This article is part of our regular travel and global health news round-up.
The crushing demands of the COVID-19 pandemic have strained healthcare systems and capacity around the world. Many communities have been responding to the pandemic and grappling with the collateral damage of COVID-19 on other public health crises, as seen by reports of increases in overdoses amid the opioid epidemic, increases in domestic abuse and as Oxfam reports, millions being pushed towards hunger.
Physical distancing measures and lockdowns have kept some infectious diseases from spreading as they normally would – for now. However, many programs and funding streams typically dedicated to providing essential healthcare services have been temporarily put on hold or redirected. This has created a vacuum for certain diseases to rebound and spread, which could have devastating and lasting consequences for millions. We must continue to control and prevent the spread of COVID-19 but we can’t risk ignoring other life-threatening diseases while these efforts are ongoing.
In this news round-up, we take a look at how COVID-19 impacts efforts to control or eradicate four infectious diseases around the world.
Dengue is endemic (regularly circulates) in more than 100 countries, with the Americas, South-East Asia and the Western Pacific most affected. Last year a record number of cases were reported in the Americas and Asia and this year could present similar challenges: Many countries, including Bangladesh, Brazil, India, Indonesia, and Singapore, are experiencing an upsurge.
This article from the LA Times focuses on the outbreak in Indonesia, where cases doubled compared to this time last year. It details the limited access to dengue testing and treatment amid the COVID-19 pandemic, as well as the difficulty of distinguishing between the two infections.
Similar to COVID-19, dengue infections can be asymptotic (no signs or symptoms) or mild, leading many cases to go undetected. The symptoms are also similar to COVID-19 and include high fevers, severe headaches, and joint pain. Co-infection with both COVID-19 and Dengue has also been reported in Thailand.
As the Pan American Health Organization warned in a recent report, the “combined impact of both COVID-19 and dengue epidemics could have potentially devastating consequences”.
PAHO urges countries to continue fight against malaria during COVID-19 pandemic, especially among vulnerable communities
Malaria is a widespread disease endemic in areas of Africa, South America, and Asia. Every year it infects approximately 230 million people and kills approximately 430,000. International and national malaria programs involving community health workers have made significant progress towards controlling and preventing malaria infections. These initiatives provide communities with highly effective drugs, rapid testing, and mosquito control techniques such as insecticide-treated bed nets and indoor residual spraying.
As this article from Reliefweb reports, before COVID-19, South America experienced an overall reduction in malaria cases. Now, however, eight countries are reporting increases in cases: Haiti, Nicaragua, Panama, Dominican Republic, Honduras, Costa Rica, and Suriname. The region faces a number of challenges with weak healthcare systems and the movement of vulnerable populations between countries. It’s expected that the pandemic will cause disruptions in detecting and testing cases, and administering treatment. This could affect health outcomes, as early detection is essential for treatment of P. falciparum malaria infection.
In Africa – which accounts for 90% of the global malaria burden – programs that distribute insecticide-treated bed nets and indoor residual spraying were suspended in several countries. The World Health Organization has since recommended that all national and local programs continue to provide core preventive and disease management interventions for malaria, even with the risk of COVID-19 transmission. This will require a significant commitment to strengthen and invest into health systems and community measures so that programs and efforts can be coordinated.
The international campaign to eradicate polio has been ongoing for 3 decades now and has led to the administration of over 2 billion polio vaccines and the near eradication of the disease.
Polio infection is classified as either wild poliovirus (WPV) or vaccine-derived poliovirus (VDPV). Wild poliovirus refers to the virus when it naturally occurs and circulates in the environment. Currently, wild poliovirus is endemic in Pakistan and Afghanistan. In these countries and others considered at risk of wild polio, global initiatives run massive vaccination campaigns where they distribute the oral polio vaccine to children at risk. The oral vaccine is highly effective, cheap to produce, and easy to distribute – it only requires dripping the vaccine directly into the child’s mouth. The only setback of the oral polio vaccine is that in rare circumstances it can create partial-immunity and allow the live version of the virus to mutate and cause polio infection. This is referred to as vaccine-derived poliovirus. Outbreaks of vaccine-derived poliovirus occur periodically in countries at risk (for example, this year cases have been reported in Angola, the Democratic Republic of the Congo, Ghana and others).
As this Wired article details, where vaccination campaigns have been suspended, communities are more likely to have difficultly controlling outbreaks and children who started the vaccine regimen won’t be able to keep up established immunity. Children in remote or conflict-stricken areas are particularly vulnerable, as their parents typically rely on mass gatherings for access to vaccines since getting to a health clinic may not be feasible or safe. Weighing the costs between restarting vaccination campaigns against the risk of COVID-19 is difficult but it’s clear that the longer campaigns are suspended, the more catching up these immunization programs will have to do.
The World Health Organization reports that due to the pandemic, 73 countries are presently at risk of running out of HIV medicines and 24 have critically low stock or are experiencing disruptions in their supply. Importantly, the report forecasted that a six-month disruption in access to these medicines could result in a doubling of AIDS-related deaths in sub-Saharan Africa in 2020 alone.
Children are disproportionately affected by the HIV epidemic – in 2019 there were 150,000 new infections among children and only 53% were receiving the antiretroviral therapy they needed. This article from AP details the difficulty of continuing to provide medical services, particularly to HIV-positive children, during the pandemic. Patients experience challenges accessing care and essential medications due to health clinic closures, fears around seeking care, shortages of essential medicines, and the limited availability of doctors (practitioners previously focused on treating HIV switched to fighting COVID-19).
Have questions about COVID-19, international travel restrictions, and what to do if you’re abroad? Check out our Q&A for answers to these questions and more:
See our previous blog posts for more on COVID-19 and travel:
- How to travel safely and responsibly as COVID-19 restrictions ease up
- Travel health insurance: Lessons from COVID-19
- COVID-19: Essential Reading
- COVID-19: Travel restrictions, returning travellers, and advice for travellers abroad
- The disease on every traveller’s mind: COVID-19
Image by Pixabay, Pexels
Article by Claire Westmacott