Covid exposes chronic patients to greater risks  

Highlights  

• Covid mounted up disease burden of chronic patients 
• Patients were in limbo as they had little scope for physical exercises  
• Chronic diseases are estimated to account for 67% of all deaths in Bangladesh: WHO 
• Experts said youths should be made aware of the diseases 

The Covid-19 pandemic has driven up the number of chronic patients in around the last two years and intensified their sufferings thanks to the suspension of screening, treatment and follow-up of the diseases, say doctors.      

As the virus slows down its roundups, public health experts emphasised that authorities should take necessary measures to prevent the non-communicable diseases such as heart disease, stroke, cancer, diabetes and chronic lung diseases to minimise deaths in case Covid-19 infections surge again.

Prof Dr Sohel Reza Choudhury, Professor and Head, Department of Epidemiology and Research, National Heart Foundation, told The Business Standard conditions of hypertension, heart disease and diabetic patients worsened as people had little scope for physical exercises and other activities during Covid-19. Besides, many of those who have Covid-19 are again suffering from these non-communicable diseases (NCDs). 

Doctors said routine medical check-ups, adherence to the treatment regimen and healthy lifestyles are key strategies for managing non-communicable diseases. During Covid-19 people with NCDs have been reported to be not receiving promotive, preventive and clinical care, and this situation has exacerbated their chronic conditions.

A study, titled "Older adults with non-communicable chronic conditions and their health care access amid Covid-19 pandemic in Bangladesh: Findings from a cross-sectional study'', notes that 23% of participants reported difficulties accessing medicine and 27% in receiving routine medical care during the pandemic. This was significantly higher among those suffering from multimorbidity.

The study was conducted in 2021 among 1,032 Bangladeshis, aged 60 years and suffering from different NCDs. 

Prof Dr Md Kamrul Islam, Managing Director and Urologist at Centre for Kidney Diseases and Urology Hospital, told TBS that patients having kidney diseases need to maintain regular treatment and follow-up measures to keep their conditions under control. But many patients did not see doctors during the epidemic in order to avoid being infected with Covid-19.

"I have received some patients whose condition remained stable with prescribed medicines, but some of them require dialysis at present. Some of them even require kidney transplants," he added.

Fear of increasing NCD deaths due to Covid-19

Prof Reza Choudhury said studies in different countries have shown that deaths caused by NCDs are much higher during the Covid-19 period. Although there has been no research in Bangladesh yet, it is believed that deaths related to NCDs have gone up in the country.

According to World Health Organisation data, NCDs are estimated to account for 67% of all deaths in Bangladesh.

A Bangladesh Bureau of Statistics report on Sample Vital Registration System (svrs) 2020 ‍says deaths from heart attacks and cancer rose by 23% and 88% respectively in 2020 compared to that in the previous year.

Dr Aliya Naheed, Head, Initiative for Non-Communicable Disease, Health Systems and Population Studies Division, icddr,b, told TBS that NCDs are already a risk factor in the country. The epidemic has increased the risk. All people over 40 in Bangladesh who died of Covid-19 had been suffering from various NCDs.

Thorough research should be conducted on NCD patients in Bangladesh, she added.

Experts have advised undertaking massive programmes to prevent NCDs on an immediate basis.

Dr Naheed further said the young population should be made aware of NCDs. Besides, it has to be ensured that NCD patients get immediate care at medical centres. Community mobilisation is also essential to control chronic diseases.

Dr Reza Choudhury said the government should place emphasis on the treatment of hypertension, diabetes screening and control in the public sector up to the upazila level. Doing so will reduce premature deaths and also reduce treatment costs. The campaign needs to be intensified to make people aware of diets and healthy lifestyles.

Dr Mohammad Robed Amin, Line Director, Non-Communicable Disease Control, Directorate General of Health Services (DGHS), told TBS, "We are reinforcing our previous programmes that were somewhat affected by Covid-19. Health workers working up to the upazila level have been trained. Besides, various day-centric campaigns are being run to make people aware."