Couva Hospital and Multi-Training Facility, the main Covid-19 Hospital in T&T. AZP News/Azlan Mohammed
By Chantalé Fletcher
TRINIDAD and Tobago has a very high prevalence of Non-Communicable Diseases (NCD’s).
The most common being diabetes, hypertension, asthma, obesity, cancer and heart disease as the most common.
This is according to General Manager Primary Care at the North Central Regional Health Authority (NCRHA) Dr Abdul Hamid at the Ministry of Health’s virtual presser on Wednesday.
Dr Hamid gave a breakdown of each of the common NCD’s listed and how they affect patients with Covid-19.
The care of Covid-19 patients with diabetes posed unique challenges which placed them at risk for severe illness, the doctor said.
He said, “Patients with type two diabetes are more likely to have serious complications.”
Dr Hamid reference to China which showed, “The case fatality rate at 7.3% amongst patients with diabetes, most likely type 2 whereas the overall case fatality rate generally was 2.3% which was extremely high.
“Whereas in a retrospective study from the United States the mortality rate was 14.8% amongst patients with diabetes and 28.8% in patients with diabetes compared with 6.2% without either. Diabetics have a much longer stay in hospital and are at a higher of death from Covid-19.”
The sustain increase of national rates of overweight and obesity was a reason for concern especially in light of the higher risk of more severe Covid-19 related illness and death in persons with obesity and other chronic NCD’s.
He said a study of 2,500 patients in New York City revealed that obesity was associated with a markedly increase of intubation or death among adults with less than 65 years of age.
Dr Hamid said, “Seventy-five studies showed that obese individuals had a 45% or higher risk of being Covid-19 positive where as 113% of being hospitalised and 74% higher risk of the need for Intensive Care Unit (ICU) and 45% increase risk death.
In the early stages of Covid-19 in T&T the mortality rate was almost exclusively associated with persons with high blood pressure.
Dr Hamid said, “In T&T today, our prevalence of high blood pressure is 30% of the adult population which equates to a 300,000 persons who are at high, high risk developing Covid-19 complications.”
In referring to data from China and the United States, he said that high blood pressure was the mostly commonly shared pre-existing conditions amongst those hospitalized, however a report from Italy revealed that 76% patients who died from Covid-19 had hypertension.
Persons with conditions such as heart failure, coronary artery disease and possibly high blood pressure were mostly likely to become severely ill from Covid-19
He said, “The virus can damage your heart directly especially if it was already weakened by th effects of high blood pressure. If you have coronary artery disease which is the buildup of plague in the heart, the virus can cause the plagues to break and cause a heart attack.”
In addition, Dr Hamid said Covid-19 may also cause inflammation in the heart muscle.
Persons with moderate to severe and controlled asthma were more likely to become hospitalised from Covid-19.
Dr Hamid said, “Those with co-existing non-allergic asthma compared to allergic asthma are at an increased risk of worse outcomes. However, to reduce the risk, persons can avoid triggers, take prescribed medications and controlled and reliver therapies.”
Persons with cancer have a higher risk of severe illness from Covid-19.
He said, “The Centres for Disease Control and Prevention (CDC) considers cancer represents an established risk factor of severe Covid-19, so all individuals with active or prior cancer and eligible to be vaccinated should be vaccinated against Covid-19.”
Dr Hamid gave persons with NCD’s some tips to stay protected and also encouraged all persons to get vaccinated, engage with primary care provider or specialist, practice the three W’s and take all prescribed medication.
He said, “Persons should eat fresh fruits and vegetables, avoid or limit alcohol, exercise, decrease salt in diet, drink adequate water and quit smoking.”