COVID-19 disrupted delivery of essential health services globally – WHO

World Health Organisation (WHO) Head-Quater in Geneva, Switzerland.
World Health Organisation (WHO) Head-Quater in Geneva, Switzerland. Copyright : WHO/Pierre Virot

A new World Health Organisation (WHO) survey has found that health services for noncommunicable diseases have been disrupted since the beginning of the coronavirus (COVID-19) pandemic.

The UN health agency said almost all health activities, especially the prevention and treatment services for noncommunicable diseases (NCDs), have been suspended by hospitals globally.

The survey, which was completed by 155 countries during a 3-week period in May, confirmed that the impact is global, but that low-income countries are most affected.

WHO said the situation is of significant concern because people living with NCDs are at higher risk of severe COVID-19-related illness and death.

Noncommunicable diseases kill 41 million people each year, about 71 per cent of all deaths globally.

Statistics from the UN health agency shows that each year, 15 million people die from an NCD between the ages of 30 and 69 years; more than 85 per cent of these “premature” deaths occur in low and middle-income countries.

WHO Director-General, Tedros Ghebreyesus, said the results of the survey confirm reports that “we have been hearing from countries for a number of weeks now.”

“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.

“It’s vital that countries find innovative ways to ensure that essential services for NCDs continue, even as they fight COVID-19.”

Service disruptions

The main finding is that health services have been partially or completely disrupted in many countries, including Nigeria.

In Nigeria, there have been various reports of continued refusal by medical institutions to receive and treat patients for fear of COVID-19.

The Secretary to the Government of the Federation (SGF), Boss Mustapha, had said at a Presidential Task Force briefing in May that Nigeria has recorded more deaths from hospitals’ refusal to attend to patients with other illnesses than from COVID-19 virus.

Mr Mustapha said there have been reports of refusal by some medical institutions to treat patients for fear of contracting the COVID-19 virus.

He said the action portrayed by these medical institutions is unacceptable.

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This buttresses the WHO survey which says more than half (53 per cent) of the countries surveyed have partially or completely disrupted services for hypertension treatment; 49 per cent for treatment for diabetes and diabetes-related complications; 42 per cent for cancer treatment, and 31 per cent for cardiovascular emergencies.

It said rehabilitation services have been disrupted in almost two-thirds (63 per cent ) of countries, even though rehabilitation is key to a healthy recovery following severe illness from COVID-19.

Reassignment of staff

The survey also found that in the majority (94 per cent) of countries responding, ministry of health staff working in the area of NCDs were partially or fully reassigned to support COVID-19.

The postponement of public screening programmes (for example for breast and cervical cancer) was also widespread, reported by more than 50 percent of countries.

This was consistent with initial WHO recommendations to minimize non-urgent facility-based care whilst tackling the pandemic.

Report

The survey said the most common reasons for discontinuing or reducing services were cancellations of planned treatments, a decrease in public transport available and a lack of staff because health workers had been reassigned to support COVID19 services.

In one in five countries, one of the main reasons for discontinuing services was a shortage of medicines, diagnostics and other technologies.

Unsurprisingly, there appears to be a correlation between levels of disruption to services for treating NCDs and the evolution of the COVID-19 outbreak in a country.

Services become increasingly disrupted as a country moves from sporadic cases to community transmission of the coronavirus.

Globally, two-thirds of countries reported that they had included NCD services in their national COVID-19 preparedness and response plans; 72 per cent of high-income countries reported inclusion compared to 42 per cent of low-income countries.

Seventeen per cent of countries reporting have started to allocate additional funding from the government budget to include the provision of NCD services in their national COVID-19 plan.

Alternative strategies for continuing care being implemented

Encouraging findings of the survey were that alternative strategies have been established in most countries to support the people at highest risk to continue receiving treatment for NCDs, it stated.

Among the countries reporting service disruptions, globally, 58 per cent of countries are now using telemedicine (advice by telephone or online means) to replace in-person consultations; in low-income countries this figure is 42 per cent .

The agency also applauded that more than 70 per cent of countries reported collecting data on the number of COVID-19 patients who also have an NCD.

The Director of the Department of Noncommunicable Diseases at WHO, Bente Mikkelsen, said “it will be some time before we know the full extent of the impact of disruptions to health care during COVID-19 on people with noncommunicable diseases.”

“What we know now, however, is that not only are people with NCDs more vulnerable to becoming seriously ill with the virus, but many are unable to access the treatment they need to manage their illnesses.

“It is very important not only that care for people living with NCDs is included in national response and preparedness plans for COVID-19 -̶ but that innovative ways are found to implement those plans.

“We must be ready to “build back better” ̶ strengthening health services so that they are better equipped to prevent, diagnose and provide care for NCDs in the future, in any circumstances,” he said.



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