The vast majority of corona patients are cared for by my colleagues, the GPs at the HMOs. We know them by their health, treat them during their illness and monitor them long after they have been released from isolation in their home or hospital. As a family medicine practitioner for many years, in parallel with management positions and teaching emergency and disaster management at the university, and communicating with many hundreds of colleagues, I seek to suggest, from countless observations, the existence of a new disease: Total lockdown disease.
To define a disease it must be shown that it has characteristic signs, etiology, course, complications and if possible also treatment. Signs of quarantine are: anxiety, depression due to loneliness and job loss, obesity and sports injuries from inactivity or alternatively from a forced change in character, psychosomatic symptoms such as headaches and abdominal pain, out of balance of chronic diseases such as diabetes and hypertension, delayed arrival in urgent treatment of conditions Life-threatening as heart attacks and strokes, and failure to perform screening tests resulting in a delay in diagnosing serious diseases such as cancer.
The disease begins in the prodrome even before the closure is imposed as a result of anxiety and uncertainty about what the Corona cabinet’s decision will be in an hour, culminates in the closure period and its damage lasts long after it
The course of the disease is characterized by being sub-acute: the disease begins in the prodrome even before the closure as a result of anxiety and uncertainty about what the Corona cabinet’s decision will be in an hour, culminating in the closure period and lasting long after closure, many months and possibly years.
Among the complications of the disease that can be noted: suppression of the immune system (while there is an outbreak of a contagious disease), domestic violence, post-trauma syndrome, suicide, increase in forced psychiatric hospitalizations and increased mortality from all the conditions described above.
Demonstrates protest against closure. Photo by Tomer Neuberg / Flash 90
The proven etiology of the disease is completely iatrogenic: the recurring general closure imposed by a government that has lost its mind in the face of a corona outbreak, a contagious disease of mild to moderate severity whose severe damage is almost exclusively in adults and people with background diseases. The full closure, which included the closure of the education system and all commercial, cultural and leisure activities, draconically restricted the movement of the entire population for an extended period and left many people stranded in their homes, which directly led to the development of quarantine disease on a very large scale.
The treatment is to make a decision to manage the corona outbreak in a different way, fueled by an understanding of the content world of epidemics and a realistic risk assessment, in which a full closure is not part of the arsenal of possible steps
As is well known, the preferred treatment for any disease is prevention and treatment of its causes, rather than symptomatic treatment. In this sense, we had a rare opportunity for a particularly effective preventive treatment with a 100% chance of cure. The treatment is to make a decision to manage the corona outbreak in a different way, fueled by an understanding of the content world of epidemics and a realistic risk assessment, in which a full closure is not part of the arsenal of possible steps.
Da Aka, the treatment involves a change of perception and consciousness among policymakers and decision makers, people who by nature have a developed ego and a belief in the rightness of the way, on whom the plague has fallen since March, crippling fear that led to tunnel vision and group thinking in decision making. In the blink of an eye, they forgot the definition of what is the health of the World Health Organization: “a state of perfect physical, mental and social well-being, and not just the absence of disease.”
In order to help decision makers flex their thinking and broaden their perspectives, they are offered to get out of the Knesset and in front of the plasmas, go down to the field, clinics, hospitals, schools and shops and talk to citizens, caregivers and patients. The endless ones will go out into nature, into the open air where there is no need to wear masks, take a deep breath and avoid making decisions for a day or two.
In this vital time-out they will take from the “guidelines” fever, one can do a mental exercise in which they will go back in time to 2019 and ponder: If they were told in 2019 that in 2020 a viral disease would break out in the world and in the country of the Corona, would they consider taking drastic steps against it as a closure Full, whose price will be full quarantine disease, unemployment, business crushing, and their cost to the economy is 160 billion shekels?
What these people would do in 2019 is open up plans that are ready for an unusual biological event (which have been neglected and forgotten). What did their eyes see? That the severity of the coronary eruption does not touch even the most lenient scenario for which the plans were prepared, that Israeli hospitals have a great capacity to increase their capacity for hospitalization to prevent insufficiency, and that full closure was never included in responses to a much worse catastrophe. Then it is possible that their own anxiety levels would drop: the rapid pulse slows, the dry mouth moistens, and the vision becomes clearer to see that the corona plague can be dealt with by relatively simple, much less harmful means, and a more rational balance between morbidity and restrictions, and coronary heart disease.
Along with strengthening the necessary public trust in times of crisis and strengthening a health system that has been weakened for years, dealing with the crisis is expected to be much more successful.
Ultimately, closure does not reduce morbidity and mortality from an epidemic. And in general, since when do you fight one disease by causing another disease, the consequences of which are probably more severe?
The main challenge in crisis management is perceptual and mental. Perceptual change among medical professionals, plus the strengthening of their spine to stand their ground in the face of the political echelon, will lead to the complete success of preventive and curative treatment for both quarantine and coronary heart disease. The political echelon, which is also plagued by terror, confusion or lacks in impure intentions, will have no choice but to draw confidence from professionals and change the way it thinks and conducts itself in the management of the crisis.
In this way the evolving dichotomous thinking that it is either a mass vaccination or a complete closure will also dissolve. Reality is made up of nuances: this dichotomous thinking is unrealistic and even destructive. Proponents of the closure argue that closure reduces morbidity. Well, the medical consensus today is that closure only reduces morbidity temporarily and that it does not reduce morbidity and mortality from an epidemic in the end. And in general, since when do you fight one disease by causing another disease, the consequences of which are probably more severe?
In conclusion, this proposes a new medical diagnosis: quarantine disease. The markers, etiology, course, complications and late side effects were described. On the face of it, the severity of the disease and its damage appear to outweigh Corona disease. A treatment was presented whose effectiveness is expected to be very high, its cost is low, and can therefore be approved in a faster procedure even with the approval of the new vaccines. It is still necessary to collect data on the prevalence of quarantine disease and present them to the public, but it is quite clear that the disease of varying severity affects the entire population of the country even more than the coronavirus patients. Precisely because of this, preventative treatment by way of avoiding a full locksmith is likely to be very effective.
At the same time, a clear statement from medical personnel and an immediate government decision is needed to remove a decision on another general closure from the discussion table and public discourse. Yet it will still be left to the health, welfare and education systems to deal with the long-term damage of the first and second quarantine diseases, which may last for years.
Dr. Yoav Yehezkeli, Independent Family Physician, Specialist in Internal Medicine and Medical Administration; Lecturer in the Emergency and Disaster Management Program at Tel Aviv University; Served as Deputy Hospital Director, District Physician and District Manager and Division of HMOs