Complicating the Coronavirus Lockdown Debate

An equitable COVID-19 response must address long-standing and pandemic infectious disease emergencies simultaneously to succeed at preventing health care systems from becoming overwhelmed. Disruptions caused by the COVID-19 pandemic and its response could catalyze a surge in HIV, malaria, and tuberculosis (TB) deaths, according to a new modeling study published in The Lancet Global Health by authors from Imperial College London.

While concern has been raised about the relationship between these disruptions and other health priorities before, the new model focuses on where the worst impact would be felt: low- and middle-income countries. Their modeling seems to suggest that at current pace HIV, TB, and malaria deaths could increase by as much as 10%, 20%, and 36% respectively over the next 5 years due to the disruption of health services.

The models indicate that the stability of programs which address long standing infectious disease health burdens are at risk. In areas with substantial prior health care resource strains, the authors even note that years of life lost (defined as the number of years a person would have been expected to live had they not died of a particular cause) could in some cases be of similar scale to the biological impact of the pandemic itself. The COVID-19 pandemic has caused substantial disruptions by overwhelming struggling health systems, and through lockdown measures limiting routine health care activity and patient care-seeking. The demobilization of many sectors of industry has also lead to interruptions in medical supply chains.

For more on this story, Contagion spoke with co-lead author Professor Timothy Hallett of Imperial College London, UK. Hallett was careful to clarify that predicting the future impact of the ongoing COVID-19 pandemic is challenging, including due to ongoing uncertainty around the novel virus itself.