Woman in medical office.

The Silent Pandemic: NCDs and Pandemic Preparedness

Tuesday, April 9, 2024

In 2020, COVID-19 took millions of lives and has taken many more since. Every individual around the world felt the impact of the vicious virus, and everyday life as we knew it was suspended. 

COVID-19 sent the world into an unprecedented standstill. However, the far-reaching consequences of the virus were not confined to the immediate physical effects. 

Social interactions dwindled to zero, supply chains crumbled, education faced abrupt interruptions.

A consequence that received considerably less emphasis than the toilet paper shortage was the impact the pandemic had on individuals suffering from non-communicable diseases (NCDs). 

These individuals, already burdened by debility and heightened vulnerability to infectious diseases, faced an additional and potentially just as harmful consequence – a major disruption in NCD services, which was reported by three quarters of countries globally

The focus during this time for these individuals tended to center around isolation and quarantine, while the broader picture of their vulnerabilities went unnoticed – a silent pandemic beneath the one we all experienced.

As the world becomes increasingly more urbanized, the burden of disease has shifted from infectious diseases to NCDs, increasing the burden of NCDs globally

A staggering 41 million people die of NCDs each year, constituting 74% of all deaths globally – more than 5 times the total toll of COVID-19

Many NCDs, such as heart disease, cancer, and diabetes, require regular treatments, medications, and services. However, as noted by the United Nations, many individuals had their treatments abruptly halted, leading to severe health consequences. 

Elective appointments and treatments were canceled or rescheduled to reduce the patient-staff interactions in clinics, access to clinics and healthcare workers was severely restricted, and the supply chain of essential medications collapsed.

Those suffering from NCDs were left to struggle with their diseases without their fundamental needs being met. 

Both the United States Department of Health and Human Services and the World Health Organization have pandemic preparedness plans and pandemic frameworks in the case that another pandemic may arise. 

These frameworks include strategies and policies to limit the spread of the specific infectious disease, vaccination production and distribution, risk assessments and more, which are all vital parts of mitigating a pandemic. 

However, they lack essential strategies for handling existing diseases during a pandemic. 

The stark reality of COVID-19 and its destruction of lives, both directly and indirectly, should serve as a lesson to enhance our preparedness as the gap in these preparedness plans is glaringly obvious. 

Incorporating the continued treatment of NCDs into pandemic preparedness plans is not only a matter of ethical responsibility; it is also a strategy to reduce the death toll of the pandemic itself. 

The health and well-being of billions of people are at stake and a more holistic approach is crucial to address the complexity of pandemics. 

Comprehensive planning should encompass strategies to ensure the continuity of essential medical services, medications, and treatment for those with NCDs, even in the face of a global crisis.

Furthermore, attention to the interaction of pandemics and existing health conditions is crucial. The theory of syndemics is an important factor to consider in the case of NCDs and pandemics. 

The term syndemic refers to the interaction of two or more epidemics, collectively contributing to a burden of disease in a specific area or population that exceeds the sum of their individual impacts. 

Given that NCDs commonly leave individuals more susceptible to infectious diseases, it is highly likely that any epidemic infectious disease will interact syndemically with a given NCD. 

With this in mind, it is imperative that we incorporate plans for continuity of treatment into our pandemic preparedness frameworks. 

The COVID-19 pandemic revealed the vulnerabilities in our global health infrastructure, emphasizing the need for a shift in how we approach preparedness and a distinct opportunity for quality improvement. 

It highlighted a huge flaw in the current operation of our healthcare systems in global health crises. It is crucial that we move beyond solely focusing on the infectious disease and take a more holistic approach in viewing the challenges that contribute to the burden of disease. 

Governments, healthcare systems, and global health organizations must collaborate in the systematic development of strategies that address the needs of everyone when a pandemic occurs, including those with pre-existing health conditions during pandemics.

As we stand on the downward slope of this pandemic, the lessons learned from the silent pandemic of NCDs should propel us towards a more comprehensive and inclusive approach to healthcare in pandemic settings. 

Recognizing the interconnectedness of health challenges and the potential syndemic interactions between infectious diseases and NCDs is imperative. 

Our preparedness frameworks must shift from singular focus on mitigation and treatment of infectious disease to a more encompassing plan that includes the needs of those with pre-existing health conditions. 

The time to make these changes is now, while the impact of the pandemic still lingers.