Mon | May 25, 2020

Garth A. Rattray | NCDs are far deadlier than COVID-19

Published:Monday | March 30, 2020 | 12:20 AM

THE ENIGMATIC ferocity of COVID-19 is truly shocking. Those affected have not been able to pinpoint when and where they were infected. COVID-19 lands on surfaces and makes them contagious for a variable period of time. It is transmissible by droplets that envelop them and render them airborne to possibly be propelled, float or otherwise transported to our eyes, nostrils and mouths.

This fearsome infection varies widely. from imperceptible to mild, moderate, severe, and even deadly. And, because it kills approximately 3.4 per cent of the people who contract it, it’s therefore deadlier than the seasonal influenza, which kills about 0.1 per cent of its victims. However, it pales when compared to SARS, with a fatality rate of 11 per cent; MERS, with a kill rate of 34.3 per cent[ and Ebola, with a fatality rate of about 40.4 per cent. However, COVID-19 is uncanny in its remarkable transmissibility…that is what makes it so very dangerous.

During this critical time when almost the entire planet is being overrun by virus particles only visible with electron scanning microscopes and detectable with polymerase chain reactions and serology tests, the malevolent and invisible enemy has brought humankind to its knees. Now, everything revolves around the COVID-19 virus. The populations of the world are only carrying out the most essential of functions necessary for survival.

For physicians on the front line of the war against diseases, it is noticeable that, because of the COVID-19 scare, far more serious and deadly conditions are either being downplayed or totally neglected. It’s understandable that people are timid about visiting doctor’s offices. However, physicians are screening patients (at the entrance doors) for fever, coughs, and for indirect or direct contacts with visitors from overseas. They are being mandatorily hand sanitised, and some of us are doing infrared temperature checks (with appropriate devices) before registration.

Additionally, social distancing is being enforced, and surfaces, handrails and doorknobs are repeatedly sanitised throughout the day. Obviously, of all places that you can visit, the doctor’s office is among the safest.

OUT OF CONTROL

Non-communicable diseases (NCDs) remain the leading cause of death globally. They account for approximately 71 per cent of all fatalities, or about 41 million deaths annually. NCDs have more than 20 times the percentage kill rate of COVID-19. And, with so much emphasis on the elderly, it must be noted that, just last year, the American Heart Association estimated that 68 per cent of people age 65 and over with diabetes will die from heart disease. Additionally, 10 to 40 per cent of patients with type 2 diabetes will suffer from kidney failure.

In Jamaica, hypertension is the number one cause of kidney disease and failure. Hypertension is present in 85 to 95 per cent of patients with chronic kidney disease. This represents a vicious cycle; hypertension leads to kidney damage, and kidney damage leads to hypertension. The combination of diabetes and hypertension wreaks havoc on the kidneys.

Chronic non-communicable diseases are expected to cost $47 trillion by 2030. The likely reason that the deleterious physical and economic effects of non-communicable diseases are not alarming people is because NCDs, like heart attacks, strokes, diabetes, chronic respiratory diseases, cancers and so on, progress fairly slowly and over a long period of time. In other words, their impact curve is fairly flat.

NCDs are preventable or modifiable. They have all the hallmarks of a pandemic, cause significant morbidity, mortality, and commandeer a huge chunk of the economy. Yet, we never see the panicked effort being put into reducing or preventing them as we see being put into the current novel coronavirus pandemic.

NCDs are far deadlier than COVID-19, but because of the COVID-19 scare, patients are neglecting their regular check-up, follow-up visits and scheduled investigations. Consequently, essential meds are often not refilled and dangerous chronic diseases are going out of control.

Garth A. Rattray is a medical doctor with a family practice. Email feedback to columns@gleanerjm.com and garthrattray@gmail.com