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• Non-communicable diseases at the time of COVID-19 pandemic
  Manas P Roy
  Published on: 7 April 2020

• Published on: 7 April 2020

  Non-communicable diseases at the time of COVID-19 pandemic

  • Manas P Roy, Public Health Specialist Ministry of Health and Family Welfare, New Delhi

  The communication from Pal and colleagues is timely. (1) However, a few more points might have been included.
  At present, Non-communicable diseases (NCDs) are responsible for 55.4% Disability Adjusted Life Years (DALY) in India. (2) The major risk factors for NCDs are tobacco, alcohol abuse, physical inactivity, and unhealthy diet. Therefore, the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) focuses on the prevention of risk factors and awareness generation. (3)
  As the ongoing pandemic of Coronavirus disease (COVID 19) is ravaging most of the countries, India has imposed a lockdown for 21 days since 25 March 2020, in an attempt to avoid the catastrophe. While it is being considered as a masterstroke for putting the spread of the epidemic on hold, it would also restrict access to tobacco or alcohol for many, in favor of NCD prevention. However, some routine activities like physical activity would need to be re-planned for this duration, as parks and gyms are not accessible. As public transport is being operated at the minimal frequency, many patients of NCD might find it difficult to reach the nearest hospital for collecting their medicines. For NCD patients purchasing medicines (out-of-pocket expenditure) from a pharmacy, access to medicine may be restricted. Migrants working as daily wager may be the worst hit as the possibility of being laid off looms large, even if the government is asking the...

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  The communication from Pal and colleagues is timely. (1) However, a few more points might have been included.
  At present, Non-communicable diseases (NCDs) are responsible for 55.4% Disability Adjusted Life Years (DALY) in India. (2) The major risk factors for NCDs are tobacco, alcohol abuse, physical inactivity, and unhealthy diet. Therefore, the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) focuses on the prevention of risk factors and awareness generation. (3)
  As the ongoing pandemic of Coronavirus disease (COVID 19) is ravaging most of the countries, India has imposed a lockdown for 21 days since 25 March 2020, in an attempt to avoid the catastrophe. While it is being considered as a masterstroke for putting the spread of the epidemic on hold, it would also restrict access to tobacco or alcohol for many, in favor of NCD prevention. However, some routine activities like physical activity would need to be re-planned for this duration, as parks and gyms are not accessible. As public transport is being operated at the minimal frequency, many patients of NCD might find it difficult to reach the nearest hospital for collecting their medicines. For NCD patients purchasing medicines (out-of-pocket expenditure) from a pharmacy, access to medicine may be restricted. Migrants working as daily wager may be the worst hit as the possibility of being laid off looms large, even if the government is asking the organizations not to treat their employees so harshly. (4) The same difficulty in the conveyance is applicable for the clients in need of counseling for de-addiction. The movement of health care workers may also suffer in the same way. Besides, access to regular dietary variety may also be restricted due to several reasons such as the disruption of the supply chain resulting from lockdown, unavailability of daily wagers owing to limited movements, and limited visits allowed to grocery stores. At times, the operating time for grocery stores is also shorter.
  With older patients being the common victims for both NCD and COVID 19, there is a need like never before to ensure optimum management for NCDs. (5) More so, because most of the countries are occupied with the pandemic and routine care for chronic diseases is on the verge of impending compromise. We need to take care of that in a delicate manner.
  References
  1. Pal R, Bhadada SK. COVID-19 and non-communicable diseases. Postgrad Med J. Published Online First: 30 March 2020. doi: 10.1136/postgradmedj-2020-137742
  2. Indian Council of Medical Research, Public Health Foundation of India, and Institute for Health Metrics and Evaluation. India: Health of the Nation's States - The India State-level Disease Burden Initiative. New Delhi, India: ICMR, PHFI, and IHME; 2017.
  3. Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India. National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke. (Available at https://dghs.gov.in/content/1363_3_%20NationalProgrammePreventionControl..., last accessed on 7th April, 2020).
  4. Covid-19: Public, pvt cos told not to cut salaries, lay off staff. Available at https://economictimes.indiatimes.com/jobs/covid-19-public-pvt-cos-told-n..., last accessed on 7th April, 2020)
  5. Chen T, Wu D, Chen H, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ 2020;368. doi:10.1136/bmj.m1091
  Conflict of Interest
  None declared

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  Conflict of Interest:
  None declared.

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