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Published on: May 22, 2020
1 minute read
By: Dr Rajan Choudhary

Corona Virus In Young Patients And Kids

Kids seem to be relatively unaffected by COVID, but this does not mean they are invulnerable. As with adults, some children have pre-existing cardiac, respiratory, or metabolic conditions, and are therefore more vulnerable to the effects of COVID. Interestingly, children appear to have one more symptom when infected with coronavirus – COVID Toes.

I personally came across this phenomenon recently, with a young patient asymptomatic for COVID who presented with unusual symptoms of dark bruises on his toes. This had been present for just a few days. He did not have any pain, itching, swelling, no recent trauma, or injury to the feet. Circulation to his feet was normal, with no other rashes or skin changes, no other abnormal features in the history to note. It was certainly an odd presentation and certainly could have been an example of COVID toes.

This new phenomenon was noticed in April and has not gained as much notoriety because it is fairly rare compared to the major COVID symptoms, such as fever, cough, and lethargy. Doctors have described lesions on the feet of young people, usually purple-colored, around the tips of the toes. They have been compared to chilblains, painful swellings on feet, and toes that appear in the cold. Similarly to chilblains they do not cause any permanent damage and usually regress in days to weeks.

It's not clear why they occur or the mechanism behind the discoloration, because the presentation is rare and in healthy patients. We know COVID can cause systemic inflammation and can increase the risk of clot formation. It may be that localized inflammation is occurring in the toes, causing the vessels to clamp down and reduce blood flow to the area. This is similar to the mechanism for chilblains forming in the foot. Micro-clotting could also be partially responsible for this phenomenon.

COVID Toes is not the only skin symptoms related to COVID. In a paper published in the British Journal of Dermatology, researchers described five common skin presentations in 375 COVID patients. These were:

Asymmetrical chilblain like lesions in the hands and feet, found in younger patients lasting up to 2 weeks.
Small itchy blisters in the trunk and limbs, found in middle-aged patients before they present with symptoms, lasting about 10 days
Pink or white areas of raised skin, itchy, usually on the body
Raised bumps called macropapules, lasting about a week, seen in more severe infections.
Mottled, blotchy red-blue skin (known as livedo) seen in patients with severe illness.

So if you are currently suffering from COVID or have recently recovered from an infection, and suddenly notice odd colored toes, you too may have a case of COVID toes.

Dr Rajan Choudhary, UK, Chief Product Officer, Second Medic Inc

www.secondmedic.com

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Only Health-Based Rewards: Why Wellness-Focused Incentives Drive Healthier Workplaces

Corporate rewards have traditionally focused on monetary incentives, gift cards or generic perks. However, organisations are increasingly realising that such rewards offer only short-lived motivation. Only health-based rewards, such as massages, gym bags and fitness trackers, represent a more effective approach to corporate wellness by reinforcing healthy behaviours that deliver long-term benefits.

In India, where lifestyle diseases are rising rapidly among working professionals, aligning rewards with health outcomes is no longer optional.

What Are Health-Based Rewards?

Health-based rewards are incentives designed specifically to improve or support employee wellbeing.

They focus on:

physical health
mental wellbeing
preventive care
recovery and stress relief

Unlike cash incentives, they encourage repeated healthy actions.

Why Traditional Rewards Fall Short

Cash rewards and generic gifts:

provide temporary satisfaction
do not influence daily habits
fail to support long-term wellbeing

Behavioural studies show that incentives disconnected from health goals have limited preventive impact.

The Case for Only Health-Based Rewards

Health-based rewards directly reinforce behaviours such as:

regular physical activity
stress management
recovery and self-care
preventive health participation

WHO workplace health guidelines emphasise incentives that promote sustained behaviour change.

Types of Effective Health-Based Rewards

Massages and Recovery Therapies

Massage therapy:

reduces muscle tension
lowers stress hormones
improves circulation

Monthly or quarterly massage rewards support physical and mental recovery.

Gym Bags and Fitness Gear

Practical fitness accessories:

encourage regular workouts
reduce barriers to exercise
promote active lifestyles

Visible gear reinforces identity as a health-conscious individual.

Fitness Trackers

Fitness trackers:

track steps, activity and sleep
create accountability
encourage daily movement

Data-driven feedback increases participation and motivation.

Psychological Impact of Health-Based Rewards

Health rewards create:

intrinsic motivation
positive habit reinforcement
long-term lifestyle shifts

Unlike cash, they associate rewards with self-care rather than consumption.

Impact on Employee Health Outcomes

Regular participation in wellness incentives leads to:

improved physical activity levels
reduced stress
better sleep patterns

ICMR data links activity-based interventions with lower lifestyle disease risk.

Benefits for Employers

Reduced Healthcare Costs

Preventive health rewards reduce chronic disease burden over time.

Improved Productivity

Healthy employees demonstrate:

better focus
fewer sick days
higher energy levels

Stronger Wellness Culture

Health-first rewards signal genuine organisational commitment.

EY-FICCI reports show preventive wellness programs deliver measurable ROI within 12–18 months.

Why Health-Based Rewards Work Better in India

Indian workplaces face:

long working hours
sedentary routines
high stress levels

Health rewards directly address these risks rather than ignoring them.

Aligning Rewards With Preventive Healthcare

Health-based rewards complement:

health screenings
fitness challenges
mental wellbeing programs

This integrated approach strengthens outcomes.

Avoiding Pitfalls in Reward Design

Effective programs:

avoid one-size-fits-all rewards
offer choice within health categories
ensure inclusivity

Poorly designed incentives reduce engagement.

Measuring Success of Health-Based Rewards

Success indicators include:

participation rates
health screening uptake
employee feedback
reduced absenteeism

Data-driven evaluation improves program effectiveness.

Long-Term Behaviour Change

Sustained wellness improvement requires:

consistency
reinforcement
meaningful incentives

Health-based rewards support gradual but lasting change.

Role of Leadership Support

Leadership participation:

increases credibility
boosts engagement
normalises wellness culture

When leaders embrace health rewards, employees follow.

Health-Based Rewards and Mental Wellbeing

Rewards such as massages and fitness trackers:

reduce burnout
improve mood
enhance resilience

Creating a Preventive Wellness Ecosystem

Only health-based rewards work best when combined with:

education
screenings
access to care

WHO emphasises integrated wellness ecosystems for maximum impact.

Conclusion

Only health-based rewards represent a strategic shift from short-term perks to long-term wellbeing investments. Incentives such as massages, gym bags and fitness trackers actively promote healthy habits, reduce lifestyle disease risk and strengthen workplace wellness culture. By aligning rewards with preventive health goals, organisations create meaningful engagement, healthier employees and sustainable productivity gains. Health-focused incentives are not just rewards—they are tools for lasting wellbeing.

References

Indian Council of Medical Research (ICMR) – Lifestyle Disease and Workplace Health Reports
World Health Organization (WHO) – Workplace Health Promotion and Incentives
National Family Health Survey (NFHS-5) – Adult Lifestyle Risk Factors
Lancet – Behavioural Incentives and Preventive Health Studies
NITI Aayog – Preventive Healthcare and Workforce Wellbeing
EY-FICCI – Corporate Wellness and Productivity Reports
Statista – Employee Wellness Incentive Trends

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