Addressing the indirect health burden of covid-19

Consider collateral impacts when planning for future crises The covid-19 pandemic’s impact extends far beyond the direct effects of infection and death, resulting in sharp increases in other causes of illness and death that demand attention. A new time-series analysis of the Global Burden of Disease data by Chen and colleagues (doi:10.1136/bmj-2024-083868) quantifies these shifts and identifies which conditions had excess burden during 2020-21.1 Their key finding is that many countries had greater than expected morbidity and mortality from non‐covid causes—a signal that health systems were strained in multiple ways. As such, policy makers must look past the virus itself and address collateral impacts. Health experts have noted that assessing health-system resilience now is “vital in helping policymakers plan for sustainable recovery” and to strengthen systems for future crises.2 The indirect health burdens have been profound. For example, a modelling study suggested that even modest service disruptions related to covid-19 in Africa could nearly double annual malaria deaths if routine programmes were interrupted.3 In practice, the findings suggest that malaria control campaigns could not simply be paused without consequences. Likewise, the pandemic has provoked a mental health crisis. The …