Smoking

Globally, heart disease is the number one cause of death. It is responsible for 17.9 million deaths each year.

According to the Centers for Disease Control and Prevention (CDC), in the United States, one person dies every 36 seconds from cardiovascular disease. Heart disease accounts for 1 in 4 deaths in the U.S.

As February is American Heart Month, today, we will tackle some persistent myths about heart disease.

1. Young people do not need to worry about heart disease

It is true that heart disease is more likely to affect people over the age of 65, but 4–10% of heart attacks occur in people under the age of 45 years, mainly in men. In addition, it is how we live our lives as children, adolescents, and adults that lays the groundwork for heart health as we age.

For instance, eating a diet that is high in trans and saturated fats or smoking tobacco slowly increases the risk of heart disease as we age. Changes to lifestyle today build the foundation for a healthier heart in later life.

In the U.S. as a whole, heart disease mortality has slowly dropped since the 1970s, although the trend seems to be slowing. However, in some regions, rates have increased.

One study that investigated heart disease mortality in different age groups in the U.S. found that “over 50% of counties [experienced] increases in heart disease mortality from 2010 through 2015 among adults aged 35–64 years.”

2. People should avoid exercise if they have heart disease

This is a myth. Exercise helps strengthen the heart muscle and improve blood flow around the body.

In August 2020, the European Society of Cardiology published guidelines on exercise in patients with cardiovascular disease. Prof. Sanjay Sharma, who was involved in creating the guidelines, explains:

“The chance of exercise triggering a cardiac arrest or heart attack is extremely low.” However, he also adds a note of caution: “People who are completely inactive and those with advanced heart disease should consult their doctor before taking up sports.”

3. I take cholesterol-lowering drugs, so I can eat whatever I like

Some drugs, such as statins, reduce the level of cholesterol in the blood. However, this does not mean that a person who is taking statins can consume foods containing saturated fats with abandon.

Cholesterol is either consumed in the food that you eat or produced in the liver. Statins block an enzyme in the liver that is necessary for producing cholesterol, reducing overall blood cholesterol levels. However, this means that ingested cholesterol can still make it into the blood.

In short, statins may just be able to override the adverse effects of a poor diet, but a poor diet will increase risk of other independent risk factors for heart disease, such as obesityhypertension, and diabetes.

4. Heart disease runs in my family, so there is nothing I can do to stop it

If close family members have experienced heart disease, it could mean that you have an increased risk. However, it is not set in stone, and there are a number of ways to reduce the risk, even for people with a genetic susceptibility.

These include eating a healthful diet, stopping smoking, managing blood pressure, and exercising regularly.

It is also worth noting that if heart disease runs in the family, it may not be a sign of genetic susceptibility. Families tend to share lifestyle factors, such as diet and exercise habits, both of which can impact the risk of heart disease.

5. Vitamins can prevent heart disease

Although most vitamins, taken at the recommended doses, are unlikely to be bad for heart health, there is no evidence that taking any vitamin supplements can reduce the risk of heart disease. And they certainly cannot replace a healthful diet and regular exercise.

For instance, a systematic review and meta-analysis looked for associations between multivitamin and mineral supplements and a number of cardiovascular outcomes, including coronary heart disease and stroke.

The analysis, published in 2018, took data from 18 existing studies, including 2,019,862 participants.

The authors concluded that multivitamin and mineral “supplementation does not improve cardiovascular outcomes in the general population.”

According to Victoria Taylor, the nutrition lead at the British Heart Foundation: “There are no shortcuts when it comes to nutrition — supplements are not a replacement for healthy food. You might be prescribed a vitamin or mineral supplement by a health professional for other reasons, but we do not recommend people take multivitamins to help prevent heart and circulatory diseases.”

6. I have smoked for years, there is no point stopping now

This is a myth. Smoking tobacco is a major cause of heart disease. As soon as a person stops smoking, the health benefits begin. The National Institute on Aging write:

“It doesn’t matter how old you are or how long you’ve been smoking, quitting smoking at any time improves your health. When you quit, you are likely to add years to your life, breathe more easily, have more energy, and save money.”

They also explain that you will lower the risk of heart attack and stroke and have better circulation.

7. Heart disease only really affects men

This is a myth, as heart disease is the leading cause of death in both men and women. In 2017 in the U.S., 24.2% of men and 21.8% of women died from heart disease.

However, when strokes, which have similar risk factors, are added in, the figures are even more similar between men and women: 28.7% of men and 28% of women died from heart disease or stroke.

It is a common misconception that only men are affected by heart disease. It is true that men tend to develop cardiovascular disease at an earlier age than women and have a greater risk of coronary heart disease. However, women have a higher risk of stroke.

One paper explains, “Although the incidence of [cardiovascular disease] in women is usually lower than in men, women have a higher mortality and worse prognosis after acute cardiovascular events.”

8. Cardiac arrest and heart attack are the same

Heart attacks and cardiac arrests are not the same thing. A heart attack is a circulation problem. It occurs when the coronary artery, which carries oxygenated blood to the muscles of the heart, becomes blocked.

A cardiac arrest is an “electrical problem,” where the heart stops pumping blood around the body effectively. Cardiac arrests are often caused by a heart attack.

During a heart attack, an individual is likely to be conscious. During a cardiac arrest, they are almost always unconscious. Both are a medical emergency.

9. Coughing during a heart attack can save your life

According to some sources, coughing vigorously during a heart attack — so-called cough CPR — can save your life.

This is an internet distortion of a paper published over 40 years ago, which showed that patients who had a cardiac arrest during arteriography in hospital and who coughed every 1–3 seconds stayed conscious for an additional 39 seconds.

There is no evidence that this technique works in the community for heart attacks that are not induced by medical procedures.

According to Christopher Allen, a senior cardiac nurse:

“The absolute priority when you think you or someone else is having a heart attack is to call [the emergency services]. This way, paramedics can assess and aid you, and you’ll get to hospital as fast as possible. There is no medical evidence to support ‘cough CPR.’”

10. People with heart disease should avoid eating all fat

A person with cardiovascular disease certainly should reduce their intake of saturated fats — which are found in foods such as butter, biscuits, bacon, and sausages — and partially hydrogenated and trans fats, which are found in foods such as baked goods, frozen pizzas, and microwave popcorn.

However, unsaturated fats can provide benefits. For instance, there is some evidence that omega-3, which is a polyunsaturated fat, might protect heart health.

The American Heart Association recommend “that all adults eat fish (particularly fatty fish) at least 2 times a week. Fish is a good source of protein and is low in saturated fat. Fish, especially oily species like mackerel, lake trout, herring, sardines, albacore tuna, and salmon, provide significant amounts of the two kinds of omega-3 fatty acids shown to be cardioprotective, [eicosapentaenoic acid] and [docosahexaenoic acid].”

