New normal strategies for life with COVID “insufficient,” say US researchers

Medical experts and researchers are warning against US strategies that do not incorporate crucial lessons from the first two years of COVID-19 into the “new normal” of life: the significant role of noncommunicable chronic diseases (NCDs) in exacerbating COVID-19, and the disproportionate burden of COVID-19 on underserved populations and communities of colour.

Jun Ma, Professor of Medicine at the University of Illinois Chicago, argued that the COVID-19 pandemic and the chronic disease crisis together create what is called a synergistic endemic, or syndemic — an overlapping of epidemics that inevitably increases the burden of disease and the likelihood of poor outcomes.

“This is a major missed opportunity to address multilevel factors that contribute to severe COVID-19 and COVID-19 mortality, not to mention other health conditions,” said Ma, who, with others propose a new normal national strategy that focuses more on the SARS-CoV-2 virus’ implications.

[Recent proposals for US are too focused on only the virus and hardly enough on the context in which the virus’ impact is most burdensome.]

“What we really need is a comprehensive syndemic control strategy because, in truth, the pre-pandemic state of health in the US was not ideal in the first place,” said Ma. The professor has cited literature proving how NCDS have created high susceptibility to severe and fatal COVID-19 outcomes and contributed to racial and ethnic inequities.

According to Ma, “failure to address NCD control and prevention as a national priority is unacceptable because it contradicts compelling evidence and misses the opportunity to use a whole set of effective intervention approaches that can save lives. […] the consequences of inaction could be devastating by allowing continuation of high vulnerabilities for severe and inequitable outcomes of NCDs and future infectious disease pandemics.”

“Though we all hope the pandemic is waning, variants keep appearing and vaccinations wane as well. Thus, we need to plan now for better responses to a possible next surge as well as future pandemics,” interjected Ma’s colleague, James Sallis, from the University of California San Diego.

The duo propose “actionable” steps that could form a more effective control and prevention strategy:

1. Prioritised screening by healthcare systems, including at COVID-19 vaccination and testing locations, for medical and psychological chronic conditions that are highly treatable but often undiagnosed and poorly managed.
2. Leveraging national infrastructure mobilised for vaccine promotion and distribution to also disseminate proven lifestyle and behavioural health programmes.
3. Partnerships between medical systems and community-based organisations could be expanded to include behaviour change interventions in routine health care delivery and coverage.
4. Providing supportive reimbursement and funding policies to target communities through more awareness, information, and opportunity for managing their health.
5. Campaigns for COVID-19 vaccination and masking that promote healthy lifestyles and mental well-being.

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