COVID-19 Has ‘Severely’ Disrupted Chronic Disease Care, WHO Warns

A new survey by WHO has found that the COVID-19 pandemic has ‘severely’ disrupted the delivery of services to prevent and treat non-communicable diseases (NCDs) in almost 80% of countries surveyed – or 122 out of 150 countries.

This is of “significant concern” WHO said on Monday in a statement, because people with NCDs also are more vulnerable to COVID-19 infection and death. And even prior to the pandemic, some three quarters of all deaths worldwide were due to NCDs.

“It is not an understatement to say that the emerging evidence is dramatic,” said CEO of NCD Alliance Katie Dain on Monday, in response to the WHO’s findings. “People exposed to…unhealthy diets, smoking, alcohol use, lack of physical activity, and air pollution are far more vulnerable to COVID-19 infection, far more vulnerable to developing severe complications, and far more vulnerable to death from the virus.” 

In Italy, for instance, 98% of people that died from COVID-19 had pre-existing NCD conditions, including cardiovascular issues (67%) and diabetes (31%). According to the WHO’s estimates, diabetics are twice as likely to die from COVID-19 compared to people without diabetes.

A main reason for the neglect of NCD treatment has been the partial or full reassignment of healthcare staff to COVID-19 prevention and response – Which was reported in 94% of the 155 health ministries surveyed.

In the WHO’s rapid assessment, rehabilitation services were the most commonly disrupted NCD service – with a partial or total standstill in two-thirds of surveyed countries. Rehabilitation services often include physiotherapy, as well as other programmes supporting recovery from heart attack, stroke, surgery, amputations and COVID-19.

Said WHO in the statement, although rehabilitation is “key to a healthy recovery following severe illness from COVID-19”, it “continues [to be] wrongly perceived as a non-essential health service for all patients when for many patients it is essential.” 

COVID-19 has also upended other services like hypertension, diabetes, cancer treatment and cardiovascular emergency services – with over half of countries reporting disruptions in hypertension management services, and about half of countries with disruptions in diabetes services. 

When outbreaks were more severe, NCD services were more likely to be disrupted – an  ‘unsurprising correlation’, said the WHO statement.

For instance, only 35% of countries reported disruptions in diabetes services when transmission was sporadic. However, this number almost doubled when outbreaks were transmitted at the community level. 

And the standstill in chronic disease services is likely to disproportionately affect low-income countries as they struggle to incorporate these essential services into national COVID-19 plans.

New Ebola Outbreak in Northwestern Democratic Republic of Congo

Wangata hospital in the Democratic Republic of Congo

On Monday, a new outbreak of Ebola virus disease was detected in Northwestern Democratic Republic of the Congo (DRC), said WHO Director General Dr. Tedros Adhanom Ghebreyesus. So far, six Ebola cases were identified in the Wangata region, of which four have died and two are alive and under care, said the WHO in a statement. 

The announcement follows a “complex Ebola” outbreak in Eastern DRC, which “seems to be in its final phase”. On 14 May 2020, DRC’s Ministry of Health began the 42-day countdown to declare the end of the Ebola outbreak in Eastern DRC.

“This is a reminder that COVID-19 is not the only health threat people face,” said Dr Tedros.

To reinforce local leadership, the WHO will deploy a team “to support scaling up the response”, said WHO Regional Director for Africa Matshidiso Moeti. “Given the proximity of this new outbreak to busy transport routes and vulnerable neighbouring countries, we must act quickly.”

Total cases of COVID-19 as of 1 June 2020, with active case distribution globally. Numbers change rapidly.

Meanwhile in South America, cases “have not reached peak yet”, said WHO Emergencies head Mike Ryan. In the past week, South America has emerged as the epicentre of the COVID-19 pandemic- And in the past day, five of the ten countries reporting the highest number of COVID-19 cases were in the Americas, including Brazil, the USA, Peru, Chile and Mexico.  

While deaths in Brazil were almost on-par with the USA in the past day, Brazil’s new cases (33 274) in the past 24 hours were double that of the US (17,962), according to the latest WHO situational report.

As of Monday, a cumulative toal of 6.2 million cases of COVID-19 were reported across the world. More than 373,000 people have lost their lives as a result, said Dr. Tedros.

Tsering Lhamo contributed to this story.

Image Credits: WHO, Johns Hopkins CSSE.