They also recommend eating plant-derived omega-3 fatty acids. These can be found in tofu and other forms of soybeans; walnutsflaxseeds, and their oils; and canola oil.

The take-home

Heart disease is common, but it is not inevitable. There are lifestyle changes that we can all implement to reduce the risk of developing cardiovascular problems, whatever our age.

Researchers have raised alarm over rising cases of hypertension among teenagers and adolescents especially those in secondary schools across the nation.

In fact, several studies concluded that the prevalence of hypertension in Nigerian children is high and appears to be increasing and there is need for routine Blood Pressure (BP) and urinalysis check for all children in especially those in clinics and wards.

Indeed, studies suggest a high prevalence of elevated blood pressure among children and adolescents in Africa, with overweight and obesity being an important risk factor. They say efforts to address this burden of elevated blood pressure in children and adolescents should mainly focus on primary prevention at the community level, by promoting healthy lifestyles and avoiding other cardiovascular risk factors, especially overweight and obesity.

According to a study published in the journal The Lancet Public Health and titled “Prevalence of elevated blood pressure in children and adolescents in Africa: a systematic review and meta-analysis”, hypertension in children and adolescents is becoming a major concern, not only because of its rising prevalence, but also because of evidence suggesting that hypertension tracks from childhood to adulthood. Almost half of adults with hypertension had elevated blood pressure values during childhood.x

Furthermore, several studies have suggested that elevated blood pressure in childhood correlates with carotid intima-media thickness, atherosclerosis, left ventricular hypertrophy, and kidney failure in adulthood. Consequently, the study recommended early diagnosis and control of hypertension in childhood are likely to have an important effect on long-term outcomes of hypertension-related cardiovascular complications.

A recent study published in European Journal of Medical and Health Sciences concluded: “There is a noteworthy prevalence of hypertension among adolescent public secondary school students in Nnewi. This was significantly higher among the female gender, lower socioeconomic level and students with minimal physical activity. Waist circumference in the obese/overweight category very likely predicts hypertension.”

The study titled “Blood Pressure Profiles And Determinants Of Hypertension Among Public Secondary School Students In Nnewi, Southeast Nigeria” was conducted by Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State.

According to the researchers, hypertension and associated factors among adolescents have not been given the deserved attention in health care, more so as hypertensive children end up as hypertensive adults with serious co-morbidities. This is even more expedient among public school students, who in our environment are generally of lower socioeconomic status than those in private schools.

The researchers set out to determine the Blood Pressure (BP) profiles and association of obesity indicators, socioeconomic level and physical activity with hypertension among public secondary school students.

A cross-sectional school-based assessment of blood pressure (BP), body mass index (BMI), weight to height ratio (WHR), waist circumference (WC), physical activity and socioeconomic level among 593 students aged 10 – 17 years in public schools in Nnewi, Southeast Nigeria was carried out.

The results of the study showed the mean systolic BP increased with age and was higher for girls than for boys.x

“The prevalence of systolic hypertension and prehypertension were 8.4 per cent and 6.6 per cent respectively, while that of diastolic hypertension and prehypertension were 5.7 per cent and 11.8 per cent respectively. Both systolic and diastolic hypertension occurred in 2.4 per cent of students. Girls had a higher prevalence of hypertension – both systolic and diastolic. There was no significant gender difference in the prevalence of systolic hypertension and prehypertension between early and late adolescents.

Early adolescent males were more likely to have diastolic hypertension and prehypertension compared to late adolescent males, while no difference in prevalence was noted among the females. Systolic hypertension was more evident in the lower socioeconomic level, those with minimal physical activity, and those in the obese/overweight categories of BMI, WC, and WHR,” the researchers noted.

Blood pressure is recorded as two numbers: Systolic blood pressure (the first number) – indicates how much pressure your blood is exerting against your artery walls when the heart beats.

Diastolic blood pressure (the second number) – indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.

Which number is more important? According to studies, typically, more attention is given to systolic blood pressure (the first number) as a major risk factor for cardiovascular disease for people over 50. In most people, systolic blood pressure rises steadily with age due to the increasing stiffness of large arteries, long-term buildup of plaque and an increased incidence of cardiac and vascular disease.

However, either an elevated systolic or an elevated diastolic blood pressure reading may be used to make a diagnosis of high blood pressure. According to recent studies, the risk of death from ischemic heart disease and stroke doubles with every 20 mm Hg systolic or 10 mm Hg diastolic increase among people from age 40 to 89.

The abbreviation mm Hg means millimeters of mercury. Mercury was used in the first accurate pressure gauges and is still used in medicine today as the standard unit of measurement for pressure.x

Another study titled “Hypertension and prehypertension among adolescents in secondary schools in Enugu, South East Nigeria” and published in Italian Journal of Pediatrics concluded: “Our study revealed a relatively high prevalence rate of hypertension and prehypertension among adolescents studied and these were more common among female subjects.

“It is therefore recommended that periodic screening and monitoring of blood pressure of adolescents should be incorporated into the school health programme, while general public health education on hypertension and its associated risk factors should be strengthened.”

The researchers are from University of Nigeria Teaching Hospital (UNTH) Enugu.

According to the researchers, hypertension is a prevalent cardiovascular disease risk factor among blacks and adolescent hypertension can progress into adulthood.

To determine the prevalence of hypertension and prehypertension among secondary school adolescents in Enugu State, a study of 2,694 adolescents aged 10-18 years in Enugu metropolis was carried out. Socio-demographic profile anthropometric and blood pressure readings were obtained. Derived measurements such as prehypertension, hypertension and BMI were obtained.x

The results showed that the mean systolic blood pressure and diastolic blood pressure for males were 106.66+ 11.80 mmHg and 70.25 + 7.34 mmHg respectively. The mean SBP and DBP for females were 109.83+ 11.66 mmHg and 72.23 + 8.26 mmHg respectively (p < 0.01). Blood pressure was found to increase with age. Prevalence of hypertension and prehypertension was 5.4 per cent and 17.3 per cent respectively with a higher rate in females (6.9 per cent) than males (3.8 per cent). Prevalence of prehypertension among males and females were 14.3 per cent and 20.1 per cent respectively. The prevalence of obesity was 1.9 per cent. Modifiable risk factors exist among adolescents. Early lifestyle modification and a strengthened school health are recommended.

Meanwhile, hypertension has been defined by levels of BP above, which lowering BP will reduce the cardiovascular risk associated with elevated BP and this level has been classically documented at 140/90 mmHg in adults. The new 2017 American College of Cardiology/American Heart Association guideline set hypertension stage 1 at greater than 130/80 mmHg rather than 140/90 mmHg as in the European guidelines.

According to a study titled “Hypertension in children: Could the prevalence be on the increase?” and published in the Nigerian Medical Journal, factors such as age, height, and gender are important factors in interpreting BP values in children. The most widely used definition of hypertension in children is delineated as BP greater than 95 per cent of expected BP for age, gender, and height.

