Slipping Through the Cracks: The Danger of Losing Sight of Non-COVID-19 Diseases

Jul 13, 2021 | Caleb Boyer | Outbreak News

Over the last year and a half, an incredible amount of resources have been devoted to containing the spread of COVID-19 by monitoring emerging hotspots and creating a vaccine for global distribution. Nations created task forces and poured money into research efforts [1,2]. Recently, as vaccination campaigns are underway across the globe, many nations have begun to return to some semblance of normalcy. Though the emergence of the delta variant led to a recent uptick in cases, newly reported cases are largely down from their peaks, both in the United States and globally. 

While this is a major success in the fight to end the pandemic, it is imperative to devote some attention to the myriad non-COVID-19 diseases that either have the potential to or have recently caused significant outbreaks.

The mosquito-borne viral disease Chikungunya, for instance, has been found in unusually high numbers in Brazil. This is particularly alarming given that Chikungunya is most common to Africa, Asia, and the Indian subcontinent. Chikungunya causes fever, severe muscle and joint pain, and nausea, among other symptoms [3].

In the year to date, the city of Santos, São Paolo reported 6,083 cases of the disease along with one death. There were only 122 cases (zero fatalities) in the year prior, meaning that the current number represents a 4,986% increase in Chikungunya cases only six months into 2021. Furthermore, Dengue cases in São Paolo are significantly higher than 2020. There have been 3,698 cases so far, compared to 324 last year. The dramatic increase of Chikungunya and Dengue cases may be explained by the prolonged focus on COVID-19, removing focus on other public health surveillance efforts. Currently, Brazil is one of the worst-hit countries in terms of case-fatality rate, deaths per capita, and total cases of COVID-19. As a result, Brazil’s focus on combating the spread of COVID-19, combined with an unusually high number of mosquitoes, allowed diseases such as Chikungunya and Dengue to spread more than normal [4].

Such abnormalities are occurring with other diseases as well. Mucormycosis, a fungal disease which causes blackened or discolored nose tissue, blurred or double vision, breathing difficulties, and coughing blood has exploded in India in recent months [5]. Dr. Raghuraj Hegde, an eye surgeon in Bangalore, noted that he saw 19 cases of mucormycosis in a two-week period from late April to early May this year. He says he has never seen more than one or two cases per year in his decade of practice. So far, India has reported more than 40,000 cases of mucormycosis during the pandemic. These cases have been devastating given mucormycosis has a mortality rate of 50%. Even if individuals don’t die, many are forced to remove an eye or teeth [6,7]. Unfortunately, surgical intervention and antifungal medications only reduce the death rate to 30%, at best [8]. Dr. Hegde has begged the government to address drug shortages, but little help has been provided. Some people have even resorted to desperate public Twitter posts in an attempt to crowdsource the antifungal medications. 

Additionally, the recent surge of cases is notable because 85.5% of these patients had recovered from COVID-19. This statistic was obtained from EpiCore, a world-wide network of public health professionals to provide verified information on public health events [9].

This illustrates the importance of addressing outbreaks of non-COVID-19 diseases, in addition to the current pandemic. Even if these individuals recover from COVID-19, they are clearly still vulnerable to mucormycosis, which is over 20-times more fatal than COVID-19, if treated, and nearly 40-times if not [10,11].

Together, these three diseases should serve as a warning for what can happen when focus remains heavily on COVID-19.Though the coronavirus pandemic is far from over, it is essential to monitor and actively support efforts against other diseases, in addition to the campaign against COVID-19. Doing so will not only address endemic diseases, such as Chikungunya and Mucormycosis, but could potentially prevent the next pandemic as well.



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