Guest Blog: COVID-19 and Social Distancing - Learning Humane Lessons of Medicine

Over the last month, our lives have witnessed possibly the largest global emergency since World War II. While we are all killing time, adapting to work from home and occasionally also bored, even in the most favourite corners of our homes, social distancing has given us an opportunity to come to closer to self.

While we have the most learned epidemiologists, scientists, super specialists and clinicians to do justice to take us through the science of COVID-19 as a disease, here is my attempt to pen down my three introspections which I largely took for granted until COVID-19 hit us and almost gave us newer goals of compassion, common sense and composure

1. Life of Chronically Ill Non-Ambulatory Patients

If a 21-day lockdown made us feel miserable, it's time that our heart goes out to individuals with chronic illnesses leading to non-ambulation like stroke, degenerative neurological conditions, geriatric population with severe musculoskeletal and movement limitations, etc. Their challenges are far beyond the ones we are addressing through therapeutic management. How do we help them? Compassion, and little efforts to help improve their social health could certainly be of great help in enhancing their quality of life.

2. Simple things in Medicine Work – Lets give them more chances

It took a massive pandemic for us to realise that modalities like "behavioural interventions" (social distancing in case of COVID-19) could make a huge impact in improving outcomes, more so in the longer run than immediately.

History has been a testimony that acute infectious illnesses often succeeded in seeking more attention, panic and in bringing out inadequacies in our care systems and practice approaches, and for the right reasons.

However, can we be more enthusiastic in reinforcing "behavioural interventions" to improve outcomes in chronic lifestyle illnesses like cardiovascular diseases, diabetes, hypertension, cancer? It is certainly arguable that acute and chronic diseases are not apple to apple for comparison, the behavioural interventions for the latter not well defined, and hard end points of benefits are not fully ascertained. While it is yet again evident that acute illnesses come straight to our face, it is the chronic illnesses that create a lot of deadwood over time, subsequently leaving the body crumbled in complications over a longer period.

As unassuming as the concept may sound, it needs to be borne in mind that COVID-19 will one day succumb to a vaccine and may even be eradicated, but chronic lifestyle illnesses will only lead way for more drugs that may add longevity with unknown effects on quality of life in the real world, in turn increasing the burden on healthcare systems, government and society. Simple interventions like well-engineered kneecap and weight loss in osteoarthritis, weight loss in PCOS, yoga in hypertension, exercises to improve insulin action are cost-effective behavioural interventions to make a valuable and sustained difference. Well, papers on poor patient compliance and adherence to lifestyle interventions may have often discouraged us to reinforce them, but behavioural interventions have always been always tough (just like this lockdown) and will demand diligence of stakeholders (healthcare professionals and patients) involved.

3. The Pursuit of Unhappiness?

We aspired binging on Netflix, cherishing marathon sessions with our kindle, doing nothing and just chilling with our favourite cup of beverage in the sweetest spot of our homes, social distancing gave us ideal circumstances for fulfilment of our dreams, still it has left us uncomfortable, drained, and brought a certain sense of void. Why?!

Uncertainty, anxiety regarding the coming weeks, economic implications have cluttered our minds and are justifiable confounding factors leading to this state of mind. After eliminating these factors, the simplest answer could be, we are social beings, with forever evolving priorities. There is an interesting theory I would like to leave for the readers as healthy "food for introspection"

"Humans are not designed probably to achieve 'sustained' happiness. Instead, we are designed primarily to survive like every other creature in the natural world. A state of 'sustained' contentment is discouraged by nature because it would lower our guard against possible threats to our survival. The fact that evolution has prioritized the development of a big frontal lobe in our brain (which gives us excellent analytical abilities) over a natural ability to be happy, tells us a lot about nature's priorities."

After COVID-19 social distancing fulfilling our stay-at-home aspirations, will we be happiest the next time we achieve something we desire? Yes, but will our happiness be sustained for ever? Probably, not. Achieving equanimity of mind seems a plausible answer to me.

Final Words

This is a unique time for us to be living in this generation. It's an opportunity for us to introspect, experience a sudden vacuum amidst living in times of abundance, to record and share our thoughts. Our experiences, more so as healthcare professionals will serve as important experiential learnings for our forthcoming generations and may give them insightful perspective and directions.

Let's be privileged story tellers of COVID-19. Stay home, stay safe, introspect and record!!

References

Adapted from:

1. Rafael Euba, Humans aren't designed to be happy – so stop trying, The Conversation, July 19, 2019, URL: http://theconversation.com/humans-arent-designed-to-be-happy-so-stop-trying- 119262

2. Ladislav Kováč, The biology of happiness, Chasing pleasure and human destiny, European Molecular Biology Organization Reports 2012;13(4):297-30

Dr Jeegar P Dattani is a columnist with Medical Dialogues and specializes in health communications and trainings. His areas of interest include Evidence Based Lifestyle Interventions and Latest Innovative Medical Updates

Disclaimer: The views expressed in the above article are solely those of the author/agency in his/her private capacity and DO NOT represent the views of Medical Dialogues.