WARNING that countries could face a “parallel epidemic”, director of the Pan American Health Organization Dr Carissa Etienne is calling on the region to ramp up efforts to protect individuals with underlying medical conditions, even as it battles the COVID-19 pandemic.

She said the parallel epidemic would be “of preventable deaths of persons with non-communicable diseases (NCDs)”.

“One of the most concerning aspects of the COVID-19 pandemic is the disproportionate impact of the virus on people suffering from non-communicable diseases or NCDs, namely hypertension, cardiovascular disease, diabetes, cancers, asthma, and other respiratory diseases, in addition to obesity. We have never seen such a deadly relationship between an infectious disease and NCDs,” Dr Etienne said on Tuesday.

The PAHO director, who was speaking during a virtual briefing, said, “Some of the data are truly alarming, especially for a region where NCDs are pervasive.”

She said studies in China, where the virus first erupted, show that more than 28 per cent of cancer patients who contracted COVID-19 died, compared with only two per cent of overall patients.

Already, based on data, there are 1.2 million people living with cancer in Latin America and the Caribbean.

Dr Etienne said a review of more than 16,000 patients with COVID-19 found that people with diabetes were twice as likely to have severe disease or to die.

“There are an estimated 62 million people in the Americas living with diabetes,” Dr Etienne disclosed, noting that smoking causes cancers, heart and lung disease, and is directly associated with reduced respiratory capacity.

“Additionally, smoking has been shown to increase the likelihood of developing severe illness from COVID-19. About 15 per cent of adults in the Americas still smoke and may face this risk. In fact, our region has a high incidence of NCDs and we are deeply concerned for the health of people living with these conditions,” she said.

Dr Etienne said, too, that approximately one in four people in the region are at increased risk of poor outcomes from COVID-19 due to underlying NCDs.

In the meantime, the PAHO director expressed concern that the COVID-19 crisis has also disrupted the routine health services that patients with NCDs count on to manage their illness.

“Many health care workers who typically provide care have been redirected to the COVID-19 response, adversely affecting the timely diagnosis and treatment of NCDs. Furthermore, some countries experience disruption of supply chains as well as challenges to the distribution of medicine and health products, all of which impact access,” she pointed out.

She said stay-at-home measures, disruptions in the provision of health care services, as well as the fear of attending health care facilities have resulted in reduced elective clinic visits and lower access to renal dialysis and cancer care, as well as delays in high-priority treatments for patients with NCDs.

“This puts patients at a higher risk of complications and death from diseases which we know how to treat. This challenge must be addressed head-on by health systems in our region, or we will be faced with a parallel epidemic of preventable deaths of persons with NCDs,” she said.

The PAHO director, in noting the dilemma, said it was imperative “to find safe methods of delivering essential clinical care for people with NCDs during the pandemic”.

“For example, many countries are quickly scaling up telemedicine, prioritising scheduled appointments to avoid crowded waiting rooms, and providing services in novel ways. We also must ensure that supply chains for essential NCD medicines are protected and continue to function efficiently, and that these products are distributed to the people who need them,” she pointed out.

“We need to help people with NCDs protect themselves from COVID-19 to avoid a situation of greater risk. This means providing them with the resources, the support system and information that is needed to protect themselves. Let us not get trapped in a false dichotomy — fighting NCDs now is integral to our response to COVID-19,” Dr Etienne declared.

She also called for “aggressive preventive measures to protect people with diabetes, respiratory and cardiovascular diseases from the new coronavirus”, adding that “we all must provide timely access to care for chronic diseases to prevent them from becoming life threatening”.

According to the director, PAHO is working with countries in the region to provide guidance and to help plan and implement these measures.

“As cases continue to rise in our region, our efforts to protect those with underlying conditions must intensify,” Dr Etienne insisted.

And, in light of World No Tobacco Day, which will be observed on May 31, Dr Etienne said: “Observing this day in the midst of the COVID-19 pandemic highlights how smoking increases our risks and vulnerabilities to this pandemic and to many other health threats.”

“This year’s focus is on protecting the youth, and if there is ever a time to quit smoking, that time is now,” she said.

On Tuesday, PAHO said, prior to COVID-19, 81 per cent of all deaths in the region of the Americas was due to NCDs and 39 per cent of these deaths were premature — occurring before 70 years of age.

“As together we reconstruct and transform our economy, our social protection systems and health systems, we need to pay critical attention to the prevention, early diagnosis and management of non-communicable diseases,” said Dr Etienne.