory Consultant
      • Robert Rutherford, Respiratory Consultant

    We read with interest the recent study by our colleagues Tan et al (1) which reported the introduction of public health measures during the pandemic, such as social distancing and universal mask wearing, were observed to coincide with a marked reduction in transmission of other circulating respiratory viral infections. They reported a reduction in hospital admissions with acute exacerbation of COPD (AECOPD) by over 50% during the six month period of the pandemic from February to June 2020. They supported this observation with microbiological data showing a significant reduction in PCR-positive respiratory viral infections compared to the pre-pandemic era.

    Ireland has the highest rate of hospitalisations for AECOPD in all OECD Countries (2). The first case of COVID-19 in the Republic of Ireland was reported on 29/02/2020 and stringent public health measures were introduced in mid-March to combat the spread (3).
    We wish to describe our experiences of hospital admission with AECOPD during the first wave of the pandemic in a tertiary referral hospital in the West of Ireland. In our clinical practice, we noticed a reduction in patients admitted with COPD exacerbations at the beginning of the pandemic. We aimed to evaluate the impact of these infection control measures on our COPD population.

    We conducted a retrospective cohort study of electronic health care records of patients who were hospitalised with a primary diagnosis of AECOPD over the four-month per...

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    Conflict of Interest:
    None declared.