Post COVID-19 Consequences to Public Health

The Coronavirus disease caused by the SARS-CoV-2 virus (COVID-19) pandemic has changed not only global epidemiological and economic developments but also the lives of every individual, with particular severity for patients. The number of acute illness cases grew rapidly, significantly increasing the workload of hospitals, and simultaneously, new chronic diseases emerged, such as persistent post-COVID-19 syndrome (PPCS), with unclear etiology, symptoms, and complexity – similar to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Accordingly, the burden of chronic diseases poses new long-term challenges for public health and requires new approaches to healthcare. The aim of this research is to provide insight into some COVID-19 pandemic revealed consequences, including an increase in the burden of chronic diseases due to new disorders such as PPCS and an extension of the existing diseases such as ME/CFS; an increase in mortality rates not only in COVID-19 directly related diagnoses but also in indirect COVID-19-related diagnoses; and tendencies of immunization. The scientific literature review, content analysis, and statistical data analysis were used to achieve the aim of this study.
Results demonstrate that there is an obvious tendency toward an increase in the burden of complex chronic diseases of unclear etiology. Under these circumstances, the importance of precision medicine is the research and use of biomarkers for diagnostics. growing, including The authors work on these issues within the Latvian Science Council‟s Fundamental and Applied Research project No. lzp-2019/1-0380 ‟Selection of biomarkers in ME/CFS for patient stratification and treatment surveillance/optimization‟. At the same time, the context in which biomarkers are used may change, for instance, ME/CFS may move from the rare disease category to a wide group of diseases with similar symptoms. Accordingly, the emphasis may shift from the use of biomarkers to „identify ME/CFS patients‟ to the new role of „distinguishing ME/CFS patients‟ in a group of similar illnesses. Certainly, this is valuable if there are specific distinguished treatment methods provided.
Another consequence of the COVID-19 pandemic is increasing in mortality rates in indirect COVID-19-related diagnoses. The example of Latvia demonstrates that during the pandemic, mortality increased notably (by 9% in 2021, compared to 2020) in the group of diseases of the circulatory system (I00-I99). It can be assumed that this tendency would be associated not only with medical consequences of COVID-19 disease, but also with significant restrictions on primary healthcare availability during the pandemic, but in-depth research would be needed to identify all impact factors.
With regard to vaccination, it may seem positive that precision medicine's medicinal products became widely available and used throughout the population. However, the result is ambiguous: with particularly intensive and global-scale use, the oncoming of new resistance, 'vaccine resistance' is observed, which can rapidly expand the scope of existing 'antibiotic resistance' and its induced problems, posing significant challenges to contemporary society. The results of these findings can help in forecasting future scenarios, to increase their value under persistent conditions of uncertainty. Additionally, this study outlines the contours for further research on the post-COVID-19 impact on public health.