20 Oct 2020
Preventable lifestyle diseases are driving COVID-19 and we need a radical change of direction to deal with it, says The Lancet
BY Tom Walker
Persistent and rising levels of lifestyle disease across the world have exacerbated the effects of the COVID-19 pandemic, according to Richard Horton, editor-in-chief of The Lancet.
Published in the latest issue of the journal, data from the Global Burden of Disease report shows that preventable diseases such as obesity, high blood pressure and type 2 diabetes have made the world more vulnerable to the virus.
According to the World Health Organization (WHO), The global prevalence of obesity nearly trebled between 1975 and 2016.
Estimates show 13 per cent of the world’s adult population (11 per cent of men and 15 per cent of women) are now obese.
Meanwhile, the official NHS guidance lists those with diabetes and obese as "clinically vulnerable" to
Coronavirus – alongside those aged 70 or older, people with asthma and those suffering from heart failure.
Writing in The Lancet, editor-in-chief Horton said the three-decade rise in preventable diseases had led to a situation where governments and public health organisations should reassess the way they are attempting to tackle the pandemic.
"As the world has passed one million deaths from COVID-19, we must confront the fact that we are taking a far too narrow approach when it comes to managing this outbreak of a new coronavirus," Horton writes.
"We've viewed the cause of this crisis as an infectious disease. All of our interventions have focused on cutting lines of viral transmission, thereby controlling the spread of the pathogen.
"The “science” that has guided governments has been driven mostly by epidemic modellers and infectious disease specialists, who understandably frame the present health emergency in centuries-old terms of plague.
"But what we have learned so far tells us that the story of COVID-19 is not so simple.
"Two categories of disease are interacting within specific populations – infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and an array of non-communicable diseases (NCDs). These conditions are clustering within social groups according to patterns of inequality deeply embedded in our societies.
"The aggregation of these diseases on a background of social and economic disparity exacerbates the adverse effects of each separate disease."
Horton calls for the pandemic to be 're-labelled' – and for there to be a fresh approach to tackling the outbreak.
"COVID-19 is not a pandemic, it's a syndemic," he writes.
"The syndemic nature of the threat we face means that a more nuanced approach is needed if we are to protect the health of our communities.
"Limiting the harm caused by SARS-CoV-2 will demand far greater attention to NCDs and socioeconomic inequality than has hitherto been admitted.
"The total number of people living with chronic diseases is growing.
"Addressing COVID-19 means addressing hypertension, obesity, diabetes, cardiovascular and chronic respiratory diseases, and cancer."
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