dr Abdul hamid

Dr Abdul Hamid.

The non-communicable diseases (NCDs) of obesity and high blood pressure was attributed as the major causes of death among patients with Covid-19.

According to Dr Abdul Hamid, it is very important to note that Trinidad and Tobago has a very, very high prevalence of NCDs.

Hamid, the General Manager of Primary Care Services at the North Central Regional Health Authority (NCRHA), who was speaking at Wednesday’s virtual Covid-19 press conference, listed the major NCDs as diabetes, hypertension, asthma, cancer, obesity and heart disease.

Covid-19 and obesity

“The sustained increase in the national rates of overweight and obesity, is a reason for concern, especially in light of higher of more severe Covid-19 related illnesses and deaths in people with obesity and other chronic non-communicable diseases," Hamid said.

He noted that a study of 2,500 patients in New York City revealed that obesity was associated with a markedly increased risk of incubation or deaths among adults under the age of 65, while another study showed that obese individuals had a 45 per cent risk or higher of being Covid-19 positive and a 74 per cent higher risk of the need for Intensive Care Unit care, as well as a 45 per cent increased risk of death.

Covid-19 and hypertension

Hamid said there’s growing data which shows a higher risk of Covid-19 infections and complications in people with high blood pressure.

“In the early stages of Covid-19 in Trinidad and Tobago, it was very much noted that the mortality rate was almost exclusively associated with persons with high blood pressure. In Trinidad and Tobago today, our prevalence of high blood pressure is 30 per cent of the adult population, which equates to about 300,000 persons who are at a high, high risk of developing Covid-19 complications.

“Data from China and the US show that high blood pressure is the most commonly shared pre-existing conditions amongst those hospitalised, affecting between 30 per cent and 50 per cent of patients.” 

He said a report from Italy revealed that 76 per cent of patients who died from Covid-19 had hypertension.

Covid-19 and diabetes

Noting that the care of Codi-19 patients with diabetes poses unique challenges as patients with diabetes are at risk for more severe illness, Hamid stated that Covid-19 patients that are afflicted with type 2 diabetes are more likely to have severe complications, and cited two examples of countries with high mortality rate among Covid-19 patients.

“In China the case fatality rate of 7.3 per cent amongst patients with diabetes, most likely type 2 diabetes, whereas the overall case fatality rate generally was 2.3 per cent, which is extremely high. In a retrospective study from the United States, the mortality rate was 14.8 per cent among patients with diabetes and 28.8 per cent in with diabetes or uncontrolled hypoglycaemia, compared with 6.2 per cent without either.

“So diabetics have generally a much longer stay in hospital and a very much higher risk of death from Covid-19.”

Stressing that poorly controlled diabetes is a risk factor for infection in general, Hamid said that elevated body mass index (BMI) is also associated with a very increased Covid mortality.

Covid-19 and heart disease

He said having heart conditions such as heart failure, coronary artery disease, cardiomyopathies, and possibly high blood pressure, can make persons more likely to get severely ill from Covid-19.

He also noted that Covid-19 can do direct damage to the heart especially if it’s already weakened from the effects of high blood pressure.

“If you have coronary artery diseases, which is the build-up of plaque in the arteries that supply your heart, the virus can make those plaques more likely to break apart and cause a heart attack.

“Covid-19 may also cause inflammation in the heart muscle, a condition called myocarditis which makes it harder for the heart to pump blood.”

Hamid said at most of the vaccination sites and centres, especially when they do outreach programmes, persons with NCDs always ask the question if they should take the vaccine.

“Our message to you today is to don’t delay, get vaccinated today.”

Covid-19 and asthma

“People with moderate to severe or uncontrolled asthma are more likely to be hospitalised from Covid-19. Also, those with co-existing COPD and non-allergic asthma compared to allergic asthma, are at increased risk of worse outcomes,” Hamid said.

He noted that to reduce the risk of these outcomes people should continue avoiding triggers and take prescribed controller and reliever therapies such as inhaled corticosteroids and inhaled beta agonists.

Covid-19 and cancer

“People who have cancer have a higher risk of severe illness from Covid-19.”

Stating that most data suggest that there’s a higher incidence of Covid-19 in cancer patients when compared to the general population, Hamid added that the Centre for Disease Control considers that cancer represent an established or probable risk factor for severe Covid-19.

He said notwithstanding possible decreased immunogenicity, all individuals with active or prior cancer who are eligible for vaccination, should be vaccinated against Covid-19.

For persons with an NCD who want to be protected from contracting the virus, Hamid said they should engage themselves in the following measures:

• Get vaccinated (speak with primary physician if necessary)

• Practice the 3Ws – wear mask, wash hands, watch your distance

• Take all medications as prescribed by your physician

• Improve your overall health to help control your NCD

He added that all the available vaccines have been approved by the WHO and have been shown to be safe and effective in protecting people against Covid-19, so people with NCDs should not delay, but get vaccinated today.

Meanwhile, Chief Medical Officer Dr Roshan Parasram stated that contrary to information out in the public domain, the Pfizer vaccines currently in Trinidad and Tobago, have not expired.

“There has been some misinformation out there as it relates to the expiry date of the Pfizer vaccine. At the end of September the manager of the Expanded Programme of Immunization (EPI) Unit would have been issued a letter form PAHO (Pan American Health Organisation) via the WHO (World Health Organisation), which has stated, “We are pleased to inform you of the recommendation to extend the shelf life of unopen vials from six months to nine months at minus 90 to minus 60.”

Noting that what this means is that the November batch of Pfizer vaccine can now be used until February of next year, Parasram added that a press release outlining all the details will be issued in the near future.

He also noted that the country’s vaccination rate is climbing but ever so slowly.

He stated that total persons with a first dose vaccination of a two-dose regimen now stands at 600,766, while total persons vaccinated with a second dose under a two-dose regimen was 526,014.

To date, a total of 26,968 persons have been vaccinated under a single dose regimen, and the total number of full vaccinations completed is 552,982.

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