The COVID-19 pandemic is having a significant impact on populations, health systems, public health programs, and economies around the world. The priority is clearly to prevent infection, reduce transmission and provide adequate care and treatment for COVID-19 patients, but non-communicable diseases (NCDs) or non-COVID continue to represent the heaviest burden in the world. health field and also require special care.
Some statistics of this worrying situation
Services for the prevention and treatment of noncommunicable diseases (NCDs) have been severely affected since the start of the COVID-19 pandemic in the region of the Americas, according to a survey by the Pan American Health Organization/World Health Organization. Health (PAHO/WHO).
The virtual survey, which was completed globally by 158 countries and regionally by 28 PAHO Member States over a four-week period in May, confirmed that the impact is global and that the interruption of routine health services constitutes a threat to the health of people living with chronic diseases.
“This situation is very worrying because it puts people living with NCDs at higher risk of becoming seriously ill if they become infected with COVID-19 and dying,” said Anselm Hennis, Director of PAHO’s Department of Noncommunicable Diseases and Mental Health, during a press teleconference organized by the NCD Alliance, Healthy Latin America Coalition and Mexico Salud-Hable.
Since the pandemic began, routine health services have been reorganized or disrupted, and many have stopped providing care to people being treated for conditions such as cancer, cardiovascular disease, and diabetes. Additionally, many health care workers who typically provide this care were redirected to the COVID-19 response. “Treatment and care for these people must continue,” said Dr. Hennis. “Countries need to find innovative ways to ensure their continuity while dealing with COVID-19.”
Before COVID-19, 81% of all deaths in the Americas were due to NCDs. It is estimated that 62 million people in the Americas live with diabetes and 1.2 million people live with cancer in Latin America and the Caribbean. Additionally, around 1 in 4 people in the Americas are at increased risk of severe illness and death if infected with COVID-19 from living with a chronic disease.
In late May, PAHO Director Carissa F. Etienne warned that failing to provide care for NCDs during the pandemic could lead to “a parallel epidemic of preventable deaths of people” with chronic diseases.
Limited access to services
Ambulatory health services have been partially interrupted in 18 countries surveyed (64%), two have completely interrupted them and in seven countries (25%) they have remained open. These interruptions have affected all types of care for people with NCDs, but even more so for diabetes, hypertension, dental care and rehabilitation services.
The main reasons cited for the interruption of ENT services include the cancellation of elective care services (58%, 14/24), clinical staff being reassigned to the COVID response (50%, 12/24), and patients who do not present (50%, 12/24).
Reassignment of staff
In the majority (89%) of the countries in the Americas that responded to the survey, the staff of the ministries of health working in the area of NCDs were partially or totally reassigned to support the response to COVID-19.
Postponement of public screening programs (for example, for breast and cervical cancers) has also been widespread, as reported by 43% of countries. This was in line with initial WHO recommendations to minimize non-urgent care in health facilities while fighting the pandemic.
However, the most common reasons for interrupting or reducing services were the cancellation of planned treatments, the decrease in available public transport, the fear of attending care centers and the lack of staff due to the fact that health workers had been reallocated to support COVID-19 response services. Additionally, some countries experienced disruptions in supply chains, as well as challenges in the distribution of medicines and health products, all of which affect access by patients.
Alternative strategies for continuity of care
The encouraging findings of the study were that alternative strategies have been established in most countries to enable the most vulnerable people to continue receiving NCD treatment. Among the countries that reported interruptions in services, 61% are currently using telemedicine (advice by telephone or electronic means) to replace face-to-face consultations, 70% said they have used triage to determine care priorities, 57% % have adopted novel NCD drug dispensing and 52% have redirected patients to alternative care settings.
“These disruptions will likely impact health outcomes for these vulnerable populations,” Dr. Hennis said, calling for “further efforts to ensure NCDs are included in national COVID-19 response plans and to ensure safe methods.” to provide essential clinical care for people with NCDs during the pandemic.”
