2 June 2020

We are living the most disruptive global menace, COVID-19 pandemic, which has radically changed the modes of human interaction and heralds most dire health economic and social consequences. As we enforce physical distancing, there is a pressing need to build and foster a strong human connection in order to alleviate individual and national suffering and support one another for survival and recovery. The continuing commitment of YADUNA in providing health care under these difficult times is pivotal and much admired.

The prevalence of noncommunicable diseases (NCD) in Lebanon and the region is concerning. Cardiovascular diseases, obesity, hypertension, and diabetes are among the leading causes of death and disability in the region.

The COVID-19 pandemic has had widespread health impacts, revealing the particular vulnerability of those with underlying conditions. In many countries, data revealed that the majority (96%) of patients who died in-hospital from COVID-19 had comorbidities, primarily cardiovascular; the most prevalent among these patients were hypertension (69%), type 2 diabetes (32%), Coronary disease (28%), chronic obstructive pulmonary disease (17%), and cancer (16%).

The Impact of COVID-19 response measures on NCDs is multifaceted. Physical distancing or quarantine can lead to poor management of recognized lifestyle risk factors, including unhealthy diet, physical inactivity, tobacco use, and harmful use of alcohol. Evidence from COVID-19 pandemic and previous pandemics suggests that chronic conditions can worsen due to stressful situations resulting from restrictions, insecure economic situations, mental stress, and unfavorable health behaviors. 

Of great concern is the clear decline of the number of patients presenting with a serious exacerbation of their existing diseases and/or life-threatening conditions such as heart attacks, stroke, or vascular complications. Concern about COVID in hospitals or disruption of the health systems and services may account for delayed or no show of these patients with serious conditions. This has resulted in worsened medical outcomes and surge of out of hospital- non-COVID death. 

The prevention and control of NCDs have a crucial role in the COVID-19 response and an adaptive response is required to account for the needs of people with NCDs. Prevention and control of NCDs are important. In this context, WHHC is to be commended for providing access, control, and treatment of women with known and unrecognized cardiovascular diseases and adverse factors. The services align with the WHO and national health systems which have started to develop actions that could be adapted to address the needs of those at risk of NCDs or who are already living with NCDs.

As we continue to adhere to the mandated safety measures to combat COVID-19, we must not ease our attention to the prevention and management of the already existing peril, Cardiovascular disease epidemic.

Samir Alam MD FACC FRCP
Professor of Medicine, Cardiology
Chief of Staff
American University of Beirut Faculty of Medicine and Medical Center
YADUNA-WHHC Board of Trustees and Directors