Noncommunicable diseases (NCDs) such as heart disease, cancer, respiratory diseases, and diabetes account for over 70% of deaths globally each year. Risk factors for NCDs, like cardiovascular disease and diabetes, can also lead to more severe cases of COVID-19. The pandemic has made it difficult for patients with NCDs to access routine medical care. Telemedicine has been promoted in India to help patients with chronic conditions receive care during lockdowns when in-person services are limited. Continued monitoring is needed to assess the long-term health impacts of the pandemic on patients with NCDs.

1. NONCOMMUNICABLE
DISEASES AND COVID-19

2. Important?
Changing social, economic, and
structural factors including
more people moving to cities
and the spread of unhealthy
lifestyles fuel the NCD crisis that
kills 15 million people
prematurely — before the age of
70 — each year.

3. WHAT IS NCD??
Noncommunicable diseases (NCDs),
also known as chronic diseases, tend to
be of long duration and are the result of
a combination of genetic, physiological,
environmental and behavioural factors.

6. •Noncommunicable diseases (NCDs) kill 41 million
people each year, equivalent to 71% of all deaths
globally.
•Each year, more than 15 million people die from a
NCD between the ages of 30 and 69 years; 85% of
these "premature" deaths occur in low- and middle-
income countries. Studies have shown people from racial and
ethnic minority groups are also dying from COVID-19 at younger ages.
•77% of all NCD deaths are in low- and middle-income
countries.

7. •Cardiovascular diseases
account for most NCD deaths, or
17.9 million people annually,
followed by cancers (9.3 million),
respiratory diseases (4.1 million),
and diabetes (1.5 million).

8. RISK FACTORS

9. • COVID-19 and non-communicable diseases
(NCDs) are closely interconnected. Underlying
chronic conditions such as cardiovascular disease
(CVD) and diabetes are predictors for severe illness
and death from covid19.
• Accumulating evidence shows that certain types of
acute damage to multiple organs in patients with
COVID-19 may persist after hospital discharge

10. • containment and mitigation measures for COVID-19,
such as home containment, social distancing, and travel
restrictions, make it difficult for patients to access
routine diagnosis and treatment services for NCDs.
• Although the current global focus is on combating the
acute health threat of COVID-19, the ramifications of
the pandemic in relation to the global burden of NCDs
still need to be systematically assessed.

11. Preexisting conditions may contribute to adverse
outcomes of COVID-19 through mechanisms such as
chronic inflammation and elevated expression of
SARS-CoV-2 receptor (i.e., angiotensin-converting
enzyme-2) in certain organs.

12. • Acute damage from the COVID-19 can progress
into long-lasting chronic conditions, such as
respiratory function decline and cardiomyopathy .
• Long-term follow-ups are thus essential in order to
observe chronic conditions among COVID-19
survivors.

13. Vulnerable population
• Stay at home with physical distancing and other
preventive measures:
• All people above age of 60 years • All these people
must be monitored for symptoms of COVID-19
since they are at high risk of getting severe disease
if they get infected

14. WHO RECOMMENDATIONS
• WHO recommend when caring for patients with
suspected and confirmed COVID-19 that have
underlying NCDs to continue or modify
previous medical therapy according to the
patient’s clinical condition. Antihypertensive
drugs should not routinely be stopped in
patients with COVID-19, but therapy may need
to be adjusted based on general
considerations for patients with acute illness,
with particular reference to maintaining normal
blood pressure and renal function

18. VACCINATION

19. Community
• Orient ASHAs to optimize Home-visits by planning
and providing follow up care to all beneficiaries.
• Ensuring supply of medicines and consumables
➢Make and estimate of requirement and ensure
supplies for three months, if possible, for
medicines for RMNCH services, communicable
diseases including those under national
programmes, diabetes, hypertension, epilepsy etc.
as well as consumables

20. • Dialysis and Cancer treatment services ➢Maintain
a list of all patients requiring regular dialysis in
your PHC area and work with District hospitals to
organize appointments via telephone for next two
months. ➢In case of patients, who cannot afford
private vehicles, RBSK vehicles can be used for
facilitating transport of patients.

21. • Care for elderly/ disabled and palliative care patients
➢Ensure that list of patients/ individuals who need extended
support are maintained at the SHC level for regular follow up.
ANMs or CHOs will undertake two visits per month to such
households during the period of the outbreak, to assess for
onset of complications and to monitor treatment adherence.
ASHAs will maintain telephonic contact with these patients
and their families and will refer them to you if needed.
Undertake screening for new onset
fever/cough/breathlessness and risk communication on
COVID-19 in this sub group. Non Communicable diseases
Continuing the essential non COVID-19 PHC activi

22. TELEMEDICINE
• During the COVID-19 pandemic, a
countrywide lockdown of nearly twelve weeks
in India reduced access to regular healthcare
services. As a policy response, the Ministry of
Health & Family Welfare which exercises
jurisdiction over telemedicine in India, rapidly
issued India's first guidelines for use of
telemedicine.
• Telemedicine can provide support to persons with
NCDs and chronic conditions in such settings.

23. • Such diseases can have lasting and even fatal
consequences if acute services cannot be
provided in a timely manner, such as dialysis
for diabetic kidney disease, surgical
procedures for coronary heart disease, and
chemotherapy for acute myeloid leukemia.

25. THANYOU