The ongoing pandemic has inevitably caused much strain and burden on healthcare workers and citizens alike.

This article has been written to highlight the relationship between non-communicable diseases (NCDs) and coronavirus disease 2019 (COVID-19) as well as Malaysia's preparedness in combating the pandemic.

As of February 21, the total number of confirmed deaths due to COVID-19 globally was 2,445,681, with half a million in the US alone.

In Malaysia, the total number of confirmed deaths was 1,056. However, to properly assess the severity of mortality due to COVID-19, we need to look at the total number of confirmed deaths per million population, where Belgium is the highest (1,889.88 deaths/1 million population), followed closely by Slovenia, the UK, Italy and the US.

In Asia, Indonesia has 126.09 deaths/1 million population, whereas Malaysia has 32.63 deaths/1 million population¹.

Having said this, there is a very high likelihood that the actual death toll from COVID-19 is higher than the recorded total confirmed deaths. This could be due to limited testing available and the inability to detect the causes of all deaths¹.

Relation between NCDs and COVID-19 and effects on disease progression

Interestingly, the notorious COVID-19 pandemic has not only called attention to the importance of personal hygiene that most take for granted, but also the detrimental health effects of NCDs.

NCDs are diseases that occur for a long duration and are caused by multiple factors such as genetics, environment and lifestyle.

Examples of NCDs include hypertension, chronic respiratory diseases, diabetes, cancers and cardiovascular diseases, including heart attack and stroke².

In Malaysia, NCDs have contributed to 74% of all deaths, with cardiovascular diseases contributing the highest percentage³.

Individuals with NCDs are at higher risks for severe COVID-19 infections. Specifically, they are at greater risk of developing severe chest infections or bilateral viral pneumonia.

Hence, risk factors for NCDs can also increase the risk of severe illnesses with COVID-19.

Major NCD risk factors include smoking, alcohol intake, unhealthy diet, sedentary lifestyle and air pollution, most of which are modifiable⁴.

The pandemic serves as a reminder to the public to take charge of your health via a healthy, active lifestyle and smoking cessation to reduce the adverse health risk.

What are the other impacts on NCD patients caused by the pandemic?

Unfortunately, the pandemic has led to a shortage of medication for NCD patients. In addition, health services are also disrupted to cater for the fight against COVID-19. 

his greatly impacts the detection and diagnosis of NCDs. Elective procedures and services for NCDs are also delayed⁵.

What can NCD patients do? The list below are tips provided by the World Health Organization for NCD patients.

1. Continue to take medication and follow medical advice

2. If possible, obtain one month supply of medication

3. Practice social distancing

4. Frequent hand-washing

5. Quit smoking and avoid alcohol or illicit drugs

6. Safeguard mental health⁶

Malaysia's preparedness and response against COVID-19

According to Datuk Dr. Christopher, Malaysia was well prepared at the start of the pandemic due to prior experience in pandemics such as SARS, H1N1 and MERS.

However, the big hit to Malaysia really began after the Seri Petaling outbreak.

Initially, China was a worry for us, but now local community outbreaks are rampant and out of control.

"We were good at combating overseas spread to the local community. But when it comes to local spread, we didn't do it so well."

With this, the stricter they implement the MCO SOPs, the faster we can put a stop to the virus. The goal here is to flatten the curve to buy time for our hospitals to ensure healthcare workers are well-prepared.

Theoretically, not leaving our homes would hinder the spread of the virus, but at what expense? How strict should our MCO SOPs be?

According to Dr. Christopher, the number of cases can never go down to zero, but if we have a low enough number, the contact tracing team can take effective measures to control the further spread of the virus.

This is essentially the purpose of MCO — to buy enough time for the healthcare sector to prepare for the next wave.

While policymakers and healthcare providers try to be as evidence-based as possible when making decisions, one must also consider that the frequent change in policies may lead to confusion for both the public and frontliners.

Were we prepared? Yes. Are we prepared now? No.

To that end, we urge everyone to play their part in combating COVID-19 through the vaccination program and compliance with SOPs.

References :

¹ Roser M, Ritchie H,Ortiz-Ospina E, Hasell J. Coronavirus (COVID-19) deaths. 2020. Available from:

² World Health Organization. Noncommunicable diseases [Internet]. World Health Organization; 2018 Jun 1 [cited 15.2.2021].

³ World Health Organization. Noncommunicable Diseases (NCD) Country Profiles 2018: World Health Organization; 2018. p. 131.

⁴ World Health Organization. COVID-19 and NCDs: Conceptual framework for the WHO NCD/WIN Technical Working Group. World Health Organization; 6 Apr 2020. p.1-2

⁵ World Health Organization. COVID-19 significantly impacts health services for noncommunicable diseases [Internet]. World Health Organization; 2020 Jun 1 [cited 15.2.2021].

⁶ World Health Organization. Information note COVID-19 and NCDs. World Health Organization; n.d.. p.1-2

Malaysian Medics International