Each coin has its downside. Even pandemics, for better or for worse. If the lockdowns and restrictions have limited pollution and cleaned up the air and done good to the fauna and the oceans, the effects on human health have also been no less. These too, for better or for worse. A positive effect was, for example, that of the 86% reduction in cases of norovirus gastroenteritis in the United States from February to September of this year, probably due to personal restrictions that limited the possibility of skin and fecal-oral contamination. The decrease was seen in many different settings, including nursing homes, day care centers, health care facilities and schools, although it was less noticeable in nursing homes.
The hepatitis C virus is probably just one example of many chronic diseases, however, whose cascade of treatments has been negatively affected by COVID-19. New research from Boston Medical Center finds that COVID-19 emergency systemic changes made to reduce in-person visits during the pandemic led to a 50% decrease in hospital-wide hepatitis C (HCV) testing and a reduction of newly diagnosed HCV by more than 60%. The results that HCV tests and diagnoses have declined during the COVID-19 surge are alarming, due to the effect an undetected disease can have on those who are unknowingly infected.
From a public health perspective, HCV is a communicable infection that can spread to a population if not detected and treated. Inpatient or outpatient screening is an actively recognized means of helping to control its spread. The study results demonstrate a greater impact in primary care clinics where there was a 72% decrease in testing and a 63% decrease in new diagnoses. This is where telemedicine has been incorporated into clinical workflows, demonstrating that standard preventive care, including testing for HCV, was not routinely performed during the pandemic and telemedicine acted as a barrier to care.
Another infection that suffered problems was that of measles. In 2019, the WHO estimated that the disease in underdeveloped countries caused at least 207,000 complications deaths. Although measles in our Western countries is considered a poorly considered exanthematous disease, not everyone knows that it can cause even fatal medical complications in the context of a compromised or debilitated organism. Although reported measles cases are lower in 2020, efforts needed to control COVID-19 have led to vaccination interruptions and paralyzed efforts to prevent and minimize measles outbreaks. In November, more than 94 million people were at risk of losing vaccines due to the suspension of measles campaigns in 26 countries.
Many of these countries are experiencing ongoing epidemics. And of the countries with planned 2020 campaigns postponed, only eight (Brazil, Central African Republic, Democratic Republic of the Congo, Ethiopia, Nepal, Nigeria, Philippines and Somalia) have resumed their campaigns after the initial delays. Global Immunization Partners are engaging leaders and public health professionals in affected and at-risk countries to ensure measles vaccines are available and delivered safely and that healthcare professionals understand the life-saving benefits of the vaccine. On November 6, 2020, WHO and UNICEF issued a call for emergency action to prevent and respond to measles and polio outbreaks.
Sadly, finally, other camps have been crippled due to the restrictions and many medical visits or treatment appointments have been postponed. It is enough to mention the hundreds of thousands of cardiological, oncological and diabetic visits that have been postponed for lockdown and procedures to follow or legislative provisions. We must not hide the fact that there have been deaths related to this reason, especially in the oncology field where many patients have seen their chemotherapy or surgery sessions postponed. On this last point, even orthopedics and rehabilitation have suffered blockages on a surgical and organizational level.
Finally, mental health cannot be forgotten. Neurology and psychiatry experts estimate that the pandemic has led to a 40% increase in anxiety or depression, and that at least 65% of those who survived an episode with therapeutic support experienced severe relapses. Many people verbatim state “this pandemic is a nightmare”, words that reflect the inner heartache that is afflicting millions of people. But it becomes useless to say “we have lost our freedom” if we don’t get rid of this invisible enemy first. And the task is divided into two: for science to find the weapons to defeat it, for each of us not to provide the means to spread it.
Edited by Dr. Gianfrancesco Cormaci, PhD; specialist in Clinical Biochemistry.
Fuady A et al. Am J Trop Med Hyg. 2020 Dec 2.
Kraay ANM et al. medRxiv preprint Dec 1.
Gold JE et al. mBio. 2020; (6):e02628-20.
Awasthi AK, Singh PK. JPH Policy 2020 Nov 24:1-5.
Stasi C et al. SN Compr Clin Med. 2020 Oct 18:1-8.