Coalition publishes results from a global survey of Covid-19 impact on hepatitis elimination
The results of a global survey on the impact of COVID-19 on hepatitis testing and treatment were published in Clinical Liver Disease on February1st. This survey was conducted August to October 2020 among clinicians and program managers.
In total, 103 respondents participated from 44 countries. Over 80% of respondents were physicians and 33 respondents were program managers.
Survey findings indicate substantial deferrals of in-person clinic visits as a result of COVID-19. Most facilities reported deferring more than 50% of clinic visits during the heavily impacted months of the pandemic. Facilities in the Region of the Americas experienced the highest level of initial deferrals. In the month of highest COVID-19 impact, over 25% of respondents indicated that HCV screening volumes decreased by more than half while over 35% of respondents reported declines in HCV treatment of greater than 50%. A similar trend was observed in HBV screening but declines in HBV treatment were not as high as for HCV.
To maintain clinic services facilities employed a variety of infection control and distance-based care strategies. Mask wearing was the most widely reported risk mitigation strategy in all regions but was not universally implemented. A transition to telemedicine and increasing pill counts for prescription medications was used to reduce the need for in-person clinic visits. While countries in the European Region, African Region, and Region of the Americas all retrospectively reported using telemedicine extensively during the month of highest COVID-19 impact, only countries in the Region of the Americas maintained high levels of telemedicine use in the month of survey completion. Increases in pill counts were used most frequently in countries in the African Region where 95% of respondents utilized this strategy. The precedent set by the distribution of HIV medication in low- and middle-income countries may have resulted in greater acceptance of this practice.
The report concludes with emerging opportunities for continued progress towards hepatitis elimination. While the pandemic challenged global health systems, the response to COVID-19 has resulted in strengthened laboratory capacity, improved healthcare staff training, and improved contact tracing infrastructure. This capacity can be transferred to hepatitis elimination programs following control of the pandemic.
As the pandemic progresses, global collaboration and sharing of innovative strategies can aid the hepatitis community in both maintaining service delivery and capitalizing on the opportunities presented by Covid-19.