Coronavirus fallout opening door to deaths from other diseases for years to come

There is still a chance to save lives when health systems reach breaking point by prioritising the most critical medical services, researcher say

Agent Jean Kinhouande carries mosquito nets on April 28, 2020 in Agla district of Cotonou during a door-to-door distribution aiming at fighting malaria amid the pandemic of the novel coronavirus (COVID-19). As the rainy season approaches Benin is the first country in West Africa to take on the challenge of providing mosquito nets to protect the population from malaria despite the disruption caused by the COVID-19.  / AFP / Yanick Folly
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Deaths from a wide range of conditions are forecast to rise drastically in the next few years as the world tackles the health fallout from the coronavirus pandemic.

Health systems in low and middle-income countries were likely to be left stretched after attention was focused on tackling the pandemic, according to modelling carried out by Imperial College London published in The Lancet.

Some countries could see HIV deaths rise by up to 10 per cent, tuberculosis fatalities increase by 20 per cent or a 36 per cent spike in malaria deaths over the next five years.

But there is still an opportunity to drastically reduce these additional deaths by prioritising the most critical health services, the researchers said.

They identified antiretroviral therapy for HIV patients, timely TB diagnosis and treatment and the provision of long-lasting insecticide-treated nets for malaria as among the most pressing needs.

"The Covid-19 pandemic and actions taken in response to it could undo some of the advances made against major diseases such as HIV, TB, and malaria over the past two decades, compounding the burden caused by the pandemic directly", said Professor Timothy Hallett from Imperial College, who co-led the research.

"In countries with a high malaria burden and large HIV and TB epidemics, even short-term disruptions could have devastating consequences for the millions of people who depend on programmes to control and treat these diseases.

“However, the knock-on impact of the pandemic could be largely avoided by maintaining core services and continuing preventative measures."

'Extraordinarily difficult decisions'

This undated electron microscope image made available by the U.S. National Institutes of Health in February 2020 shows the virus that causes COVID-19. The sample was isolated from a patient in the U.S. Excitement about treating the new coronavirus with malaria drugs is raising hopes, but the evidence that they may help is thin. (NIAID-RML via AP)
An electron microscope image showing the virus that causes Covid-19. AP

Covid-19 could cause such disruptions by overwhelming sometimes fragile health systems or by limiting routine health programmes and interrupting medical supply chains.

"Our findings underscore the extraordinarily difficult decisions facing policymakers. Well-managed, long-term suppression measures could avert most Covid-19 deaths,” Mr Hallett added.

“But if these interventions are not well managed they could cause people to stay away from hospitals and clinics and force public health programmes to be cancelled, leading to a large spike in deaths from other major infectious diseases that had been coming under control."

The authors warned that predicting the impact of the pandemic was fraught with difficulty, especially when so much remained unknown about the virus.

"Many of the gains made in malaria control over the past decade have been due to distribution of long-lasting insecticide-treated nets in Sub-Saharan Africa where the vast majority of malaria deaths occur, said co-lead author Dr Alexandra Hogan, also from Imperial.

“However, the Covid-19 pandemic will likely disrupt these distributions in 2020, resulting in more malaria deaths.

"Routine preventative measures must be prioritised, ensuring mosquito net distribution campaigns and prophylactic treatments, such as mass drug distribution and seasonal malaria chemoprevention, are maintained."

World Health Organisation statistics show malaria deaths worldwide have decreased by half since 2000, and around 94 per cent of people who die from the disease are in Sub-Saharan Africa.

Global HIV/Aids deaths have also halved in a decade, driven by the availability of antiretroviral therapy.

An estimated 49 million people were saved through TB diagnosis and treatment from 2000 to 2015, but the disease still claimed the lives of 1.8 million people in 2018.