Attached Files:
PIH Guide to COVID & NCDs - April 30 307 KB

This PDF is accompanied by a longer guide on Clinical Management of COVID-19which also includes detailed information on Mental Health and Psychosocial Support (Section 6). This version of the guide is updated as of April 21, 2020, we will continue to shared updated versions as complete. 

Through the COVID-19 pandemic, patients living with diabetes, sickle cell disease, or conditions treated with immune-suppressing medications may be at increased risk for infection. And many patients with chronic conditions of all kinds who do get infected are at higher risk of severe complications, hospitalization, and death. Yet among those living in poverty, social distancing measures can be particularly challenging to implement, the economics shocks of job loss, increased cost of commodities, and restricted mobility will be devastating, and lowest-income countries have weakened capacity to provide critically needed high-dependency care due to limitations in human resources, essential medications, oxygen concentrators, and safe and isolated clinical space.

As a result, the NCD Synergies team has put together the attached resource document to outline clinical considerations for patients with chronic disease through the COVID-19 crisis. The document outlines:

  • Risk considerations
  • Strategies to limit COVID-19 transmission
  • Disease-specific diagnostic/treatment considerations for patients with type 1 diabetes, rheumatic heart disease, chronic liver disease, and hypertension among others

More information on Partners In Health’s general strategy for COVID-19 can be found here, please also see our detailed COVID-19 manuals for Testing, Contact Tracing, and Community Management and Clinical Management of COVID-19 (which also includes guidance for mental health and psychosocial support). A statement on COVID-19 on behalf of the NCD Synergies program and the Program in Global NCDs and Social Change at Harvard Medical School can be found here.

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Early Clinical Adaptations for NCDI Patients through the COVID-19 Crisis

In the settings where PIH and our partners work, our colleagues are quickly working to adapt routine clinical activities to protect NCD patients in the midst of increasing threats of COVID-19 in their communities. Where possible, our NCD clinical teams have explored the following program adjustments:

  • Extending clinic hours to reduce crowding at facilities and better enable our providers and patients to adhere to social distancing
  • Setting up separate triage points in district hospitals and health centers to separate patients experiencing COVID-19 symptoms as soon as they enter hospital grounds, to ensure that wards are kept safe for healthcare workers and vulnerable patients been seen for other conditions
  • Increasing medicine orders for stable patients in order to lengthen the time needed between follow-up
  • Instituting a phone-based triage system in order to reduce in-person contact
  • Monitoring and supplementing insulin and other necessary NCD medications should supply chains be disrupted in the midst of national emergency support

In addition to clinical considerations, patients and families impacted by COVID-19 in low-income countries will require the world to proactively invest in social support, which is paramount to protect impacted communities. If we don’t take immediate action to support people living with NCDs who will find themselves experiencing many of the exacerbating socioeconomic impacts that COVID-19 may pose on communities – food insecurity, income loss, limited access to safe transportation, stress and isolation, stigma and discrimination –  the ripples of this pandemic will continue to be felt far beyond its clinical manifestations. Our teams are working to support our patients through targeted solutions such as direct cash transfers, food packages, home visits, transportation options, or psychosocial support through this challenging time.

Full access to the PIH Guide COVID & NCDs (April 30)