Researchers warn US leaders and health officials against national strategies for a “new normal” in life with COVID-19.
The warning, published in a commentary in the Journal of General Internal Medicine, argues that talking about a new normal may not incorporate important lessons learned from the first two years of the COVID-19 pandemic: its significant role as a non-communicable chronic disease plays in the aggravation of COVID-19 and the disproportionate burden of COVID-19 on underserved populations and colored communities.
Non-communicable chronic diseases are those that do not spread from person to person and persist for at least a year, such as diabetes, heart disease and cancer. They are the leading cause of death worldwide and represent a global health threat that precedes the COVID-19 pandemic – according to the US Centers for Disease Control and Prevention, the non-communicable disease crisis kills more than 15 million Americans prematurely each year.
Jun Ma, from the University of Illinois Chicago, is the co-author of the view. She said the COVID-19 pandemic and the chronic disease crisis together create what is called a synergistic endemic or syndrome – overlapping epidemics that interact, increasing the disease burden and the likelihood of poor outcomes. Recent proposals for a new normal national strategy in the United States focus too much on the SARS-CoV-2 virus and too little on the context in which the impact of the virus is most burdensome, she said.
“This is a great missed opportunity to address the multi-level and multifactorial factors that contribute to severe COVID-19 and COVID-19 mortality, not to mention other health conditions,” said Ma, Beth and George Vitoux. medicine and director of the Vitoux Program on Aging and Prevention at the UIC College of Medicine.
“What we really need is a comprehensive syndemic control strategy because the pre-pandemic health condition in the United States was not really ideal in the first place,” said Ma, who is also associate research director in the Department of Medicine. .
In support of this argument, Ma and her co-author, James Sallis, of the University of California San Diego, cite data published in the medical literature showing how non-communicable chronic diseases have created high susceptibility to severe and fatal COVID-19 outcomes and contributed to racial and ethnic inequalities. E.g:
- Nearly 95% of American adults hospitalized with COVID-19 between March 2020 and March 2021 had an underlying condition.
- Vaccinated individuals with breakthrough infections were 44% to 69% more likely to suffer from severe outcomes if they had a chronic illness.
- Non-communicable diseases and risk behaviors such as smoking, substance abuse, and physical inactivity gave a higher risk of severe COVID-19, according to the CDC based on conclusive evidence.
According to Ma and Sallis, “failure to address NCD control and prevention as a national priority is unacceptable because it contradicts compelling evidence and misses the possibility of using a whole set of life-saving effective intervention approaches. is volatile and the consequences of inactivity can be devastating by allowing the continuation of high vulnerabilities to severe and unequal outcomes of NCDs and future infectious disease pandemics. “
In their article, the authors also recommend “practical, immediate action-oriented steps” to incorporate chronic disease prevention and control into existing COVID-19 policies and infrastructure. E.g:
- Health systems could prioritize screening, including at COVID-19 vaccination and testing sites, for medical and psychological chronic conditions that are highly treatable, but often undiagnosed and poorly managed.
- The national infrastructure mobilized for vaccine promotion and distribution could also be used to disseminate documented lifestyle and behavioral health programs.
- COVID-19 vaccination and masking campaigns can expand messages to also promote healthy lifestyles and mental well-being.
- Partnerships between medical systems and community-based organizations and efforts by public and private insurance companies to COVID-19 emergency preparedness can be extended to include behavior change interventions in the routine delivery of health care and coverage.
Ma said that agencies such as the Centers for Medicare & Medicaid Services and state and local governments would need to prioritize supportive reimbursement and funding policies in order for these steps to be realized, but that the benefits could be felt by individuals and communities through more awareness, information and opportunities. to deal with their health.
“We can help people get a sense of control over their health,” Ma said.
“While we all hope the pandemic is declining, variants keep popping up and vaccinations are also declining. Therefore, we need to plan now for better responses to a possible next increase as well as future pandemics,” said Sallis, professor. at UCSD’s Herbert Wertheim School of Public Health and Longevity Science.
Ma and Sallis’ Journal of General Internal Medicine article entitled “A national strategy for COVID response and pandemic preparedness aims to address non-communicable chronic diseases. “
