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Twin epidemics of covid-19 and non-communicable disease

BMJ 2020; 369 doi: (Published 30 June 2020) Cite this as: BMJ 2020;369:m2618

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  1. Trevor A Sheldon, professor of health services research1,
  2. John Wright, director2
  1. 1Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University, London, UK
  2. 2Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford
  1. Correspondence to: T A Sheldon t.sheldon{at}

Worse than the sum of their parts

The exclusive focus of political, regulatory, health service, and public health agencies on covid-19 has concealed another less visible epidemic. Non-communicable diseases (NCDs) such as obesity, diabetes, heart disease, stroke, cancer, chronic respiratory diseases, and mental health disorders cause many times more premature deaths and greater suffering than covid-19, year after year.

Like children playing Sunday football, we have all been chasing after the covid-19 ball but have left the goal wide open. The response to coronavirus has constrained the physical and mental freedoms of people with NCDs and severely disrupted access to essential services.1 The management of the acute epidemic in isolation from the chronic epidemic is short sighted and will leave a legacy of great harm from the effect of lockdown and the serious disruption of health and care services for people with NCDs.


These two epidemics are closely connected and act synergistically on morbidity and mortality: people with NCDs are more vulnerable to severe covid-19 and death2; covid-19 and NCDs share a common set of underlying risk factors, …

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