The researchers from the Departments of Paediatrics, College of Medicine, Enugu State University of Technology and College of Medicine, University of Nigeria, Nsukka, Nigeria; and Child Survival Unit, Medical Research Council, Fajara, The Gambia, said unlike in adults where essential hypertension is very common, both secondary and essential (primary) hypertension are seen in children– primary hypertension being influenced by factors such as birth weight, maturity during birth, heredity, and diet while secondary is influenced by renal abnormalities, coarctation of the aorta, medications, neoplasm, etc.

Worldwide, the prevalence of hypertension in children ranges between one per cent and five per cent, with a significant proportion of them under-diagnosed. The prevalence of hypertension in children and adolescents in the United States of America is 3.3 per cent, whereas in Europe, prevalence ranging from 2.2 per cent to 22 per cent has been documented. Across Africa, the prevalence also varies between 0.2 per cent and 24.8 per cent, with a pooled figure of 5.5 per cent.

In Nigeria, various studies have also demonstrated similar prevalence rates in the neighborhood of 3.5 per cent and six per cent. In 2013, in Enugu, southeast Nigeria, Ujunwa et al. reported a prevalence of 5.4 per cent. A similar study in 2014 on pre-school children in Enugu, Nigeria, noted a comparatively low prevalence rate of elevated BP prevalence of 1.9 per cent.x

The authors opined that the prevalence of hypertension in children mighy still be on the increase. A higher prevalence value, however, may be expected when other groups of children are considered since BP increases with growth and development and results in hypertension during the first two decades of life. Although the pathogenesis of raised BP in obese children is not widely understood, evidence abounds on other comorbid conditions, which further accentuate the risk of hypertension. Aside from the risks associated with it, childhood hypertension is a major killer and one of the most common health concerns in children worldwide.

There is also substantive evidence linking it with long-term cardiovascular risk in adulthood. Therefore, it is of public health importance.

The researchers noted: “BP measurement is usually done for adults and has proven to be crucial in the assessment of cardiovascular health. This important measurement is not usually done routinely for children, although childhood hypertension detection is a measurement identifying potential future morbidity (essential hypertension) or existing underlying disease (secondary hypertension). In general, screening of children for hypertension is focused on essential hypertension since this is usually asymptomatic in children and may go unnoticed, but later becomes a risk in adulthood. Secondary hypertension comes to the fore with the presentation of the underlying disease. Consequently, childhood essential hypertension has been termed a strong predictor of hypertension in the adult population.

“Interestingly, identifying children with elevated BP and successfully treating them will have an impact on long-term outcomes of cardiovascular disease as well as a sizeable effect on hypertension-related morbidity and mortality. The cost implication of treating adults with raised BP will be addressed when attention is paid to childhood primary hypertension. To further understand the degree of attention that should be given to hypertension in childhood, knowledge of its prevalence and factors associated with it need to be continuously emphasized. It can also inform the need for routine BP check in children and adolescents in the routine children’s clinic.”

Meanwhile, as part of efforts to curb non communicable diseases including hypertension, the World Health Organisation (WHO) on Tuesday, launched a year-long global campaign for World No Tobacco Day 2021 – “Commit to Quit.” The new WHO Quit Challenge on WhatsApp and publication “More than 100 reasons to quit tobacco” are being released today to mark the start of the campaign.

The COVID-19 pandemic has led to millions of tobacco users saying they want to quit. The campaign will support at least 100 million people as they try to give up tobacco through communities of quitters.

“Commit to Quit” will help create healthier environments that are conducive to quitting tobacco by advocating for strong tobacco cessation policies; increasing access to cessation services; raising awareness of tobacco industry tactics, and empowering tobacco users to make successful quit attempts through “quit & win” initiatives.

WHO, together with partners, will create and build-up digital communities where people can find the social support they need to quit. The focus will be on high burden countries* where the majority of the world’s tobacco users live.

WHO welcomes new contributions from partners, including private sector companies that have offered support, including Allen Carr’s Easyway, Amazon Web Services, Cipla, Facebook and WhatsApp, Google, Johnson & Johnson, Praekelt, and Soul Machines.x

Quitting tobacco is challenging, especially with the added social and economic stresses that have come as a result of the pandemic. Worldwide around 780 million people say they want to quit, but only 30 per cent of them have access to the tools that can help them do so. Together with partners, WHO will provide people with the tools and resources they need to make a successful quit attempt.

“Smoking kills eight million people a year, but if users need more motivation to kick the habit, the pandemic provides the right incentive,” said WHO Director-General, Dr. Tedros Adhanom Ghebreyesus.

WHO released a scientific brief earlier this year showing that smokers are at higher risk of developing severe disease and death from COVID-19. Tobacco is also a major risk factor for noncommunicable diseases like cardiovascular disease, cancer, respiratory disease and diabetes. Moreover, people living with these conditions are more vulnerable to severe COVID-19.

Both global and regional cessation tools will be rolled out as part of the campaign. WHO’s 24/7 digital health worker to help people quit tobacco is available in English and will soon be released to support people in Arabic, Chinese, French, Russian, and Spanish.

“Millions of people worldwide want to quit tobacco – we must seize this opportunity and invest in services to help them be successful, while we urge everyone to divest from the tobacco industry and their interests,” said Dr. Ruediger Krech, Director of Health Promotion.

To create environments conducive to quitting tobacco, WHO has worked with partners and countries around the globe to implement tobacco control measures that effectively reduce the demand for tobacco.

WHO calls on all governments to ensure their citizens have access to brief advice, toll-free quit lines, mobile and digital cessation services, nicotine replacement therapies and other tools that are proven to help people quit. Strong cessation services improve health, save lives and save money.

Nigeria is one of the 22 campaign focus countries.

Image credit: yanjf/Getty Images

A new survey identifies one LGB+ group that is more likely to start smoking cigarettes after coming out.

Previous research suggests that LGB+ individuals are more likely to smoke cigarettes. However, a new study from the School of Public Health at Boston University (BU), MA, looks more closely at sexual identity and smoking.

The research finds that the association applies only to bisexual people, primarily during the first 3 years after coming out.

People coming out as bisexual are twice as likely to start smoking after coming out when compared to heterosexual, lesbian, gay, or other non-heterosexual people.

According to Andrew Stokes, the study’s corresponding author, the new research “highlights the importance of moving beyond static measures of sexual identity towards more dynamic measures that capture critical periods of vulnerability.”

This shift in the researchers’ perspectives, says lead author and doctoral candidate Alyssa Harlow, “turned out to be really important because it revealed disparities that would have otherwise been missed if we measured identity at one time point, or grouped all LGB+ identities together.”

The research appears in the journal JAMA Pediatrics. Stokes and Harlow were joined in the study by BU’s Dielle Lundberg, Julia Raifman, Carl Streed, and Emelia Benjamin, as well as Andy S.L. Tan of the University of Pennsylvania in Philadelphia.

