The Forgotten Epidemics During COVID-19

The world’s attention is justifiably focused on battling the COVID-19 pandemic which continues to ravage indiscriminately across the globe. There are, however, three other epidemics that we were dealing with prior to COVID-19 that are at risk of being forgotten:

The Opioid epidemic
The Obesity epidemic
The Physician Burnout/Mental Health epidemic

All three have been exacerbated by COVID-19 and if we aren’t careful, we will be back at ground zero if we don’t start to give a little bit of attention to what’s happening.
The Opioid Epidemic
On June 30 th , the American Medical Association (AMA) updated their brief on the increase in opioid-related overdoses during the COVID pandemic. In it the AMA states that it is:
“greatly concerned by the increasing number of reports from national, state and local media suggesting increases in opioid-related mortality – particularly from illicitly manufactured fentanyl and fentanyl analogs. More than 30 states have reported increases in opioid-related mortality…”
Several factors are contributing to this increase:

The shuttering of safe injection sites due to the lock-down
A reduction in the capacity of opioid treatment centers that have remained open (due to a lack of PPE and now due to physical distancing requirements)
Disruption to the drug supply-chain forcing people to seek less trustworthy suppliers
An increase in the lethality of available opioids
More people are using alone due to restrictions on gatherings
More people feeling helpless during this pandemic due to isolation, job loss and financial pressure

What can be done? The AMA is calling on state governments to:

Adopt the new SAMHSA and DEA rules and guidance (which allows patients to obtina up to 28 days of take-home medication if they are stable) for the duration of the COVID-19 emergency—including flexibility for evaluation and prescribing requirements using telemedicine.
Remove prior authorization, step therapy and other administrative barriers for medications
Remove existing barriers for patients with pain to obtain necessary medications. This includes removing arbitrary dose, quantity and refill restrictions on controlled substances.
Enact, implement and support harm-reduction strategies, including removing barriers to sterile needle and syringe services programs.

The Obesity Epidemic
Prior to COVID-19, obesity was recognized by many as a national public health crisis. There was growing awareness of the harmful downstream impacts of obesity including: heart disease, diabetes, and cancer. A 2013 study showed that obesity “accounted for 18% of deaths among Black and White Americans between the ages of 40 and 85”.
As if that wasn’t dire enough, scientists have recently shown there is a link between obesity and patients with severe COVID-19...

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