NCD prevalence has increased dramatically in recent decades, including in low- and middle-income countries. Across North Africa, from Morocco to Egypt, high obesity and diabetes imply high COVID-19 vulnerability. Obesity and diabetes likewise elevate risk in South Africa and South America, especially Argentina and Chile. In Europe and Russia high population levels of hypertension, cardiovascular disease, and lung disease equate to high vulnerability to COVID-19. High rates of cardiovascular disease, lung disease, and obesity likewise exacerbate COVID-19 risk in the United States and Australia.
It is too early to say whether some underlying conditions are riskier than others, and we do not yet know whether there are less visible aspects of those diseases or other aspects of individual health status that determine which COVID-19 patients will suffer higher severity outcomes and probability of death. For now, the map assumes that each underlying condition contributes equally to COVID-19. The weighting can be adjusted in the future if new evidence indicates that certain chronic conditions have a larger impact on COVID-19 risk and severity of disease.
NCDs are not the only cause of COVID-19 vulnerability. As more data emerges from hospitals, we are beginning to perceive the wider factors that determine whether patients survive the virus, including blood type, the strength of health systems, socio-economic and nutritional status, and other yet to be documented factors. Living conditions, health system capacity, and policy decisions all play a part in determining how the pandemic unfolds around the world.
Understanding how the prevalence of NCDs contributes to COVID-19 vulnerability can help policymakers and health planners to anticipate what to expect and how best to respond. Countries with highly vulnerable populations must ready their health system to handle a possible rapid escalation of severe cases.
The world has been slow to take action on NCDs, even though NCDs are escalating across countries and already cause more than 70% of worldwide premature deaths, with 80% of these in low- and middle-income countries. A serious reckoning with the factors that increase risk of NCDs—unhealthy diets, physical inactivity, tobacco use, harmful alcohol use, and unhealthy air quality—would reduce COVID-19 vulnerability; lessen the devastating health, economic, and societal consequences of the pandemic; and immeasurably improve lives.
Curious about the global burden of specific NCDs and risk factors? Additional world maps can be found below: