Long-term mass population effects of the COVID-19 pandemic: a long way to go

Abstract

The COVID-19 pandemic has been referred to as one of the most impacting, mass disabling events in the recent public health history, emphasizing the long-term direct effect on those experiencing the disease and the implications for health policy and planning 1,2 . Alternatively, the term "mass deteriorating event" has been proposed, considering the long-term consequences of COVID-19 may present via a broad range of symptoms, from feelings that your health was better before the infection to permanent impairment 3,4 . Long-term effects, referred to as long-COVID or post-acute sequelae of SARS-CoV-2 infection (PASC), need a multidisciplinary research approach to inform the prevention and care of those affected 4,5,6 .However, the influence of pandemics are potentially disruptive, directly and indirectly affecting the population's health 7 . The COVID-19 pandemic might not be different from other pandemics, but there is still a long pathway to go through in order to evaluate if COVID-19 impact will be worse. Beyond the immense numbers of acute and PASC cases and deaths, the COVID-19 pandemic is likely to have also affected the delivery of preventive programs, such as immunization and cancer screening, as well as the continuous care of chronic conditions, such as diabetes 8,9,10,11 . The magnitude of such indirect effects on the population's health is still to be verified. However, a modeling study suggests that, without adequate mitigation strategies, a 12-month delay to mass drug administration due to the COVID-19 pandemic could result in up to a 2-to 3-year delay in reaching the agreed public health targets for some neglected tropical diseases, such as schistosomiasis, trachoma, lymphatic filariasis, and onchocerciasis 12 .Cioffi & Cecannecchia 13 explore this issue, focusing on the effect of the COVID-19 pandemic on vaccination coverage, specifically against measles. As the authors noted, the number of measles cases has already increased in the first two months of 2022 compared to the same period in 2021 14 . Indeed, as of April 1st 2022, 43 countries have postponed at least one immunization campaign since the onset of the pandemic, 19 against measles, putting millions of children at risk 14 . Unfortunately, insufficient vaccination coverage due to postponed or canceled campaigns extend to other diseases, such as meningitis, polio, yellow fever, tetanus, and diphtheria 15 .Since the 1980s, Brazil has shown stable high vaccination rates, reducing the burden or elimination of many vaccine-preventable diseases such as poliomyelitis, tetanus, pertussis, and measles 16 . However, a decrease in immunization coverage against measles to values below the recommended CARTA LETTER Long-term mass population effects of the COVID-19 pandemic: a long way to go Efeitos populacionais em massa a longo prazo da pandemia de COVID-19: um longo caminho a percorrer Efectos masivos a largo plazo de la pandemia de COVID-19 en la población: un largo camino por recorre

Gender, psychological distress, and subjective well-being two years after the onset of the COVID-19 pandemic in Spain

“…The COVID-19 pandemic has been considered one of the most impactful mass disability events in recent public health history 33 , greatly impacting the health and well-being of the general population, albeit with important individual and group differences, including gender. Although the direct effects of the COVID-19 pandemic seem to have more greatly affected men with higher mortality rates 34 , 35 , its indirect effects have affected women more 35 , 36 , with greater deterioration in their mental health after the onset of the COVID-19 pandemic than in men 37 , 38 as the pandemic intensified preexisting inequalities between women and men 7 , 8 , 35 , 36 .…”

Epidemiologia e pandemia de Covid-19: oportunidades para rever trajetórias e planejar o futuro

“…A pandemia de Covid-19 alcança a população brasileira em uma situação de franca vulnerabilidade social, econômica e programática 24 . Formou-se, assim, uma tempestade perfeita, ancorada no desmonte das políticas sociais, no crônico subfinanciamento do Sistema Único de Saúde (SUS) e na gestão catastrófica da pandemia 25,26 . Pandemias são, simultaneamente, fenômenos com dimensões biológicas, ecológicas, sociais e históricas e, como tais, desvelam e aprofundam desigualdades sociais, fazendo que a maior carga de adoecimento e morte da Covid-19 incida sobre os mais vulnerabilizados 27,28 .…”

“…Pandemias são, simultaneamente, fenômenos com dimensões biológicas, ecológicas, sociais e históricas e, como tais, desvelam e aprofundam desigualdades sociais, fazendo que a maior carga de adoecimento e morte da Covid-19 incida sobre os mais vulnerabilizados 27,28 . Esse quadro dramático pode ser mais bem expresso como uma sindemia, na qual a pandemia de Covid-19 interage com diferentes fontes de vulnerabilidades sanitárias, sociais e ambientais, potencializando os efeitos adversos de todos os fatores sobre a saúde da população 26,29 .…”

Epidemiology and the Covid-19 pandemic: opportunities to review trajectories and plan for the future

“…The Covid-19 pandemic caught the Brazilian population in a situation of profound social, economic, and program vulnerability 24 . Thus, a perfect storm was formed, grounded on the dismantling of social policies, on the chronic underfunding of the Brazilian National Health System (SUS), and on the catastrophic management of the pandemic 25,26 . Pandemics are phenomena with biological, ecological, social, and historical dimensions.…”

“…As such, they unveil and deepen social inequalities, causing the greatest burden of illness and death from Covid-19 to fall on the most vulnerable 27,28 . This dramatic picture can be better expressed as a syndemic, in which the Covid-19 pandemic interacts with different sources of health, social, and environmental vulnerabilities, and intensifies the adverse effects of all factors on the population's health 26,29 .…”