Dear Editor
On March 11, 2020, the World Health Organization announced a pandemic related to a new corona virus infection known as the COVID-19 which first started in Wuhan, China.1 Iran, aside to China, has experienced a massive increase in rates of COVID-19.2
The pandemic has affected the health care system in unexpected manners. We recently witnessed a significant increase in number of patients referring to our health care centers in Fars province with methanol poisoning. More than 200 cases of methanol poisoning were seen in one of our emergency departments in Namazi Hospital, Shiraz, Iran (unpublished data) in only a week time.
We suspect there are multiple potential causes for the increase in methanol poisoning. First, obtaining alcoholic drinks in Iran is far more difficult than in other countries in which the sale of alcoholic beverages is legal. This limited access to alcohol has been exacerbated by the emergence of COVID-19 in Iran where the disease has spread to more than 100,000 cases.2 Specifically, the large industrial use of ethanol for the manufacturing of hand sanitizers, which has been promoted for combating the spread of COVID-19, has created an unprecedented shortage in ethanol and has given way to individuals who were previously using ethanol for the manufacturing of alcohol beverages to shift to the use of methanol instead. As a result alcohol drinks are perhaps being spiked or, in other words, bootleg alcohol (using methanol) is being produced and used in some regions. Second is the misconception among the public that drinking alcohol-based drinks may be protective against COVID-19 and thus causing an increase in the use of alcoholic drinks. Finally, increased unstructured leisure time, decreased sports activity due to closure of gyms and the mass advertisement to the public to remain home have all led to increased use of alcohol drinks3 , 4 and this has added more difficulty to the fight against the COVID-19 issue in our region.
As seen in other countries in the world, many people are stocking up on items which are in any way related to sanitation in an attempt to fight the spread of the virus or simply due to the mass fear the pandemic has caused. As the Center for Disease Control and Prevention has advocated the use of hand sanitizers with a greater than 60% ethanol or 70% isopropanol for hand hygiene,5 these hand sanitizers are on low stock in most local markets due to the unprecedented public demand and use.
All this together suggests that COVID-19 may have affected aspects of the healthcare system which were not previously anticipated. However, research studies will be required to determine the validity of these arguments and the true impact of the above proposed events in promoting methanol poisoning.
AUTHORS CONTRIBUTIONS
P.A. aided in conceptualization, preparation of manuscript. M.P. and J.R. aided in conceptualization and critical revision of final manuscript. All authors approved the final form of the manuscript.
Footnotes
There is no conflict of interest to be declared regarding the manuscript
REFERENCES
- 1.World Health Organization, WHO director-general's opening remarks at the media briefing on COVID-19 – 11 March 2020. Published 2020. Available at: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19—11-march-2020. Accessed March 18, 2020.
- 2.World Health Organization . 2020. Coronavirus disease (COVID-2019) situation reports. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports. Accessed May 8, 2020. [Google Scholar]
- 3.Chen C-Y, Wang I-A, Wang N. Leisure activity participation in relation to alcohol purchasing and consumption in adolescence. Addict Behav. 2019;90:294–300. doi: 10.1016/j.addbeh.2018.11.017. [DOI] [PubMed] [Google Scholar]
- 4.Prieto-Damm B, Pedro A, Lopez-del Burgo C. Leisure activities and alcohol consumption among adolescents from Peru and El Salvador. Drug Alcohol Depend. 2019;199:27–34. doi: 10.1016/j.drugalcdep.2019.03.002. [DOI] [PubMed] [Google Scholar]
- 5.Center for Disease Control and Prevention, CDC statement for healthcare personnel on hand hygiene during the response to the international emergence of COVID-19.https://www.cdc.gov/coronavirus/2019-ncov/infection-control/hcp-hand-sanitizer.html. Accessed March 14, 2020.