This year has welcomed a number of new ideas and words to the public’s vocabulary including cytokine storm, lockdown, coronavirus, and now “syndemic”. Apparently, this word was coined in the 1990’s with the HIV/AIDS crisis, but I had never heard it until today’s article. We have heard multiple studies highlighting the connection between chronic diseases like diabetes with the severity of COVID infection. Now we can condense that sentence into one term, “syndemic”, and even add to the meaning with the following idea. The societal effects of COVID hysteria lead to obstacles to health care for those living with chronic medical conditions, thus often worsening their chronic condition which further raises their risk for COVID death.
After several studies showed a link between chronic illness and COVID deaths, it has become accepted dogma that those with diabetes, cancer, heart conditions, and respiratory conditions along with the elderly should take extra precautions. Reports that 86% of the COVID-19 patients in India and 72% of the COVID-19 patients in China had comorbidities make those individuals rightfully nervous (Thakur). Australia has reported 86% of its deaths as having occurred in those with chronic medical conditions (Yadav).
The article describes how the COVID 19 pandemic negatively affected those with chronic medical conditions. As communities and countries locked down normal functions, many health care services were also curtailed. Those living with these conditions were either unable to access needed care as easily or self-limited access due to fear of catching COVID 19. As isolation continued indefinitely the social vacuum then contributed to further mental health decline. The mental health decline added to the individual’s overall risk as their chronic condition was exacerbated. Taken together, the risk of COVID 19 for those with chronic medical conditions heightened further.
We should not be surprised however that COVID 19 deaths appear condensed in those with these conditions. Studies show that 72% of worldwide deaths result from these non-infectious conditions. Diabetes, heart disease, cancer and others kill more people than infections. Adding COVID 19 to the mix only worsens the death rate, likely related to the increased baseline inflammatory state and weakened immune system (Chen).
To counteract this “syndemic” the study author proposes several standard approaches. This includes the development of alternative care delivery plans in a time of pandemic. This includes information campaigns to educate such individuals on self-care. This includes shifting such health care from the central medical community to decentralized community health workers. While these ideas and others that they mention are not bad, they miss the boat on two other areas.
First, they assume that the lockdowns and the resulting fear which both hinder individual’s care are unavoidable necessities of the pandemic. That is not a foregone conclusion. When we know both by simple logic and actual studies that chronically ill individuals fare better when they receive appropriate medical care, how can we justify the grossly delayed care during this pandemic? In order to avoid risk of COVID, we have chosen to harm others with the over-zealous lockdowns.
Second, the media propaganda of hysteria has created an unnecessary pandemic of fear that is harming everyone but especially those who chose to forego needed medical care. We do need to create safe means of delivering care for such high-risk individuals, but we then need to disseminate reassuring messages to counteract the fear mongering.
Okay, I have stated what should be obvious to most reasonably minded people. Now let me highlight the biggest pink elephant on the public stage that others want to ignore. Our world has a problem with chronic medical conditions. People were already dying at high rates of these disease prior to COVID 19. The conventional medical model DOES NOT address this adequately. We need the functional medicine model which emphasizes lifestyle modification, patient empowerment, and root cause health care. We also need to step outside the insurance driven model which incentivizes and enables the broken conventional system while making the functional medicine approach difficult to implement.
We have problem in conventional medicine. We need to stand up and say, “I am America. I have a problem. Let’s change our approach.” This “syndemic” highlights the disastrous consequences of playing doctor but not treating the root causes of illness. Drive change by looking for a functional medicine approach in your next medical provider. Drive change by stepping outside the confines of insurance-based medicine. Strive for a healthier more abundant life instead of staying on the treadmill of conventional medicine.
Uday Narayan Yadav, Binod Rayamajhee, Sabuj Kanti Mistry, Shradha S. Parsekar, Shyam Kumar Mishra. A Syndemic Perspective on the Management of Non-communicable Diseases Amid the COVID-19 Pandemic in Low- and Middle-Income Countries. Frontiers in Public Health, 2020; 8 DOI: 10.3389/fpubh.2020.00508
Thanks to Science Daily:
University of New South Wales. “COVID-19 a double blow for chronic disease patients.” ScienceDaily. ScienceDaily, 23 October 2020. <www.sciencedaily.com/releases/2020/10/201023123141.htm>.
Other articles cited:
Thakur J. Novel coronavirus pandemic may worsen existing global noncommunicable disease crisis. Int J Noncommun Dis. (2020) 5:1–3. doi: 10.4103/jncd.jncd_2_20
Chen L, Deng H, Cui H, Fang J, Zuo Z, Deng J, et al. Inflammatory responses and inflammation-associated diseases in organs. Oncotarget. (2018) 9:7204–18. doi: 10.18632/oncotarget.23208
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.