Three interviews, 3 years

The researchers followed 7,843 young people and young adults over 3 years by analyzing data from the nationwide Population Assessment of Tobacco and Health (PATH) study. The group, whose ages ranged between 14–29 years, was interviewed three times between 2013–2018.

“The PATH study is unique because it asks youth about their sexual orientation and gender identity. Most national surveys do not,” says Lundberg.

The researchers adjusted for a variety of factors, including individuals’ sex, age, education level for those over 18, their parents’ level of education, race, ethnicity, and where they lived.

One limitation of the study is that there were not enough transgender participants in the original survey to consider the group sufficiently represented, so the new research applies only to LGB+ individuals.

By the final round of interviews, 14% of the PATH participants reported having smoked cigarettes, while 6% were current smokers.

While initial analysis of the entire LGB+ group supports the doubled likelihood of being a smoker, breaking down the data by sexual identity revealed that it applied only to bisexual individuals. This association applied equally to those who had once smoked and to those who still did.

Individuals who had maintained the same LGB+ status throughout the 3 years were no more likely to smoke than people with a constant heterosexual identification.

The bisexual individuals who had just come out — moving from one identity to another during the 3-year survey period — were found to be the only group that was twice as likely to start smoking.

Being bisexual is unique in the LGBTQ+ community

“The findings point to a need for public health interventions specifically designed to address the unique needs, experiences, and stressors associated with coming out and identifying as bisexual,” according to Harlow, who notes that bisexual people “may experience stigma from heterosexual individuals as well as from within the LGB+ community.”

Harlow adds, “There’s also prior research showing that bisexual populations have worse mental health outcomes than LG+ populations.”

Providing much-needed support

To better address the needs of bisexual and LGBTQ+ individuals, people who are disproportionately affected by mental health and substance use issues, the authors say a more fine-grained approach to health surveys is necessary:

“We must advocate for better data. Whenever national surveys fail to ask about sexual orientation and gender identity, they are directly contributing to health inequities for LGBTQ+ populations.”

Getty Images

A study links smoggy urban days to an increase in food deliveries and plastic waste.

A new study from the National University of Singapore asserts that urban air pollution leads to more plastic waste.

On smoggy days, urban workers wishing to remain indoors often have lunch delivered to their offices, and the packaging in which the food arrives adds to the plastic waste stream.

When air quality is poor, people working in offices order significantly more takeout delivery.

Study author Alberto Salvo of the university’s Department of Economics says:

“Plastic waste is a growing global environmental concern. While we see more research on the impact plastic pollution is having on the natural environment, there has been less work trying to understand the human behavior that drives plastic pollution.”

The study focused on three Chinese cities that experience high levels of air pollution: Beijing, Shenyang, and Shijiazhuang. Food delivery services are popular in China, with 350 million registered users. More than half of the 65 million food containers discarded each day in China are thrown away by office workers.

According to Salvo, “Air quality in the urban developing world is routinely poor, and in the past decade, the food delivery industry has been growing sharply.”

The study appears in Nature Human Behaviour.

Air pollution and food delivery

The study rated pollution levels according to PM2.5 measurements. PM2.5 is the abbreviation for “fine particles less than 2.5 micrometers in diameter.”

In the United States, the maximum acceptable 24-hour ambient air quality is 35 micrograms per cubic meter (μg/m3). The air pollution levels recorded in the studied cities considerably exceeded that threshold, and the pollution was visible to the naked eye.

The NUS researchers, which also included Liu Haoming and Chu Junhong, gathered food ordering data from two sources:

  • 251 office workers in the three cities were surveyed regarding their lunch choices for 11 days, between January and June 2018.
  • 3.5 million food orders placed with an online food delivery service whose 350,000 customers representing all market segments

When the researchers matched this data to air-pollution records, they found a strong connection between higher air pollution levels and increased food orders.

The data indicated that a 100 μg/m3 increase in air pollution resulted in a 7.2% increase in orders from all market segments.

Office workers were six times more likely than other people to order food delivery when pollution increased by 100 μg/m3.

Chu notes that people at home have the option of preparing their lunch without going out, but, “Faced with smog or haze outside, a typical office worker at lunchtime can avoid exposure only by ordering food to be delivered to [their] doorstep.”

Food delivery and plastic waste

The researchers asked the office workers they surveyed to submit photos of the food they purchased at restaurants and for delivery. This allowed the researchers to assess the plastic packaging associated with their lunchtime choices. The participants submitted over 3,000 photos.

The researchers estimated that the average restaurant meal used about 6.6 grams (g) of plastic while takeout food used about 54 g.

The average takeout meal came with 2.8 single-use plastic implements.

Putting the pieces together, the researchers calculated that each time pollution increased by 100 μg/m3, plastic use also went up by about 10 g, which is equivalent to about a third of a plastic food container.

Based on the food orders they analyzed, the researchers concluded that if China experienced a 100 μg/m3 increase in air pollution on a single day, it would equate to 2.5 million more orders for takeout food, resulting in the use of 2.5 million plastic containers.

A concerning connection

While the Chinese cities included in the research are known for their air pollution issues, they are not alone.

“Our findings probably apply to other typically polluted developing-nation cities, such as Bangladesh, India, Indonesia, and Vietnam. Waste management practices vary widely, with the wind blowing plastic debris away from uncovered landfills or plastic being discarded into rivers and from there into the ocean,” says study co-author Dr. Haoming Liu.

“So, with 8 million tonnes of plastic estimated to enter the seas each year, our study speaks to a wider issue. Individuals protect themselves from — and show their distaste for — air pollution by ordering food delivery, which often comes in plastic packaging. It is evident from our study that air pollution control can reduce plastic waste,” he adds.

1269733189 Image credit: EThamPhoto/Getty Images

A study of 160 people in the United States finds associations between worries around COVID-19 and substance use. The authors warn that the pandemic may increase the risk of substance abuse in some people and advocate for specific interventions to protect mental health.

Beyond the physical effects of the novel coronavirus, the onset and continuation of the COVID-19 pandemic have dramatically affected people’s mental health in the United States and worldwide.

recent study highlighted how levels of depression in the U.S. have tripled during the pandemic. Symptoms of anxiety may also be on the rise, according to recent trends in Google searches.

Understandably, the pandemic generates fear in many people, as the world finds itself in an unprecedented situation filled with uncertainty.

People manage uncertainties in different ways, but there is a risk that the stress the pandemic causes may trigger an ongoing mental health problem in some people.

A recent study led by the University of Houston, TX, finds that worry about COVID-19 may be a risk factor for substance use, which could, in turn, lead to misuse in some people.

The findings, which appear in Psychiatry Research, suggest the pandemic could adversely affect mental health for years to come.

COVID concerns

This study explored worries and fears about COVID-19 among three groups of people: those who do not use substances, people who were substance users before the pandemic, and people who started to use substances during the pandemic.

