Photo: INÊS LOPES/OPEN MEDIA GROUP

More than Covid

It is about time the world realised that life … and health … is more than Covid. And it depends on individual behaviour.

The COVID-19 pandemic has transformed the world in such a strong, unexpected way that everything will have to be rethought. It has had a severe impact on the economy, society, psychology, education and on general health, obviously.

First of all, through a direct and very specific effect, as globally (October 25, 2021 data), there have been 243,260,214 confirmed cases of Covid-19, including 4,941,039 deaths, reported to WHO.

It is extremely important not to forget that the pandemic has, beyond any possible doubts, disrupted all healthcare systems around the world, having a terrible, irreversible effect on the care for other diseases, despite the problems still being there.

The forgotten-neglected patients
The picture is tragic! The impact of COVID-19 on people living with non-communicable diseases during the pandemic has been dramatic.

The combination of the breakdown of health systems, the lockdown and a sense of fear among people, avoiding medical settings like hospitals and health centres, has led to a lack of assistance with reduced diagnoses and delayed treatment of people with severe diseases, such as heart attacks, strokes or oncological diseases, and to the neglect of regular preventive check-ups.

The fact that the immediate threat of COVID-19 consumed health systems and their resources has also been a very relevant negative factor for the exacerbation of this problem.

Scientific research around the world has also focused on COVID-19, potentially delaying research and breakthroughs on other diseases.

The Bill & Melinda Gates foundation assessed data on routine vaccine coverage from the first portion of the pandemic and concluded that vaccine coverage in health systems had been pushed back around 25 years in 25 weeks.

The reduction of outpatients, hospital visits and hospitalisations for non-COVID-19 patients during the the pandemic is certainly related to a significant increase in non-COVID-19 out-of-hospital deaths.

Nevertheless, social distancing and lockdowns have obviously reduced the number of diagnoses of infectious diseases, such as seasonal influenza, as would be expected with reduced social contact.

Is it all over?
CDC director Dr. Rochelle Walensky says that she cannot predict when the pandemic will end, as it depends on human behaviour. And that might be a problem.

“We have vaccines,” she said. “What we can’t really predict is human behaviour. And human behaviour in this pandemic has not served us very well.”

Although some communities have high vaccination rates and are very well protected, “there are pockets of places that have very little protection.”

“And the virus is not stupid, it will go there,” Walensky said. “So, when it will possibly be over depends on how well we coalesce together, as a humanity and a community, to do the things that we need to do to get ourselves protected.”

The spread of the Delta variants and vaccine hesitancy made the transition toward normalcy much more complicated. Vaccine hesitancy makes it more difficult to reach the population-wide vaccination level rates that confer herd immunity and makes it easier for the virus to mutate, creating variants that are easier to transmit, more aggressive and might be more resistant to the available vaccines.

The burden of disease caused by COVID-19 in vaccinated people seems similar to, or lower than, the average burden of influenza over the last decade, while the risks from COVID-19 to unvaccinated people are significantly higher.

All pandemics end eventually, and Covid-19 has started to go down that road, but it is believed that it will not be eradicated; instead, it will gradually become endemic.

If that is the case, circulating and mutating from year to year, the coronavirus will remain a threat to the elderly and infirm. Having settled down, Covid will then be a familiar, manageable enemy, like the flu.

Expanding international vaccination remains essential to achieve a postpandemic sense of “normal” worldwide. Full vaccination is a must, and the third dosage is also very relevant due to the decreasing levels of immunity.

Nothing surprising, we also have the flu vaccine every year.

Not normal!
The UN General Secretary António Guterres said the pandemic has highlighted the fragility of our societies and the need to build back better.

Asked about what the so-called “new normal” means to him, the UN chief refused to characterise our collective present state in those terms, calling it instead “abnormal”.
“For me, human life needs human contact,” he told the participants and maintained, “we will not have a new normal before we are able to establish that contact”.

“There is a rainbow in every storm”
We all know that major crises also give rise to major hopes, as need is very often the engine of growth. In order to build the so-called new “normal”, the global health community and its partners will have to promote new strategies.

For quite a long time, when I finish writing an article, I tell myself it will be the last one “centered around Covid” but, unfortunately, it has not been possible so far and I end up telling people to be careful and to continue with all the well-known, but often forgotten, necessary measures of “what must not be done” and “what must be done”.

“We have the tools to bring the pandemic under control, if we use them properly and share them fairly,” said a WHO Chief.

The rainbow is certainly there. We just don’t know when we will be able to see it clearly. It depends on each one of us.

Best healthy wishes,
Dr. Maria Alice

By Dr Maria Alice
|| features@algarveresident.com

Dr Maria Alice is a consultant in General and Family Medicine. General Manager/Medical Director – Luzdoc International Medical Service. Medical Director – Grupo Hospital Particular do Algarve/ Hospital S. Gonçalo de Lagos