Letters

The two-edged sword of COVID-19 and NCDs

The Bahamas not only continues to have the highest number of active COVID-19 cases in the English speaking Caribbean, but its COVID-19 deaths are occurring at more than twice the rate of deaths in Jamaica, which is currently experiencing a marked surge in cases.

COVID-19 deaths in The Bahamas are occurring at an even higher rate than that of the Dominican Republic, which leads the region with over ninety-four thousand confirmed cases.

Determining the infection fatality rate for COVID-19 globally continues to be a challenge for researchers, because individual countries have different reporting, testing and case counting strategies that would impact what their death rate would be.

During the first wave, health officials said investigations would be carried out to determine why the country’s COVID-19 infection fatality rate was more than double that of Caribbean Disaster Emergency Management Agency (CDEMA) countries.

If such an investigation was launched, the findings were never disclosed to the public.

In this second wave, precious little information has been offered on the challenges faced in treating moderate to severely ill COVID-19 patients.

It is also not known to what extent case management by phone for COVID-19-positive individuals in home-isolation enables healthcare providers and those they monitor to adequately assess the risk of symptoms suddenly and drastically deteriorating.

Worldwide, non-communicable diseases (NCDs) are observed as primary comorbidities for COVID-19 deaths.

According to the Ministry of Health’s latest data, close to half of the country’s COVID-19 fatalities suffered from hypertension or heart disease and a third suffered from diabetes.

Non-communicable diseases are a scourge in the Caribbean and they along with their risk factors accounted for 78 percent of deaths in the region a decade ago, according to the Pan American Health Organization (PAHO).

Just last year, the ministry reported via its STEPS survey that 71.6 percent of adult Bahamians were overweight, with 43.7 percent of that number being obese; 47 percent had hypertension and diabetes, including pre-diabetics with a prevalence of almost 19 percent.

These figures point to the high probability that many of the country’s healthcare workers, and other essential personnel, suffer from at least one of these NCDs – bringing home the urgency of getting a handle on the country’s incidences of COVID-19.

Tackling NCDs in The Bahamas will take a sustained, collaborative effort; and the two-edged sword of COVID-19 and NCDs worldwide, is that the strain of the novel coronavirus on healthcare systems has resulted in NCD sufferers not receiving the care necessary to keep their conditions under control.

According to the World Health Organization (WHO) in a survey report issued in June, many people who need treatment for diseases like cancer, cardiovascular disease and diabetes have not been receiving the health services and medicines they need since the COVID-19 pandemic began.

The report indicated that more than 53 percent of the countries surveyed have partially or completely disrupted services for hypertension treatment; 49 percent for treatment for diabetes and diabetes-related complications; 42 percent for cancer treatment and 31 percent for cardiovascular emergencies.

Rehabilitation services have also been disrupted in almost 63 percent of countries, according to the WHO, even though “rehabilitation is key to a healthy recovery following severe illness from COVID-19”.

The most common reasons for discontinuing or reducing services were cancellations of planned treatments, a decrease in the availability of public transportation and a lack of staff because health workers had been reassigned to support COVID-19 services, the survey found.

Though health officials have pointed to the impact of COVID-19 on routine vaccinations for children, there have been no public discussions on how management of the country’s primary killers – NCDs – has been impacted since we have been in a state of emergency.

But just as COVID-19 is not going anywhere, neither are NCDs.

How NCD services are factored in to national COVID-19 response planning moving forward will be critical to safeguarding the country’s stability in the face of a novel virus experts say is here to stay.

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