The substances in question included alcohol, cigarettes, cannabis, e-cigarettes, stimulants, opioids, and other drugs. According to the National Institute of Drug Abuse, these are among the most commonly used substances in the U.S.

In total, 160 people took part in the online study between April and May 2020.

The survey took around 30 minutes to complete and included questions about COVID-19 exposure and diagnosis, fears and worries about the pandemic, and a series of questions about substance use, including when and how people used substances and why they did so.

Worry fuels substance use

Almost 6% of the participants said they had received a diagnosis of COVID-19, and around half reported having pre-existing medical conditions.

Many of the participants also reported changing their substance use since the start of the pandemic.

Some participants reported starting using the following substances since the beginning of the pandemic:

  • alcohol (8.8%)
  • cigarettes (6.9%)
  • stimulants (5.6%)
  • opioids (5.6%)
  • cannabis (5%)
  • e-cigarettes (4.4%).

The results also found that worrying about the pandemic had associations with using substances to cope. Substance users reported worrying about COVID-19 more than non-users, and people who started using substances during the pandemic (excluding opioids) had the highest levels of worry.

“Results generally suggest the persons using substance experience the highest levels of COVID-19-related worry and fear,” the authors explain in their paper. “Additionally, worry about COVID-19 is related to coping motives for substance use.”

COVID-19-specific interventions

The authors say that doctors could find their findings useful. They suggest that doctors assessing levels of worry about COVID-19 help identify people at greatest risk for substance use, and ultimately substance abuse.

With this knowledge, doctors might prevent such problems from developing, for example, by recommending therapy or helping the person develop healthy coping mechanisms. The authors write:

“These results provide preliminary evidence that COVID-19-related worry and fear may be putative risk factors for substance use initiation in the face of COVID-19, and these results may provide critical clinical information for helping individuals cope with this pandemic.”

The authors state the importance of developing specialist interventions for COVID-19-specific mental health problems, including addictions, as the pandemic continues to evolve.

It is crucial to roll out such initiatives early to prevent a wave of mental health problems in the future, says Prof. Michael Zvolensky, senior author of the study.

“The impact of COVID-19 on psychological symptoms and disorders, addiction, and health behavior is substantial and ongoing and will negatively impact people’s mental health and put them at greater risk for chronic illness and drug addiction. It will not equally impact all of society. Those at greater risk are those that have mental health vulnerabilities or disorders,” he closes.

The Centers for Disease Control and Prevention (CDC) offers advice and helplines on managing stress during the pandemic.

Scientists have made four major advances in search cures for hangover, diabetes, coughs and colds and drug resistant germs.

New researches showed that honey is more effective than antibiotics for curing coughs and colds as insect wings inspired new ways to defeat drug-resistant germs.

Also, scientists claim cheap drug containing L-cysteine can alleviate dreaded nausea, headaches and anxiety. They have also created insulin-making pancreatic cells that escape disease’s attacks, can be transplanted into patients

Honey has long been a folk remedy for an irritating cough, sore throats and the common cold. But research now showed that honey is more effective at treating these ailments than antibiotics or over-the-counter medication.

Experts at Oxford University, United Kingdom (U.K.), said doctors should tell patients to have a spoonful of honey rather than prescribing antibiotics, which can fuel antimicrobial resistance.

They reviewed studies, which compared the effectiveness of honey against cough suppressants, antihistamines and painkillers when treating upper respiratory tract infection (URTI) symptoms – which include a cough and cold.

Overall, honey was found to be ‘superior’ at relieving coughs, sore throats and congestion – and unlike other medications it had no harmful side effects.

Honey was on average 36 per cent more effective at reducing cough frequency than common medications and it cut cough severity by 44 per cent more.

The study was published in the British Medical Journal.

Not all old wives’ tales stand up to scientific scrutiny. But a spoonful of honey really does seem to relieve a cough.

This is firstly because it contains hydrogen peroxide, which gives it anti-microbial properties. Due to this, it has been used in traditional medicine as a topical antibiotic for centuries.

And secondly, because it is thick and sticky, honey has a soothing effect on the throat that can reduce irritation and help relieve a dry, tickly cough.

In addition to eating it straight out of the jar with a spoon, honey can be served with lemon in tea.

There was also evidence honey reduces the time it takes to recover from URTIs by up to two days.

“Honey was associated with a significantly greater reduction in combined symptom score, cough frequency and cough severity,” the study in the British Medical Journal said.

Meanwhile, scientists have revealed how nanomaterials inspired by insect wings are able to destroy bacteria on contact.

The wings of cicadas and dragonflies are natural bacteria killers, a phenomenon that has spurred researchers searching for ways to defeat drug-resistant superbugs.

New anti-bacterial surfaces are being developed, featuring different nano-patterns that mimic the deadly action of insect wings, but scientists are only beginning to unravel the mysteries of how they work.

In a review published in Nature Reviews Microbiology, researchers have detailed exactly how these patterns destroy bacteria — stretching, slicing or tearing them apart.

Lead author, RMIT University’s Distinguished Professor Elena Ivanova, said finding non-chemical ways of killing bacteria was critical, with more than 700,000 people dying each year due to drug-resistant bacterial infection.

The wings of cicadas and dragonflies are covered in tiny nano-pillars, which were the first nano-patterns developed by scientists aiming to imitate their bactericidal effects.

Since then, they’ve also precisely engineered other nano-shapes like sheets and wires, all designed to physically damage bacteria cells.

Bacteria that land on these nanostructures find themselves pulled, stretched or sliced apart, rupturing the bacterial cell membrane and eventually killing them.

Ginger CREDIT: DiabetesUK

The new review for the first time categorises the different ways these surface nano-patterns deliver the necessary mechanical forces to burst the cell membrane.

The researchers said producing nanostructured surfaces in large volumes cost-effectively, so they could be used in medical or industrial applications, remained a challenge.

Meanwhile, scientists claim to have found a cure for hangovers in the form of a pill, which can be bought for as little as 15p (N75).

It contains a chemical called L-cysteine, one of many amino acids already present in the body and also used to extend the shelf life of bread.

Researchers tested the tablet on a group of men who were ordered to drink alcohol for several hours on six different occasions.

Men given the pill reported fewer hangover symptoms of nausea, headache, stress and anxiety compared to men given a placebo, results showed.

The researchers claim that if the pill helps to reduce stress and anxiety, people are less likely to drink again to brush off the hangover — otherwise known as ‘hair of the dog’.

L-cysteine tablets can be bought online for around £15 ($20)/N7,700 for a pack of 100 — the equivalent of 15p (20 cents)/N75 per capsule.

L-cysteine — often sold as a dietary supplement — is deemed important for its role in making proteins within the body, and boosting other metabolic functions.

It can be made naturally in the body and is also found in high-protein foods, such as chicken, turkey, cheese, eggs and seeds.

