COVID’s Impact on Diabetes Care in Africa and Beyond as the Omicron Variant Spreads
When a new variant of COVID-19, called Omicron, was announced by the World Health Organization (WHO) on November 26, 2021, the world braced itself for what the new variant would do to the state of the pandemic. All eyes have been on South Africa, where the variant was first identified and where active studies race to determine its affects.
Omicron Variant Spreading Swiftly
The Omicron variant of COVID-19 is currently the most dominant form of the virus in South Africa and is spreading twice as swiftly through its population as the Delta variant did. A very early study shows the Omicron variant may increase the risk of reinfection of COVID-19. Scientists in South Africa have since reported that the Omicron variant may be more transmissible than earlier forms of the virus and the variant spreads more than 2.5 times as high as the Delta variant. This information is being updated on a daily basis by scientists actively learning about the variant and changes in the virus.
Diabetes Care and COVID-19 Prevention Must be Managed Together
Even before the pandemic, uneven socioeconomic factors contributed to the high mortality rate from diabetes in Africa, such as lack of access to diabetes education and treatment. A recent tweet by a South African resident complained that half of the people in her diabetes support group of 250 members did not know what their last A1C was or what that term meant. 60% of people living with diabetes are undiagnosed in Africa, making it the highest proportion of people unaware of their medical condition. A 2019 study of diabetes care in older South Africans showed that officials advocated for an integrated approach in providing medical services to treat diabetes and other diseases. Diabetes care is essential during the pandemic where the effects of a COVID-19 infection can be deadly. With the disruption of every day life due to the pandemic, diabetes care has been negatively impacted.
Many are aware of the more severe implications of COVID-19 for those with diabetes, which can be underscored in the following statistics in Africa: the fatality rate for patients of COVID-19 with diabetes was 10.2% versus the 2.5% fatality rate for COVID-19 patients overall. On November 11, 2021, before the Omicron announcement, Dr. Matshidiso Moeti, the WHO (World Health Organization) Regional Director for Africa, called for action to better address the prevalence of diabetes in Africa and how the pandemic has negatively impacted the management of the disease. “COVID-19 is delivering a clear message: fighting the diabetes epidemic in Africa is in many ways as critical as the battle against the current pandemic.”
Costs and access to insulin vary in Africa, with each country having its own policies on providing insulin to its citizens. For instance, in Ghana, where citizens pay for diabetes care with their own funds, it would take an average worker more than five days of earnings to save for a monthly supply of insulin. In South Africa, where less than 20% of those with diabetes are covered by private health insurance, those without insurance must obtain insulin from public hospitals or clinics. Citizens have complained that hospitals and clinics have previously run out of medication or were unable to provide advanced doses. The cost of insulin would be prohibitive to many otherwise. When the pandemic caused millions in South Africa to lose their jobs, people with diabetes began stretching medication or did not receive treatment. The emergency regulations put in place to protect the public against COVID-19 exposure widened the gap in treatment accessibility. Government-imposed lockdowns were initiated to limit the spread of COVID-19. Still, these mitigation policies and others also impeded access to proper healthcare, glucose monitoring, and insulin treatment and disrupted access to healthy food.
Fortunately, in April 2021, the WHO launched the Global Diabetes Compact, which coincided with the 100th anniversary of the discovery of insulin. The vision of the Compact is to reduce the risk of diabetes and ensure those diagnosed have access to comprehensive treatment and care.
Recommendation for General Caution — Vaccines/Boosters
Health officials have widely acknowledged that African nations must take advantage of low-cost rapid diagnostic tests to routinely test people with diabetes to ensure early detection and proper care. Also, overcoming vaccine shortages and vaccine distrust in South Africa is necessary to reduce the spread of COVID-19. As of December 3, 2021, about 37% of adults in South Africa have been fully vaccinated. Given the global crisis in both diabetes and COVID-19, health officials recommend that people receive vaccinations and vaccine boosters, while also exercising precautions to protect themselves from severe COVID-19 complications. By highlighting the parallel fights against the diabetes epidemic and the COVID-19 pandemic, as seen in the current emergency struggle of South Africa, the world can hopefully, one day, arrive at a healthier and safer place.
