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COVID-19 significantly affects health services for noncommunicable diseases
GENEVA – Non-communicable disease prevention and treatment (NCD) services have been severely disrupted since the onset of the COVID-19 pandemic, a WHO study released today showed. The survey, which was completed by 155 countries over a three-week period in May, confirmed that the impact is global, but that low-income countries are most affected.
This situation is of great concern because people living with NCDs are at higher risk of serious diseases and deaths associated with COVID-19.
“The results of this research confirm what we have been hearing from countries for several weeks now,” said Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Many people who need treatment for diseases such as cancer, cardiovascular disease and diabetes have not received the health services and medicines they need since the beginning of the COVID-19 pandemic. It is vital that countries find innovative ways to ensure the continuation of essential services for NCDs, even when fighting COVID-19. “
Service interruptions are widespread
The main finding is that health services have been partially or completely discontinued in many countries. More than half (53%) of the countries surveyed partially or completely disrupted hypertension treatment services; 49% for the treatment of diabetes and complications associated with diabetes; 42% for cancer treatment and 31% for cardiovascular emergencies.
Rehabilitation services have been discontinued in almost two-thirds (63%) of countries, although rehabilitation is key to a healthy recovery after a severe illness from COVID-19.
Deployment of staff and postponement of screening
In the majority (94%) of countries that responded, the Ministry of Health staff working in the NCD area was partially or fully assigned to support COVID-19.
Delays in public screening programs (for example for breast and cervical cancer) have also been widespread, reported by more than 50% of countries. This is in line with the WHO’s initial recommendations to reduce emergency care at the facility while addressing the pandemic.
But the most common reasons for discontinuation or reduction of services were cancellation of planned treatments, reduction of available public transport and lack of staff because health workers were redirected to provide COVID19 services. In one in five countries (20%) that reported disruptions, one of the main reasons for service outages was a lack of drugs, diagnostics and other technologies.
Not surprisingly, there appears to be an association between levels of disruption of NCD treatment services and the evolution of the COVID-19 epidemic in a country. Services are becoming increasingly disrupted as the country shifts from sporadic cases to coronavirus transmission in the community.
Two-thirds of countries worldwide reported including NCD services in their COVID-19 national preparedness and response plans; 72% of high-income countries reported inclusion compared to 42% of low-income countries. Services to combat cardiovascular disease, cancer, diabetes, and chronic respiratory diseases are most commonly covered. Dental services, rehabilitation, and tobacco cessation are not as widely included in response plans according to country reports.
Seventeen percent reporting countries have started allocating additional funds from the state budget to include the inclusion of NCD services in their national COVID-19 plan.
Alternative strategies for continuous care are being implemented
Encouraging research findings have shown that alternative strategies have been established in most countries to support those most at risk of continuing to receive NCD treatment. Among countries reporting termination of services, 58% of countries globally use telemedicine (telephone or online counseling) to replace personal consultations; in low-income countries this figure is 42%. Prioritization procedures are also widely used in two thirds of countries reporting reports of widespread use.
It is also encouraging that more than 70% of countries have reported collecting data on the number of COVID-19 patients who also have NCDs.
“It will be a while before we find out the full extent of health care disorders during COVID-19 on people with non-communicable diseases,” said Dr. Bente Mikkelsen, director of the WHO’s Department of Noncommunicable Diseases. “However, what we now know is that not only are people with NCD more susceptible to becoming seriously ill from the virus, but also many are unable to access the treatment they need to manage the disease. It is very important to take care of people living with NCDs includes in national response plans and readiness for COVID-19 -̶, but to find innovative ways to implement them.We must be ready to “improve” ̶ strengthen health services so that they are better equipped for prevention, diagnosis and providing care for NCDs in the future, under any circumstances. ”
Editor’s note
Noncommunicable diseases kill 41 million people a year, representing 71% of all deaths worldwide. Every year, 15 million people die from NCDs between the ages of 30 and 69; more than 85% of these “premature” deaths occur in low- and middle-income countries.
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