The Institute of Chemical Technology in Mumbai found pears, lime, cheese, tomato, cucumber, black tea and green tea boosted enzymes alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH).

These have the ability to wipe out acetaldehyde, which builds up when you drink alcohol.

The following boosted one enzyme: buttermilk, probiotic drink; wheat; mace, turmeric, ginger; and coconut water, dates, cocoa.

The following foods were found to decrease the activity of both enzymes, and therefore are best to be avoided when you have a hangover: milk; oats, peanuts, millet, sorghum, maize; pepper, cloves, nutmeg, cumin, cinnamon, cassia; vitamin C, coffee, eggs, commercial anti-hangover product.

The study, published in the journal Alcohol and Alcoholism, recruited two dozen volunteers who were aged between 21 and 60.

According to the study results, L-cysteine was found to have reduced or eliminated hangover symptoms of nausea, headache, stress and anxiety to a “statistically significant level”.

The scientists noted that all L-cysteine tablets contained other vitamins, like B1 and C. They could not rule out that these had some sort of effect.

Meanwhile, researchers claim clusters of insulin-producing pancreatic cells that can be given to type 1 diabetics could be the first step towards a cure.

From stem cells, a team at the Salk Institute in La Jolla, California, United States (U.S.), created beta-like cells that produce insulin in response to glucose.

When these cells were transplanted into diabetic mice, controlled blood glucose and the rodents didn’t need to be given immunosuppressive drugs.

The treatment is experimental and in early stages of testing, but scientists believe that its powerful effect could be a game-changer in the treatment of diabetes.

For the new study, published in Nature, the team focused on how to grow these beta-like cells in an environment similar to the human pancreas.

They found another protein-coding gene, WNT4, turns on a switch that allows the beta-like cells to attain their fully functional state that mimic islets in the pancreas.

To prevent immune rejection, they used the protein PD-L1, which keeps immune cells from attacking non-harmful cells in the body.

“By expressing PD-L1, which acts as an immune blocker, the transplanted organoids are able to hide from the immune system,” said first author Dr. Eiji Yoshihara, a former staff scientist at the Salk Institute.

When these completed clusters were transplanted into diabetic mice, they controlled blood glucose control and were not attacked by the immune system.

The team hopes to conduct more experiments in mice and prove that it’s safe for humans as well.

“We now have a product that could potentially be used in patients without requiring any kind of device,” Evans said.

Moderate-intensify exercise can help improve your thinking and memory in just six months.

You probably already know that exercising is necessary to preserve muscle strength, keep your heart strong, maintain a healthy body weight, and stave off chronic diseases such as diabetes. But exercise can also help boost your thinking skills. “There’s a lot of science behind this,” says Dr. Scott McGinnis, an instructor in neurology at Harvard Medical School.

Exercise boosts your memory and thinking skills both directly and indirectly. It acts directly on the body by stimulating physiological changes such as reductions in insulin resistance and inflammation, along with encouraging production of growth factors — chemicals that affect the growth of new blood vessels in the brain, and even the abundance, survival, and overall health of new brain cells.

It also acts directly on the brain itself. Many studies have suggested that the parts of the brain that control thinking and memory are larger in volume in people who exercise than in people who don’t. “Even more exciting is the finding that engaging in a program of regular exercise of moderate intensity over six months or a year is associated with an increase in the volume of selected brain regions,” says McGinnis.

Exercise can also boost memory and thinking indirectly by improving mood and sleep, and by reducing stress and anxiety. Problems in these areas frequently cause or contribute to cognitive impairment.

Is one exercise better than another in terms of brain health? We don’t know the answer to this question, because almost all of the research so far has looked at walking. “But it’s likely that other forms of aerobic exercise that get your heart pumping might yield similar benefits,” explains McGinnis.

A study published in the Journal of the American Geriatrics Society found that tai chi showed the potential to enhance cognitive function in older adults, especially in the realm of executive function, which manages cognitive processes such as planning, working memory, attention, problem solving, and verbal reasoning. That may be because tai chi, a martial art that involves slow, focused movements, requires learning and memorizing new skills and movement patterns.

McGinnis recommends establishing exercise as a habit, almost like taking a prescription medication. And since several studies have shown that it takes about six months to start reaping the cognitive benefits of exercise, he reminds you to be patient as you look for the first results — and to then continue exercising for life.

Aim for a goal of exercising at a moderate intensity — such as brisk walking — for 150 minutes per week. Start with a few minutes a day, and increase the amount by five or 10 minutes every week until you reach your goal.

For additional advice and tips to help you get the most from your workouts, read the Workout Workbook, a Special Health Report from Harvard Medical School.

A review suggests smoking and vaping could increase the severity of COVID-19 due to blood vessel damage and a higher risk of stroke.

“There is a growing body of evidence to suggest that, as well as the respiratory symptoms of COVID-19, the disease can also cause, among others, neurological effects.”

A recent report from a neurological hospital in the United Kingdom identifies cases of delirium, brain inflammation, nerve damage, and stroke in COVID-19 patients.

Reports of stroke in COVID-19 are particularly prevalent. Some reports estimate that 30% of critically ill COVID-19 patients experience blood clots. And if they occur in the brain, they may trigger a stroke.

Researchers from Texas Tech University Health Sciences Center previously found that smoking and vaping increases the risk of viral infection. They have now published a review on how these activities might affect the risk of neurological dysfunction in COVID-19, particularly from damage to blood vessels in the brain.

They found that both smoking and vaping could increase the risk of stroke in COVID-19 due to damage to the blood-brain barrier and a higher risk of blood clots.

The details are published in the International Journal of Molecular Sciences.

Higher risk of blood clots

Smoking causes well-known damage to the lungs and respiratory system. Previous research has shown that it also makes a person more vulnerable to influenza.

Smoking can also affect the vascular system in the brain, prompting the researchers to review the evidence on how this activity might influence the neurological symptoms of people who contract COVID-19.

They first looked at the evidence on SARS-CoV-2 and neurological disorders, including stroke. They found one study which showed that 36.4% of COVID-19 patients had neurological symptoms. Another paper found five cases of sudden stroke in COVID-19 patients aged 30–40 years due to abnormal blood clotting in their large arteries.

But how does this relate to smoking? The researchers explain that when the body is deprived of oxygen, which occurs with smoking, the amount of clotting factors in the blood increase.

In combination with COVID-19, which also increases blood-clotting proteins, the risk of stroke rises.

“COVID-19 seems to have this ability to increase the risk for blood coagulation, as does smoke. This may ultimately translate in higher risk for stroke.” – Luca Cucullo, Ph.D., Center for Blood-Brain Barrier Research, Texas Tech University Health Sciences Center

What about vaping?

Although there is less evidence around vaping, the authors found studies that show vape aerosol components can harm blood vessels in the brain.

Vaping also appears to affect the blood-brain barrier, the defensive structure which protects the brain from toxins and pathogens in the blood.

