Podcast: The Detail

Lockdown’s hidden health issues

Some astonishing statistics are starting to filter through about unintended medical consequences from lockdown - including a downward trend in premature births. But are they all that they seem? 

The Covid-19 pandemic has been the biggest health story in town for most of the year.

But the lifestyle changes the pandemic has imposed on us have also had a big effect on other areas of health you might not expect – and some of them are baffling medical researchers.

Today on The Detail, Emile Donovan speaks to three medical professionals about interesting data coming out around the world regarding premature births; stroke and heart attack presentations; and the near-disappearance of seasonal flu in New Zealand.

Premature births

Of about 60,000 babies born each year in Aotearoa, around 5000 are born pre-term – defined as being born before 37 weeks of pregnancy.

Not all premature births are unplanned, and not all of them will necessarily have negative effects on the baby. But as a rule, the more pre-term a baby is, the greater the risk.

The specific cause of a premature birth often isn't clear, but there are risk factors: having a previous premature birth for example; smoking cigarettes or using drugs while pregnant; some infections and chronic health conditions can contribute, as can stressful life events; a short interval between pregnancies; and problems with the uterus, cervix or placenta.

Breathing, heart and brain problems, issues with gastrointestinal function, the baby's metabolism, and an underdeveloped immune system are all associated with very premature births, and longer-term, they can lead to increased chance of cerebral palsy, learning difficulties, issues with vision and teeth development, and increased chance of chronic health issues.

But many countries around the world, including Ireland, Denmark and Australia, are reporting an enormous reduction in the number of premature births they’re seeing – in some cases the drop is more than 70 percent – and Dr Katie Groom, an associate professor of maternal and perinatal health at the University of Auckland, says researchers are at a loss as to why.

“In New Zealand I think certainly anecdotally it seemed a lot quieter during lockdown, and that wasn’t just on all of the wards it was seen in NICU as well … but actually looking at pre-term birth rates we’ve seen no difference,“ she says. “But obviously over time we can look in more detail and it might be that we’ve had less of the very pre-term babies and therefore it seems like NICU is less busy because the very young ones stay the longest.”

While there isn’t yet any reliable data to see whether this trend is also occurring in New Zealand, Groom says the picture will become clearer over the coming months and years.

“It does take time to get population-based data that is useful and interpretable.”

Groom points out it may be the case that fewer pre-term births has led to an increase in the stillbirth rate, with very sick babies not being detected.

Seasonal flu

One of the big concerns when lockdown was first announced was what might happen if there were outbreaks of both coronavirus and the seasonal flu.

While it’s a ubiquitous disease which ramps up every year, the flu is still a serious illness, contributing directly or indirectly to the deaths of hundreds of New Zealanders annually.

The lockdown also neatly coincided with New Zealand’s “flu season”, which starts around April and can extend as long as October.

But this year, seasonal flu rates have been vanishingly low – down about 90 percent.

Dr Nikki Turner from the Immunisation Advisory Centre says increased awareness of personal hygiene and limited possibility of movement have been big contributors.

“What is absolutely dramatic and extraordinary is that we have seen very little flu this season at all,“ she says.

“We’re seeing the degree to which social distancing and responsible management of our coughs and colds have made a difference … and of course we did have the flu vaccination programme as well.”

And Turner says while these numbers reflect well on how seriously we’re taking public health messaging, it’s important to stay vigilant and keep doing things such as washing our hands properly.

“The traditional stuff we’ve always known about … what a difference it’s actually making.“

For the full story, including an explanation of why stroke and heart attack rates are also way down around the world (and why this could actually be a bad thing), listen to the podcast by clicking the play button at the top of the page.

Want more from The Detail? Find past episodes here.

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