DR MAXWELL ADEYEMI
It is no secret that covid19 is raging and wreaking havoc all across the globe and our country is not spared of this catastrophic event.
Underlying this serious problem however is a quieter but equally devastating one; the non-communicable disease including hypertension, diabetes, cancers and heart diseases that we may be tempted to pay less attention because of global preoccupation with covid19 pandemic.
Here as in many parts of the world, most patients who have died from covid19 have had underlying medical conditions and comorbidities, mostly non-communicable diseases. Heart diseases and diabetes in particular may be associated with more severe cases of covid19.
Globally, the disruption of continuity of care is escalated as covid19 transmission increases. If left unchecked, these disruptions might result in more death from other diseases than from covid19.
It is expected that in this crisis period that patient visits to health care facilities have fallen drastically, many health workers have been diverted from routine duties to provide covid19 care, Clinics have closed or ceased offering non-emergency services and stocks of medicine and diagnostic testing resources may dwindle owing to disruptions in global supply chains or increased demands on the limited available finances.
A recent study in the United Kingdom revealed that the number of heart attacks diagnosed fell by forty per cent during the covid19 pandemic because patients were not going to the hospital over fears they may catch the covid19. Yet in another study, hospital admission for strokes also fell by thirty-one per cent.
Many countries are also reporting that immunisations against infectious diseases such as measles, mumps and chicken pox are down during this pandemic, a development that can trigger the re-emergence of diseases if not properly addressed and managed.
It is extremely important to strengthen health services and policies to prevent and treat infectious and non-communicable diseases at this crucial time. Combating avoidable sickness and death from non-communicable diseases starts with paying attention to these diseases despite the menace of covid19, funding preventive programmes, care, treatment and rehabilitation services. This will allow health care workers to provide better services for people with non-communicable diseases throughout the pandemic and beyond.
The health system can make changes that makes it safer for people with non-communicable diseases to continue to receive care during the pandemic. These may include scaling up community delivery of medications, extending the duration of prescription so that patients need to refill them less frequently.
Leveraging technology such as telemedicine and virtually delivered health care intervention will be most useful and can reduce the need for physical meetings between health workers and patients, including those with non-communicable diseases who often require frequent outpatient visits. And just as education is embracing technology in various ways to deliver its mandate, health care delivery will have to adapt to use of these technological options to achieve its goals.
As we work to maintain life-saving care for patients with chronic non-communicable diseases during covid19, we must not lose sight of the factors that cause the conditions such a poor dietary habit, lack of exercise, smoking, alcohol abuse and stress, all of which may increase during covid19 lockdown measures and though preventable, may exacerbate the ill health condition.
Policies and guidelines that improve healthy lifestyles and focus on improving the health of the entire population, reducing our risk from covid19 and mitigating the impact of comorbidity with infectious diseases, should be encouraged and implemented at this crucial time.
Patients need to recognise that even though covid19 is raging, the discipline to prevent and control, if already diagnosed, chronic diseases is their responsibility, therefore healthy eating, compliance with medications, regular exercise, in as much creative ways as possible within the allowed regulations, are very important.
Home testing and monitoring of blood sugar and blood pressure as well as regular conversation with your health care provider, even if via telephone conversation and social media when physical consultation is not feasible, are essential.
Another significant area of health that could witness an eruption is mental health, the reality now is that people are “stressed”. With covid19 comes an increased level of stress and different forms of stressors across all ages. The elderly are lonely and isolated, the working class is fearful of getting sick, many are losing their jobs or experiencing financial stress, mothers are stressed owing to limited options in childcare assistance and children supervision (worse still if they are working, single mothers who will now have to add school work supervision owing to the new normal online teaching); students are stressed owing to prolonged home stay and less school, outdoor or extra-curricular activities; employers and businesses are stressed owing to low economic activities. Stressors from job losses, death of loved ones and financial problems that may occur with covid19 increases the odds of depression
As this pandemic continues, a higher emphasis needs to be placed on mental health services and preventive services to mitigate feelings of anxiety or sadness even before they begin, in order to avoid upsurge in depressive illnesses that may not only affect adults but teenagers and children
The essentials of primary health care and preventive behaviour on chronic non-communicable diseases should not be relegated at this time.
The intersection of covid19 and non-communicable diseases creates a double threat to the health of our population and we should therefore take concrete steps both to prevent non-communicable diseases and to maintain the treatment of those already living with these conditions during the pandemic. If we fail to maintain a balance and focus mainly on covid19, we may wake up one day during the pandemic or after the pandemic is over and realise we have a bigger epidemic on our hand silently created by NCDs and fuelled by conditions imposed on us by covid19 pandemic.
Contact Dr Maxwell on 363-1807 or 757-5411.