The researchers also found specific evidence that long-term vaping may increase the risk of stroke.

Vaping may also make a person more vulnerable to COVID-19 by increasing the number of ACE2 receptors expressed in the body, which are used by the novel coronavirus to infect cells. Smoking can also increase expression of the ACE2 receptor, and damages the blood-brain barrier.

More research needed

The authors conclude that smoking and vaping may increase the severity of COVID-19 by increasing expression of the ACE2 receptor, which allows the virus to infect more cells. They were also found to damage the blood-brain barrier, which increases the risk of neurological complications.

There is an elevated risk of stroke in COVID-19 patients who smoke due to increased blood clotting factors in the blood.

However, the authors say more research is needed, including comparisons of autopsy samples from COVID-19 patients who did or did not smoke, and further animal studies.

Medical experts have warned that non-communicable diseases (NCDs) such as hypertension, diabetes, cancer, cardiovascular diseases are responsible for the majority of Coronavirus disease (COVID-19) deaths in the country.

President, NCD Alliance Nigeria, Olorogun Dr. Sonny F. Kuku, in his opening remarks during a webinar on, “Non-communicable Diseases and COVID-19 in Nigeria – The response”, held Tuesday, July 21, 2020, said: “… We are only seeing the tip of the iceberg and unfortunately, people with NCDs are at greater risk. It is impacting the poorest people and most vulnerable. People with hypertension, diabetes and heart disease are the most vulnerable. We are now seeing stroke as symptom. This means COVID-19, which is an infectious disease is manifesting as an NCD in the form of stroke…”

Vice President, Scientific Affairs, NCDs Alliance Nigeria, Dr. Kingsley Akinroye, has said blamed the situation on the nation’s years of lack of commitment to the course of NCDs. The cardiologist said NCDs account for 29 per cent of deaths in Nigeria.

Akinroye, at the launch of the New Civil Society Solidarity Fund on NCDs in response to COVID-19, harped on the need to strengthen the healthcare system, intensify awareness, increase access to care and treatment, and vote more money for NCDs care and management.

However, the NCD Alliance Nigeria and 19 other global and national NCD Alliances have been awarded $300,000.

Akinroye added that regional and national NCD Alliance including NCD Alliance Nigeria would get $15,000 to address the critical needs of people living with NCDs during the pandemic through advocacy and communication activities that would support stronger organisational stability and resilience

According to the cardiologist, COVID-19 shows many connections between it and NCDs stating that people living with NCDs are more vulnerable to COVID-19 with a substantially higher risk o becoming severely ill or dying from the virus.

The expert said that actions taken to control NCDs in Nigeria include the launch o the First Multi-Sectoral Action Plan or Prevention and Control o NCDs by the Federal Ministry of Health (FMoH) and the NCD Alliance Nigeria Publication of the Handbook on Civil Society Organisation in NCDs.

“Activities in Nigeria will include the development of a database of people living with NCDs in Lagos, Osun, and Federal Capital Territory and by NCD area of focus. Also, establishment and support for people living with NCDs with skills and knowledge, and connect them to NCD Alliance Nigeria, federal Ministry o Health, World Health Organisation and State Ministry of Health in the four states,” he added.

Akinroye further stated that they would build capacity for people living with NCDs on advocacy for their rights to health, prevention, access to treatment and care; provision of support and empowerment

He explained that NCD Alliance Nigeria would develop a directory and a database in the states by area of focus cardiovascular disease, diabetes, cancer, sickle cell disease, respiratory diseases and mental health and also develop advocacy communication materials targeting Lawmakers, Policymakers and opinion leaders that are persuasive and effective to improve prevention, care and access to treatment for people living with NCDs.

The expert, however, tasked the Presidential Taskforce on COVID-19 to mobilise for more testing and awareness amongst the grassroots and also provide free hypertensive and diabetic drugs or the vulnerable population.

Executive Director, NCD Alliance Nigeria, Prof. Akin Osibogun, also presented a paper on “NCDs in Nigeria and COVID-19: The Nigerian experience.”

Osibogun is a consultant public health physician/epidemiologist, a member of Lagos State COVID-19 Response Team and former Chief Medical Director (CMD), Lagos University Teaching Hospital (LUTH) Idi Araba.

Member, Nutrition Committee, Nigerian Heart Foundation (NHF) and Food Scientist, Prof. Isaac Adebayo Adeyemi, spoke on “COVID-19 and Nutrition: Gathering evidence.”

Akinroye delivered a paper on “People Living with NCDs in Nigeria and COVID-19.”

Adeyemi, who is Vice chancellor of Bells University of Technology Ota, Ogun State, and the pioneer Deputy Vice-Chancellor, Ladoke Akintola University of Technology (LAUTECH), Ogbomoso, Oyo State, said functional foods are important to boost the immune system.

Adeyemi said that a well functioning immune system is key to providing robust defence against pathogenic organisms. Adeyemi noted that mortality in people living with NCDs is likely the result of immune decline or impaired immune response.

The expert said that energy is required to fight the virus likewise, protein to produce essential antibodies.

He encouraged intake of Phytochemicals like quercetin from onions, phloretin and also Epigallocatechin gallate (EGCG) as well as conventional foods containing bioactive food compounds like vegetables, fruits, grains, dairy, fish and meat.

“Eat fresh and unprocessed food every day like fruits and vegetables, legumes and whole grains and animal products. Eat a moderate amount o fats and oils. Eat at home to reduce your rate of contact with other people,” he added.

Adeyemi urged the consumption of plant food such as grains, legumes and oilseeds, fruits and vegetables containing vitamins, minerals, fibre and phytochemicals.

He, however, stressed on the need to avoid the intake of caffeine, trans fat while also limiting the intake of salt because they are predisposing factors that contribute to morbidity o patients with COVID-19.

According to a study published in Scholars Journal of Applied Medical Sciences and titled “COVID-19 and Nutrition: Review of Available Evidence”, nutritional support is indicated for depleted patients with respiratory diseases because it provides not only supportive care, but direct intervention through improvement in respiratory and peripheral skeletal muscle function and in exercise performance.

The researchers noted: “A combination of oral nutritional supplements and exercise or anabolic stimulus appears to be the best approach to obtaining significant functional improvement. Patients responding to this treatment even demonstrated a decreased mortality. Furthermore, weight loss and malnutrition opens the door of infection reoccurrence. Poor response was related to the effects of systemic inflammation on dietary intake and catabolism.

“Dietary management of pre-existing diseases has been suggested as a strategy to minimise the potential risk of COVID-19 infection in conditions such as irritable bowel syndrome, Crohn’s and Colitis. WHO, dietetic associations and dietitians have been calling for patients with pre-existing conditions to continue abiding by their dietary advice and nutritional therapy steps received from their dietician if tested positive for COVID-19.”

