THE PANDEMIC of the novel coronavirus is a bow wave, slicing through whole populations at breakneck speed. But what is not being seen yet is the enormous collateral damage to global health. The pandemic is making it harder or impossible to combat such scourges as measles, polio, HIV, tuberculosis and malaria, which caused death and suffering even before covid-19, and now will bring even more. The wake of the pandemic may become every bit as devastating as the bow wave.
The decades-long quest to eradicate polio, which came close to success, is now being paused to fight the coronavirus. The oversight board of the Global Polio Eradication Initiative says that its resources and assets are being turned to fight the pandemic, and it has recommended that all countries planning vaccination campaigns suspend them until the second half of the year. It makes no sense for polio vaccine campaigners to go door-to-door at the time of a pandemic, and the polio campaign does have significant experience with case detection, contact tracing, laboratory testing and community education. Let’s hope the polio campaigns can return later this year.
In the meantime, more children will suffer. The number of cases in the last two remaining countries where wild polio virus is endemic, Afghanistan and Pakistan, was down to 33 in 2018, then climbed to 175 in 2019. With the vaccination campaign suspended, wild polio cases will grow and may spread to other countries. On top of that, polio fighters were struggling with outbreaks of a form of the poliovirus that can emerge in under-immunized populations.
In rare cases, the use of the oral polio vaccine, which uses a mixture of live, weakened strains, can revert and spread, causing circulating vaccine-derived polio virus, or cVDPV, which occurred in a number of countries in Africa and Asia last year. A high-level World Health Organization panel warned recently that “the risk of new outbreaks in new countries is considered extremely high, even probable.”
Meanwhile, the Measles & Rubella Initative, a global partnership to stop measles, reports that because of the pause in mass vaccination campaigns, more than 117 million children in 37 countries may miss out on receiving the measles vaccine this year. This is a major setback when measles cases have exploded around the world and claimed more than 140,000 lives in 2018, mostly children under the age of 5.
At the same time, Post correspondents Max Bearak and Joanna Slater report that in Africa and South Asia, the coronavirus will affect carriers of HIV and tuberculosis disproportionately. Tuberculosis is primarily a respiratory disease, like covid-19, which means that those who suffer from it often have severely diminished lung health. And HIV causes a progressive failure of the immune system, leaving carriers more susceptible to death from other infections. There are also serious concerns that the coronavirus pandemic could disrupt health-care systems and lead to a resurgence in malaria, which killed 405,000 people globally in 2018.
One virus is creating so much mayhem that other diseases will flourish, too.