First modification: 16/10/2020 – 01:58

Faced with the spread of Covid-19, which in March led the WHO to classify the emergency as a pandemic, and its incidence in the poorest and most vulnerable populations, international scientists have begun to suggest that the health crisis should be treated as a syndemic , by reflecting the interaction of various social and biological factors.

Although March 11 went down in history for being the day on which the World Health Organization (WHO) classified the spread of the Covid-19 outbreak as a pandemic, due to its speed of contagion, but not due to its lethality, seven months later a new term appears in the clinical picture in the midst of this crisis: syndemic.

This word that, despite not yet appearing in the records of the Royal Spanish Academy (RAE), It is considered valid by the Foundation for Urgent Spanish (Fundéu) as a translation for Anglicism syndemic, has gained greater visibility in recent days thanks to the suggestions of several scientists.

Technically, its meaning refers to the synergy or combination of various pathologies that, according to the Fundéu, “share social factors and coexist in time and place.”

Just a few weeks ago, The medical journal The Lancet published an article in which experts explained that the crisis that, so far, has left more than a million fatalities, should not be handled as a pandemicbut as a syndemic, a change that could transform the way the world is coping with the spread of the new coronavirus.

The origin of the term and its biological and social implications

Although it seems like a new term in Spanish, it was coined in English since the 1990s by the American medical anthropologist Merrill Singer.

A health worker performs a CRP test on student Theo Barbosa Rodrigues at the Almir Pereira Bahia Reverendo state school in Taboao da Serra, on the outskirts of Sao Paulo, Brazil, October 15, 2020.

A health worker performs a CRP test on student Theo Barbosa Rodrigues at the Almir Pereira Bahia Reverendo state school in Taboao da Serra, on the outskirts of Sao Paulo, Brazil, October 15, 2020. © Amanda Perobelli / Reuters

When consulted by media such as BBC Mundo, Singer explained that a syndicate occurs when two or more pathologies or viruses interact and cause greater damage.

“Syndemics are characterized by biological and social interactions between conditions and states, interactions that increase a person’s susceptibility to harm or worsen. In the case of Covid-19, targeting non-communicable diseases will be a prerequisite for successful containment. “, notes the publication of The Lancet.

Clinically, in cases in which patients infected with Covid-19 also have other diseases, such as cancer, hypertension, diabetes and obesity, their risk of death or serious condition increases, which makes them even more vulnerable and infected. It is equivalent to a syndemic, as it represents the biological combination of two pathologies.

Globally the count performed by Johns Hopkins University reflects that the United States continues to be the country that adds the most infections and deaths worldwide, which is interpreted by experts not only as a sample of the effect of the minimization of the emergency by the Donald Trump government, but also incidence of interaction with obesity and hypertension pathologies of its inhabitants.

India's economy has been devastated by the coronavirus epidemic, but the government has announced loan plans.
India's economy has been devastated by the coronavirus epidemic, but the government has announced loan plans.
India’s economy has been devastated by the coronavirus epidemic, but the government has announced loan plans. INDRANIL MUKHERJEE / AFP

But for a syndemic to occur, not only the interaction of two diseases or biological factors is evaluated, since social factors must also be taken into account, which are decisive at the time of the spread of a virus in a population.

When reviewing the count of the aforementioned university, the second country most affected by the pandemic is India and the third is Brazil, both with a high population density and deeply intricate social scourges such as poverty and inequality, which favor the spread of the disease. coronavirus given the precarious health and nutritional conditions of the populations. A scenario that is also described by experts as a clear syndemic panorama.

Thus, the comorbidities and social conditions added to Covid-19 configure what the scientists consulted by The Lancet qualify as a syndemic crisis.

What would change when going from pandemic to syndemic?

First, it is key to clarify that it is not a scale of severity in which one term is more dangerous than the other, since they do not respond to a hierarchical order. They simply describe the conditions under which a virus spreads.

While the pandemic emphasizes the speed of contagion, the syndemic focuses on the interaction of other risk factors as a catalyst for spread and risk.

So, in the event that the WHO ends up accepting the suggestions of the medical teams that have been expressed, so far, in favor of treating the crisis as a syndemic, some of the measures would have to change.

According to The Lancet, although it sounds utopian, if it does not work on the treatment and containment of non-contagious but frequent pathologies, such as cancer, obesity and hypertension, the possibility of containing the coronavirus crisis will be increasingly removed, which would require that the management of these diseases is not seen as an exclusive feature of the richest and most powerful nations.

Expanding health coverage, guaranteeing basic nutrition and improving the health conditions of the poorest populations are some of the proposals of the experts, who argue that carrying out thousands of daily tests in the largest cities does not guarantee anything if the vulnerable populations remain homeless.

With international media

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