The impact of Covid-19 extends beyond the virus, with increased deaths from other conditions

The impact of Covid-19 extends beyond the virus, with increased deaths from other conditions

Disrupted care during the Covid-19 pandemic led to sharp increases in other non-hollow causes of illness and death, particularly mental illness, malaria in young children, and stroke and heart disease in older adults, a study published today by the BMJ finds.

For example, new cases of depressive disorders among ages 5 to 14 increased by 23% and malaria deaths increased by 14% among children under five from 2020 to 2021.

The researchers say future responses to potential pandemics or other public health emergencies of international concern “will need to go beyond infection control to consider the long-term implications for syndemic health.”

Most health services have been severely affected during the pandemic, hampering efforts to prevent and control many diseases. However, an in-depth analysis of the impact of the pandemic on other causes of illness and death is still needed.

To account for this, researchers in China used data from the 2021 Global Burden of Disease Study to simulate the burden of 174 health conditions in 2020 and 2021 across different regions, age groups and genders.

A total of 204 countries and territories were included in the analysis. The main measures of interest were incidence (number of new cases), prevalence (number of people living with a disease), deaths and years of life lived (DALYS) - a combined measure of quantity and quality of life.

Depressive and anxiety disorders along with malaria were most significantly affected, with a significant increase in disease burden compared to other causes.

For example, the age-related malaria incidence rate increased by 12% (to 98 per 100,000). Daly rates for depressive and anxiety disorders also increased by 12% (to 83 per 100,000) and 14% (to 74 per 100,000), respectively, particularly among women.

The standardized incidence and prevalence rates for depressive disorders increased by 14% (to 618 per 100,000) and 10% (to 414 per 100,000), respectively, while anxiety disorders increased by 15% (to 102 and 628 per 100,000).

Heart disease prevalence rates also saw notable increases, particularly among individuals aged 70 years (169 per 100,000 for ischemic heart disease and 27 per 100,000 for stroke).

There was also a significant (12%) increase in the standardized mortality rate from malaria (12%), particularly among children under five years of age in the African region.

The researchers acknowledge that their methods may not fully capture the complexity and variation of pandemic disorders, and factors such as uneven data quality across regions, possible underreporting, and delayed diagnoses during the pandemic may have influenced the accuracy of their results.

But they say their analysis is broader in scope than previous studies and offers actionable, policy-relevant recommendations to improve the health care system.

Therefore, they conclude: “These results underscore the urgent need to strengthen health system resilience, improve integrated surveillance, and inform strategies to support equitable preparedness for future public health emergencies.”

This study highlights how data can guide smarter recovery to ensure future health crises disrupt lives less and affect populations more evenly, researchers say in a linked editorial.

By integrating these insights into post-pandemic plans, countries can improve resilience, they write. Specific steps include allocating budgets for essential services in emergencies, strengthening primary health care, expanding disease surveillance networks, and prioritizing universal health coverage with a focus on disadvantaged or marginalized communities.

“Ultimately, recognizing and planning for the indirect toll of the pandemic will save lives and leave health systems stronger and fairer for future public health emergencies,” they conclude.

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