Meanwhile, according to a World Health Organisation (WHO) survey, prevention and treatment services for NCDs have been severely disrupted since the COVID-19 pandemic began. The survey, which was completed by 155 countries during a three-week period in May, confirmed that the impact is global, but that low-income countries are most affected.

This situation is of significant concern because people living with NCDs are at higher risk of severe COVID-19-related illness and death.

Director-General of the WHO, Dr. Tedros Adhanom Ghebreyesus, said: “The results of this survey confirm what we have been hearing from countries for a number of weeks now.

“Many people who need treatment for diseases like cancer, cardiovascular disease and diabetes have not been receiving the health services and medicines they need since the COVID-19 pandemic began. It’s vital that countries find innovative ways to ensure that essential services for NCDs continue, even as they fight COVID-19.”

The main finding is that health services have been partially or completely disrupted in many countries. More than half (53 per cent) of the countries surveyed have partially or completely disrupted services for hypertension treatment; 49 per cent for treatment for diabetes and diabetes-related complications; 42 per cent for cancer treatment, and 31 per cent for cardiovascular emergencies.

Rehabilitation services have been disrupted in almost two-thirds (63 per cent) of countries, even though rehabilitation is key to a healthy recovery following a severe illness from COVID-19.

In the majority (94 per cent) of countries responding, ministries of health staff working in the area of NCDs were partially or fully reassigned to support COVID-19.

The postponement of public screening programmes (for example for breast and cervical cancer) was also widespread, reported by more than 50 per cent of countries. This was consistent with initial WHO recommendations to minimize non-urgent facility-based care whilst tackling the pandemic.

But the most common reasons for discontinuing or reducing services were cancellations of planned treatments, a decrease in public transport available and a lack of staff because health workers had been reassigned to support COVID19 services. In one in five countries (20 per cent) reporting disruptions, one of the main reasons for discontinuing services was a shortage of medicines, diagnostics and other technologies.

Unsurprisingly, there appears to be a correlation between levels of disruption to services for treating NCDs and the evolution of the COVID-19 outbreak in a country. Services become increasingly disrupted as a country moves from sporadic cases to community transmission of the coronavirus.

Globally, two-thirds of countries reported that they had included NCD services in their national COVID-19 preparedness and response plans; 72 per cent of high-income countries reported inclusion compared to 42 per cent of low-income countries. Services to address cardiovascular disease, cancer, diabetes and chronic respiratory disease were the most frequently included. Dental services, rehabilitation and tobacco cessation activities were not as widely included in response plans according to country reports.

Seventeen percent of countries reporting have started to allocate additional funding from the government budget to include the provision of NCD services in their national COVID-19 plan.

Encouraging findings of the survey were that alternative strategies have been established in most countries to support the people at the highest risk to continue receiving treatment for NCDs. Among the countries reporting service disruptions, globally 58 per cent of countries are now using telemedicine (advice by telephone or online means) to replace in-person consultations; in low-income countries, this figure is 42 per cent. Triaging to determine priorities has also been widely used, in two-thirds of countries reporting.

Also encouraging is that more than 70 per cent of countries reported collecting data on the number of COVID-19 patients who also have an NCD.

Director of the Department of NCDs at WHO, Dr. Bente Mikkelsen, said: “It will be some time before we know the full extent of the impact of disruptions to health care during COVID-19 on people with NCDs.

“What we know now, however, is that not only are people with NCDs more vulnerable to becoming seriously ill with the virus, but many are unable to access the treatment they need to manage their illnesses. It is very important not only that care for people living with NCDs is included in national response and preparedness plans for COVID-19 – but that innovative ways are found to implement those plans. We must be ready to ‘build back better’- strengthening health services so that they are better equipped to prevent, diagnose and provide care for NCDs in the future, in any circumstances.”

According to the WHO, NCDs kill 41 million people each year, equivalent to 71 per cent of all deaths globally. Each year, 15 million people die from an NCD between the ages of 30 and 69 years; more than 85 per cent of these “premature” deaths occur in low- and middle-income countries.

The federal government has received $890 million as grants from the Global Fund to fight HIV/AIDS, tuberculosis and malaria.

The Minister of Health, Dr. Osagie Ehanire, said yesterday that the fund would be used to implement programmes aimed at eradicating the diseases over a three year period, from 2021 to 2023.

Ehanire said that the Global Fund also approved a grant of US$21.9 million to support Nigeria’s COVID-19 response.

He said: “The purpose of this press briefing today is to announce the receipt of a grant, made to the Federal Republic of Nigeria by The Global Fund to fight HIV/AIDS, tuberculosis and malaria, amounting to $890 million, over an implementation period of three years, beginning from 2021 to 2023.”

The minister noted that the grant, which is the largest given to any country in this funding cycle, is sequel to a successful funding request made by the Nigeria Country Coordination Mechanism (CCM).

The Global Fund for the fight against HIV/AIDS, Tuberculosis and Malaria (GF) is an innovative international financing mechanism that was established by the United Nations in 2002, with its headquarters in Geneva, Switzerland.

The fund is made up of global partnership of governments, civil societies and private donors and established for the purpose of attracting, leveraging and investing resources to fund public health interventions that would accelerate the eradication of HIV, tuberculosis and malaria in affected high burden countries to further goals of Sustainable Development Goals (SDGs).

The Global Fund has committed the sum of USD$2.586 billion since 2002 to operations in Nigeria, which are split into four program areas: HIV/AIDS, tuberculosis, malaria and the Resilient Systems Strengthening for Health, (RSSH).

Nigeria has accessed $2.436 billion, which represented 94 percent of the committed amount.

The minister said the grant would complement the investment of the government of Nigeria and of other Development Partners in HIV/AIDS, tuberculosis and malaria programmes, including the Resilient and Sustainable System for Health, over the period 2021-2023.

He said the approval of the grant came following the review of the proposal that the CCM Nigeria submitted on March 23, 2020, which was adjudged to be technically sound and strategically focused by the independent Technical Review Panel of the Global Fund.

Ehanire said: “This grant will support access to malaria prevention, diagnostic and treatment services in 13 states. The States include Adamawa, Delta, Gombe, Jigawa, Kaduna, Kano, Katsina, Kwara, Niger, Ogun, Osun, Taraba and Yobe States.

“Access to HIV/AIDS and tuberculosis services across all the 36 states and the FCT; Improvements in our health system, particularly, provision of infrastructure for warehousing and distribution of health commodities, laboratory services, data management and capacity building for our healthcare providers, including support to community system.”

The minister said the implementation of the grant would specially target the poor, the most vulnerable and disadvantaged, and those at higher risk of the target diseases, to promote equity in access to health care services.

He further said: “With regard to Nigeria’s COVID-19 response effort, The Global Fund gave approval to repurpose the sum of US$6.2 million out of our on-going grants for HIV, tuberculosis and malaria to support the implementation of our initial Incident Action Plan (IAP) for COVID-19.