PAHO: ‘Parallel epidemic’ as COVID bumps NCD care

A “parallel epidemic of preventable deaths” is looming, the Pan American Health Organisation warned today as patients with non-communicable diseases (NCDs) are sidelined in the fight against the coronavirus.

With one in four people in the Americas at higher risk of worsening illness and death from COVID-19 due to underlying NCDs, PAHO Director Dr Carissa Etienne stressed the response to the COVID-19 pandemic must include chronic disease care.

The warning came in the PAHO director’s weekly briefing to journalists where she declared the Americas the epicentre of the COVID-19 pandemic with more than 2.4 million cases and over 143,000 deaths.

Pointing to the hike in cases in Brazil,  Peru and Chile, she appealed to countries not to relax “restrictions or scale back preventive strategies. Now is the time to stay strong, remain vigilant and aggressively implement proven public health measures,” Dr Etienne said.

“We have never seen such a deadly relationship between an infectious disease and Non-Communicable Diseases. Some of the data are truly alarming. Especially for our region, where NCDs are pervasive,” she said. “We need aggressive preventive measures to protect people with diabetes, respiratory and cardiovascular diseases from the new coronavirus.”

Diabetes, stroke, hypertension, heart disease, cancer and obesity are already among the leading causes of death in the hemisphere.

People with diabetes are twice as likely to have severe disease or die, and 28 per cent of cancer patients who contracted COVID-19 died, compared with two per cent of overall patients, she said, citing recent studies. Smoking also increases the chance of severe disease from COVID-19.

Stay-at-home measures, disruptions in provision of health care services, as well as the fear of attending care facilities, have resulted in reduced elective clinic visits and lower access to kidney dialysis, cancer care, and delays in high priority treatments for patients with NCDs, Dr Etienne said. Many health workers who normally provide care for people with chronic disease “have been redirected to the COVID-19 response, adversely impacting the timely diagnosis and treatment of NCDs”, PAHO’s Director added.

Lower access to care from disruptions in health care services “puts patients at higher risk of complications and death from diseases which we know how to treat,” and health systems must find ways to respond “or we will be faced with a parallel epidemic of preventable deaths of persons with NCDs,” Dr Etienne said.

Prior to COVID-19, 81 per cent of all deaths in the Americas was due to NCDs and 39 per cent of these deaths was premature, occurring before 70 years of age. The PAHO Director said it was important to find safe methods of delivering essential clinical care for people with NCDs during the pandemic. “For example, many countries are quickly scaling up telemedicine, prioritizing scheduled appointments to avoid crowded waiting rooms and providing services in novel ways.”

Dr Etienne said that countries should ensure that supply chains for essential NCD medicines are protected and continue to function efficiently and that these products are distributed to the people who need them.

“We also must ensure timely access to care for chronic diseases to prevent them from becoming life-threatening. PAHO is working with countries in the region and providing guidance to help plan and implement these measures. As cases continue to rise in our region, our efforts to protect those with underlying conditions must intensify,” she said.