A recent review of the literature found that people with noncommunicable diseases (NCDs) such as high blood pressure, diabetes, and chronic heart and lung diseases are doubly worse off during the ongoing pandemic.

All data and statistics are based on publicly available data at the time of publication. Some information may be out of date.

Researchers from Australia, Nepal, Bangladesh and India worked together to review the literature on COVID-19 and NCDs. They identified some key general trends and made recommendations for a holistic approach to helping people with pre-existing conditions.

The researchers found that NCDs and the COVID-19 pandemic are adversely affecting each other.

People with NCDs are at higher risk for severe COVID-19. At the same time, various aspects of the pandemic increase the risk of developing these diseases.

On the one hand, people with NCDs are more likely to have serious consequences if they develop COVID-19. On the other hand, their socio-economic circumstances and access to health care can be affected by public health responses.

The survey authors advocate a “syndemic perspective” in treating people with NCDs during the ongoing pandemic.

The term “syndemic” – short for “synergistic epidemic” – was coined in the 1990s. It refers to the interplay of socio-ecological and biological factors that lead to adverse outcomes.

During syndemia, people with NCDs are more exposed to risk factors such as mental health problems, inadequate access to health services, and poverty.

According to the present study, published in Frontiers in Public Health, the COVID-19 pandemic had turned into a syndeme by mid-June 2020. This is due to factors such as loneliness, financial insecurity and limited access to health care.

For example, due to loss of income, people are more likely to lower their food costs and potentially have poorer diets as a result. People with mental health problems may experience worsened symptoms due to isolation.

For people living with NCDs, such factors can increase their risk of severe COVID-19 and worsen their pre-existing conditions.

Lead author Uday Narayan Yadav’s goal – a Ph.D. Student at the University of New South Wales in Sydney, Australia – and the team should focus on low and middle income countries, although they also included supporting references from other countries.

They highlight some evidence in support of the idea of ​​higher rates of malnutrition and mental health problems in people with NCDs.

The researchers then hypothesize that people with pre-existing conditions who live with more social and economic deprivation are less likely to have access to health services during the pandemic.

Some measures aimed at reducing the spread of the virus responsible for COVID-19, such as lockdowns, quarantines and physical distancing, have made it difficult for people to access health services under other conditions.

A World Health Organization (WHO) survey of data from 155 countries found that 53% of those countries had partially or completely compromised services for people with NCDs.

Studies have also shown that negative coping mechanisms such as tobacco use and the consumption of unhealthy processed foods increased during the pandemic, adding further risks.

These and similar problems could worsen pre-existing conditions, leading to increased hospitalization and high societal costs.

To address the problem, the authors recommend that public health responses to the pandemic take into account not only individual health issues, but also a combination of pre-existing conditions and socio-economic status. That’s what they mean by a syndemic perspective.

The authors of the article highlight four areas where a syndemic approach can bring about positive change:

  • Basic deliveries and information dissemination: They demand a supply of basic necessities such as food and hygiene items, as well as the timely dissemination of information and the fight against fake news.
  • Self-government support at the community level: They urge health officials to educate and assist people with NCDs as they monitor their symptoms, follow treatment plans, and seek care. The authors note that traditional and social media, as well as community health workers, also play a crucial role.
  • Health care revitalization: They call for the continued use of digital health platforms to improve access to services and information needed for people with NCDs. This also depends on the increasing mobilization of healthcare workers.
  • Politics, advocacy and research: They call on governments, civil society organizations, researchers and the private sector to pool expertise and resources. International organizations, philanthropists and industrialists should also come forward to help countries facing financial crises.
  • Increased taxes on unhealthy items: These should be used to subsidize the cost of nutritious foods.

The authors emphasize that while their work has focused on low- and middle-income countries, some of their recommendations are relevant to places with more developed economies.

They also believe the syndemic approach will be helpful in combating future pandemics.

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