The direct and indirect health effects of Covid-19 on SA citizens

By Edward West Time of article published Aug 19, 2020

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CAPE TOWN - A long lockdown could lead to much sicker patients and dramatic increases in death rates for major illnesses such as cancer, and the number of people who die as a result of these delays could end up exceeding deaths due to Covid-19.

This alarming outcome of the Covid-19 pandemic was contained in “The Covid-19 Future Trends Report: Navigating The Flux” that was commissioned and released yesterday (tue) by the Liberty life insurance group.

The report looked at the direct and indirect short- and long-term health effects of Covid-19 on South African citizens and healthcare providers.

The biggest of the direct short-run health effects was the threat of hospital and Intensive Care Unit overload as Covid-19 victims sought treatment, the risk of which had declined somewhat due to the slowing of the infection rate.

The severity of Covid-infections was correlated with age, demographic factors, and pre-existing medical conditions; notably obesity and diabetes, which were prevalent in great numbers in South Africa.

The prevalence of Covid-19 was also correlated with working, transport and living conditions and socio-economic status.

The top five comorbidities were hypertension, obesity, chronic lung disease, type 2 diabetes and cardiovascular disease - these were associated with serious Covid-19 illness.

Cardiovascular diseases were already the third-biggest killer in South Africa after tuberculosis and diabetes.

They were often linked to obesity, uncontrolled high blood pressure, smoking, diabetes and high cholesterol, the report noted.

Multiple studies had shown that Covid-19 patients with diabetes were significantly more likely to have received invasive mechanical ventilation or care in ICU, with one third of Italian Covid-19 fatalities linked to diabetes.

In South Africa, almost 13 percent of adults, or more than 4.5 million people, were living with diabetes.

The indirect short-run health effects to the health and insurance industries from Covid-19 included Covid- related stress and loneliness effects on mental health and wellness.

The South African Depression and Anxiety Group said call volumes had more than doubled since the beginning of lockdown, from 600 to 1200 - 1400 calls a day.

Direct long-run health effects were around the lasting health complications for Covid-19 survivors.

Indications were that the disease caused lung damage.

Dr Samira Bell, Kidney Specialist, Ninewells Hospital, Dundee, said in a statement: "We are seeing patients are suffering from moderate to severe acute kidney injury in about 20-30 percent of patients and 30 percent of patients who are admitted to intensive care for Covid infection are requiring dialysis, so the numbers are much bigger than we envisaged based on the data coming out of China.”

The indirect long-run health effect included a negative impact on patients with other critical and chronic conditions who delay going to hospitals for treatments or procedures until the risk of contracting Covid-19 was reduced or until hospitals had the resources to attend to them.

In South Africa, researchers estimated that Covid-19 precautionary measures would result in

146 000 cancelled surgeries, 12 000 of them for cancer.

In Africa, activists were also concerned that Covid-19 would set back women’s access to reproductive healthcare and contraceptives.

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