With all the attention on Covid 19… are we allowing other health problems slip through the cracks?

The Covid-19 pandemic hit us in Nigeria in March 2020, and to say our health sector was not prepared for it would be stating the obvious. There were already so many gaps in our healthcare system: the massive brain drain of healthcare personnel to other countries, the lack of an efficient and effective emergency response system, lack of infrastructure, and basic medical equipment to mention a few. We were already grappling with childhood immunization coverage, hypertension, diabetes and heart disease, malaria, tuberculosis, HIV/AIDS, and so on; then this strange disease comes in to disrupt an already fragile situation.

In the beginning, there was a lockdown, restricting movements, and shutting down all but the most essential services. There was also a misconception that “Covid resides in hospitals”. This led to many people not getting care for severe/life-threatening illnesses; either because they could not get to the hospital because of the movement restrictions, or because they were afraid to go to the hospital because of the fear of contacting Covid in the emergency room.

There was also the spate of closing of hospitals where Covid cases were discovered, which led to many physicians turning away many cases that resembled Covid, for fear of being shut down by the government.
With a better understanding of the virus and its mode of transmission and the easing up of the lockdown, there has been a sharp increase in the number of Covid cases due to the community transmission. This has led to a huge emphasis on Covid treatment to the detriment of other illnesses, especially preventive medicine.

What is the scope of the problem?
Immunisation services has been adversely affected since the onset of the Covid pandemic in Nigeria. Authorities monitoring immunizations have noticed a decrease in immunisations in the months since the COVID-19 outbreak began. What this translates to, is that we may be faced with an upsurge of childhood diseases like measles, etc in the coming months.
Upsurge in mental health problems in the community due to the loss off a loved one from Covid related deaths, fear of catching Covid, reduction in social interaction and compulsory isolation, as well as general uncertainty.

There is also an increase in depression and burn out rates amongst healthcare personnel, from seeing all the severe cases of Covid, colleagues dying from Covid and the fear of contacting Covid from patients they are caring for.
Regular Non-communicable disease clinics (hypertension, diabetes etc) are cutting down on number of clinic visits by patients. This is because many health professionals are on isolation from time to time due to Covid infection and the drafting of extra health workers to Covid units and emergency rooms to cope with the upsurge of Covid cases. With this, many people don’t get to have their routine visits as often as they used to, leading to problems with drug compliance and complications like stroke, etc.
Delay in care of patients. Some diseases like heart failure, embolism and pneumonia have the same features as Covid (cough, difficulty in breathing). The only way to exclude Covid is to do a test, which may take as long as 48 hours before the results come back. Precious time would have been wasted.

What can be done?
Robust education and campaign on the dangers of non-immunization of children. Parents should be encouraged to keep up with immunization appointments and schedules.
Hospitals need to set up a mental health unit and encourage their staff to seek care regularly.
Community support by way of health education, mental health help lines as well as Covid protocol compliant or virtual group meetings may help alleviate some of the Covid related anxiety.
The use of tele-medicine in the management of patients with chronic illnesses will help bridge the gap between clinic visits.
Rapid triage and quicker/more efficient testing methods for Covid 19 infection that would give accurate test results within a few minutes.

Dr Monisola Adanijo FMCP a Cardiologist and Co-Founder of Naveen Healthcare.
With experience spanning over 20 years, she built her pathway in medicine and cardiology working in reputable medical centres such as Mecure Healthcare Limited, Barnes Hospital, Lagos University Teaching Hospital, University College Hospital, Ibadan, Chevron Hospital, Lagos to mention but a few.
Her passion for preventive cardiology led her to convene the Naveen Healthcare 10,000 Hearts Project, in order to help individuals detect, protect and correct cardiovascular diseases.
Skilled in cardiovascular diagnostic procedures and treatment, a fellow of the National Postgraduate Medical College of Nigeria, a member of Nigerian Cardiac Society, American College of Physicians, Hypertension society of Nigeria and an international associate of the American College of Cardiology. She also has a Diploma in Leadership and Management from the University of Washington, USA,

As a Continuous Medical Education (CME) provider, she has worked with the likes of Trigen Healthcare Solutions, Pfizer GP Academy, Diamond Helix Medical Assistance, Pfizer Pharmacy Academy, Global Health Project and Resources, Sanofi-Aventis Nigeria, Novartis Nigeria and Servier International. She has helped build capacity in Electrocardiogram interpretation, preventive cardiovascular diseases, management of heart failure, patient education and more.
She launched the first TeleElectrocardiogram project in Nigeria and West Africa and does her part in contributing to good health and wellbeing, a Sustainable Development Goal (SDG3) of the United Nations.

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