india

Updated: Apr 24, 2020 05:31 IST

One in five people globally has a health condition that heightens the risk of severe coronavirus disease (Covid-19), a new working paper has estimated. In India, around 30% of the working age population between 15 and 64 years of age have at least one condition that makes them vulnerable to Covid-19 complications, the paper indicates.

In the absence of a vaccine, an option is to shield high-risk people by more intensive physical distancing measures than the rest. “This may be especially important at times and places where health systems risk being overwhelmed by cases,” said the study, which was led by researchers at the London School of Hygiene & Tropical Medicine and published in Medrxiv, a website for pre-print health research.

An estimated 1.7 billion people (22% of the global population) have at least one and 0.4 million have at least two underlying conditions that could increase their risk of severe Covid-19 infections. The prevalence of one or more condition was 10% by age 25 years, 33% by 50 years, and 66% by 70 years, indicating even a large share of younger persons are at risk of co-morbidities. The most prevalent conditions in those more than 50 years old were chronic kidney disease (CKD), cardiovascular disease (CVD), and chronic respiratory disease (CRD).

Populations in high income countries are at a greater risk compared to Africa and some other parts of the world, the paper said, with the vulnerable population ranging from 16% in Africa to 28% in North America and 31% in Europe. The highest estimates were in European and other high-income countries with chronic illnesses, according to researchers who used the Global Burden of Disease (GBD) Study and other global studies to arrive at the estimates.

Prevalence estimates were extracted by age, sex and country for CVD, CKD, CRD, chronic liver disease, diabetes, cancers, HIV/AIDS, tuberculosis, chronic neurological disorders, sickle cell disorders, among others.

African countries with a high prevalence of HIV/AIDS and Island countries Fiji, Guam, Kiribati etc with a high prevalence of diabetes, had a high share (24% with at least one comorbidity that can make Covid-19 severe in Oceania) of the population at increased risk.

“Wherever people live longer, the burden of non-communicable disease is higher, which makes them vulnerable to viral infections. In India, there is premature onset of non-communicable diseases, with one in three adults developing hypertension in most cases early and one in 10 have diabetes. So, we have a large number of people who could have severe Covid-19 disease, but what we have seen is 70% to 80% of those who are Covid-19 positive in India have very mild symptoms or are asymptomatic,” said Dr Giridhar R Babu, professor and head, Lifecourse Epidemiology, Public Health Foundation of India.

The data in the paper should help create a plan for the elderly and those with early onset comorbidities for the post lockdown period when infections are expected to peak. “They have to be protected, by limiting their movement outdoors, the use of mask, physical distancing etc. They can also get specialised care in hospitals.”