Correspondence Collateral effect of COVID-19 on public health in low-resource countries Vadisha S Bhat Dear Sir, The COVID-19 pandemic, which has spread with an unexpected higher velocity, has broken the backbone of the conventional healthcare system in many countries. As COVID-19 is more contagious than the SARS pan- demic of 2003, the number of new cases is increasing exponentially worldwide across all socioeconomic and racial strata. 1 In a low-resource country such as India, even though COVID-19 is not as aggressive as seen in some European countries, the collateral effects on health are a matter of concern. 2 The fear caused by the pandemic and the regulations by the authorities to control the spread of COVID-19 has put the lives of few non-COVID-19 patients at risk. This fear is more relevant to vulnerable groups such as the elderly and immunocompromised people. Essential investigations and treatments are delayed for few non-COVID-19 patients who reside close to the geographical area where a COVID-19 patient resides, which is designated as containment zones. 3 Diagnosis and treatment of dis- eases like head and neck malignancies, which are among the common malignancies, were also delayed, where the results are better if diagnosed and treated early. 4 Evaluation of critical conditions like stroke is also affected, even in high-resource countries. 5 Collateral effects of COVID-19 can be due to three reasons: delay from the patient to seek healthcare; over- cautious hospitals working in a defensive mode; and administrative policies. In a situation of lockdown, those people residing in a distant area are not able to visit a hospital due to the non-availability of transport facilities. Even hospitals are not able to offer all the possible services, though they were serving the emer- gencies. The spread of infection from an asymptomatic COVID-19 patient is the primary concern of most pri- vate hospitals when treating any other illness. Hence most of the hospitals have put all elective medical and surgical procedures on hold. In a country like India, where the land is divided into different states, the COVID-19 pandemic has limited the movement of the people across state borders. People residing near the borders had to face the maximum collateral effects. A person who was availing treatment for a particular illness from a hospital situated in a different state could not continue with the same treatment after the pandemic, as the state borders were closed to prevent the spread of the disease. 6 In countries such as India, COVID-19 brought some significant changes to the field of healthcare. The healthcare system seems to be coming out of fear and has started delivering hope to the general public. As nations come out of lockdown, the management of semi-emergent and elective surgeries is also a chal- lenge. 7 An additional cost of appropriate personal pro- tective equipment will be a burden to the system. Now it is time to accept COVID-19 as a part of medical practice and extend standard care to all patients with due precautions. Let us not ignore non-COVID patients out of fear and let us offer them the best pos- sible care. Declaration of conflicting interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The author(s) received no financial support for the research, authorship, and/or publication of this article. ORCID iD Vadisha S Bhat https://orcid.org/0000-0002-8510-0785 References 1. Summary of probable SARS cases with onset of illness from November 1, 2002, to July 31, 2003. Available at: https://www.who.int/csr/sars/country/table2004_04_21/ en/ (last accessed 21 May 2020). 2. Coronavirus Update. Available at: https://www.world- ometers.info/coronavirus/ (last accessed 21 May 2020). Professor, Department of Otorhinolaryngology, KS Hegde Medical Academy, Mangalore, Karnataka, India Corresponding author: Vadisha S Bhat, Professor, Department of Otorhinolaryngology, KS Hegde Medical Academy, Nitte (Deemed to be University), Mangalore 575018, Karnataka, India. Email: bvadish@yahoo.co.in Tropical Doctor 0(0) 1–2 ! The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/0049475520941276 journals.sagepub.com/home/tdo