Coronavirus And Chronic Disease: A Perfect Storm
Anyone but not everyone……
It is no surprise that anyone can be infected by a covid-19 virus, sadly the virus seems to increase among people with pre-existing non-communicable diseases, the disease includes cardiovascular disease, cancer, diabetes, chronic respiratory diseases, stroke, and other NCDs. For decades academics and policymakers have been informed of the hazards of a viral pandemic with outcomes as overwhelming as Ebola in 2013, HIV/AIDs among many others. Nonetheless what they did not predict, however, was its synergy with a coexisting pandemic of chronic diseases. Coronavirus is a complete storm, NCDs and the risk factors associated with them are disproportionately high among all age groups in more disadvantaged communities.
Although older people are more likely to develop NCDs, NCDs in young people, as well as their underlying conditions such as cancer, Alzheimer’s, diabetes, and kidney disease, to name a few, are all linked to a high risk of serious illness, hospitalization, and COVID-19-related deaths, which are on the rise due to the pandemic.. Of particular concern is the association with cancer, heart, and respiratory diseases, associated with poverty in Rwanda and many parts of the world. In Rwanda, 10,704 new cancer was diagnosed, increasing the annual mortality rate in 2018 to 7,662 with an estimation of adult 18 years and above, 11.5% women, and 9.2% of men are obese although the percentage of obesity in Rwanda might not seem scary they are expected to keep rising if nothing is being done ahead of time.
Where is it heading!
COVID-19 and its variants have been mostly recognized as a vertical sickness globally, but it would make a lot more sense if we addressed the complete environment of our measures and responses to Covid-19’s relationship with not just poverty, but also chronic diseases. However, it is particularly important to note that deprivation and poverty are not just leading causes of death as a result of COVID-19 and the reaction. Poverty has been targeted by COVID-19 over the country, from Kigali to Rusizi to Huye, and it has been magnified as a powerful indicator of health, affecting adversely populations with a lack of care and health services. For example, in Rwanda, where marginalization is rife, is an intersection with poverty, NCDs patients in communities make up 90% of covid-19 victims in Rwanda, representing a significant percentage of the population.
(Hudson Kuteesa, 2020)
And it got even worse.
Measures including lockdowns, keeping a social distance, wearing masks, and hand sanitizing hygiene have led to health service disruption and access to screening, medicine, and other health services, NCDs included. As result health outcomes got worsened, particularly for vulnerable communities, disadvantaged by household food security. Access to social services was restricted or disrupted. Furthermore, in contrast to Rwanda, it is anticipated that half a billion people will face food insecurity, job loss, expensive healthcare, limited access to education, and increased unemployment as a result of the COVID-19 pandemic. extreme poverty. As a result, these will have a long-term impact on global morbidity and death.
So what is next?
However, sustainable development goals (SDGs), known as the duty to tackle typical fitness coverage, pandemic readiness, and continual diseases, have been built on the premise that complex social problems require complex solutions. There are no magic bullets when it comes to complicated multi-sectoral interventions, such as health, and the context and electricity of health structures matter. In a similar vein, the WHO Independent High-Level Commission on NCDs urged for the inclusion of NCDs and mental fitness into national SDG and traditional health insurance implementation. These desires and suggestions must be brought up in the face of COVID-19.
Given the connection between COVID-19 and NCDs, there is a critical issue that must be addressed: we must promptly discuss the fundamental drivers of the NCD pandemic that are driving up COVID-19 mortality rates. First and foremost, this necessitates adhering to the principles of “precision public health,” which emphasizes risk reduction for those who are most vulnerable. This will not be possible without improved information sharing. While the indicators clearly show that NCDs are a risk factor for COVID-19, global health researchers do not have access to granular statistics from the more than 400,000 deaths worldwide to investigate the role of competing risk factors, disorder history, treatment interactions, or other possible socioeconomic or demographic associations. It is offered for purchase or researchers should sign restrictive data sharing agreements if it is available.
Now that we know so what?!
Furthermore, we are aware of and capable of comprehending the hazardous factors in order to perform better. Even without these data, now is the time to shift from a vertical approach to a population-based approach to research associated hazards, goal prevention, involve interacting communities in the response, and create synergies across care platforms, notably between NCDs and infectious diseases. We must target those in danger with different localized solutions rather than employing blunt tools such as lockdowns to the entire population. At the same time, we must provide a roadmap for those who are socioeconomically vulnerable to offset the pandemic response’s consequences on poverty, which is a direct determinant of health. A good example of this strategy is being used in Pakistan, where the government has provided emergency money transfers to over eighty million people.
To yet, the worldwide response to COVID-19 has focused only on COVID-19, rather than the numerous people who are at risk. Fear and bewilderment have resulted, as well as a notable misallocation of resources. Is it too late to intervene in the current scenario?, since COVID-19 continues to spread and there are fears of a second wave and new varieties arising at any time. No, it’s not too late to start using the tools of precision, evidence-based public health and move away from a singular focus on COVID-19 deaths to tackling the underlying causes of illness and mortality. This possibility concentrates prevention efforts on those suffering from NCDs. It employs a 2030 Agenda for Sustainable Development perspective, which goes beyond a single public health endpoint to address several factors affecting population health.
Link to the infographic copy here:
- Cancer Centre. (2020, February 24). https://rbc.gov.rw/index.php?id=722
- https://www.facebook.com/HealthPolicyWatch. (2019). The COVID-19 And NCD Syndemic: Experiences From Rwanda, The UK, And India – Health Policy Watch. Health Policy Watch. https://healthpolicy-watch.news/79399-2/
- Hudson Kuteesa. (2020, October 26). Covid-19: 90% of victims in Rwanda had NCDs Minister.TheNewTimesRwanda.https://www.newtimes.co.rw/news/covid-19-90-victims-rwanda-had-ncds-minister
- Non-communicable diseases killing more people than ever before: UN health agency. (2020, December 10). UN News. https://news.un.org/en/story/2020/12/1079722
- Rwanda Key Message Update: COVID-19 lockdown threatens poor urban household food security, January 2021 – Rwanda. (2021, January 29). ReliefWeb. https://reliefweb.int/report/rwanda/rwanda-key-message-update-covid-19-lockdown-threatens-poor-urban-household-food
- Sania Nishtar. (2020, May 5). COVID-19: Using cash payments to protect the poor in Pakistan. World Economic Forum. https://www.weforum.org/agenda/2020/05/using-cash-payments-protect-poor-pakistan/