Dear Editor,
Coronavirus disease 2019 (COVID-19) pandemic caused severe damage to humankind not
only by affecting the healthcare systems of many countries but all the socio-economic
structures of the entire globe. As of May 4, 2022, 512 million cases of COVID-19 have
been reported with a mortality of 6.23 million people (World Health Organization,
https://covid19.who.int/). The epidemiology of COVID-19 in Russia, Ukraine, and refugees-hosting
countries during the Russo-Ukraine war has been delineated in Table 1
. The COVID-19 pandemic has no definitive treatment other than supportive care, though
a vaccine course has been developed but remains elusive. Amid the scarcity of reliable
and standard therapeutic regimens, prevention approaches such as social isolation,
face mask use, and aggressive hygiene are effective ways to contain the causative
agent of COVID-19, i.e., severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
[1,2]. While many countries’ serious efforts are underway to contain the COVID-19
pandemic, the Russo-Ukraine conflict has emerged as a severe threat that can change
the trajectory of the pandemic. Hence, the aim of this correspondence article is to
highlight the global effects of the Russo-Ukraine war during the ongoing COVID-19
pandemic.
Table 1
Epidemiology of COVID-19 in Russia, Ukraine, and refugees-hosting countries.
Table 1
Feb 24, 2022
March 24, 2022
Persons fully vaccinated per 100 population
Vaccinated % March 28, 2022
Cases
Deaths
Cases
Deaths
Russia
132998
762
25387
418
49.603
79,914,874 (54.77%)
Ukraine
25789
276
3855
55
34.65
15,729,617 (36.19%)
Poland
18282
341
8988
146
58.85
22,582,308 (59.75%)
Romania
11477
119
4521
40
41.88
8,162,071 (42.67%)
Hungary
5512
102
2651
35
62.72
6,401,980 (66.45%)
Belarus
6230
15
1647
10
58.9
5,801,653 (61.44%)
Slovakia
15183
24
9649
24
50.69
2,819,636 (51.74%)
Moldova
1069
14
431
7
25.98
1,081,073 (26.87%)
Ritchie, Hannah; Mathieu, Edouard; Rodés-Guirao, Lucas; Appel, Cameron; Giattino,
Charlie; Ortiz-Ospina, Esteban; Hasell, Joe; Macdonald, Bobbie; Beltekian, Diana;
Dattani, Saloni; Roser, Max (2020–2021). Coronavirus Pandemic 2019 (COVID-19). Our
World in Data. Retrieved March 28, 2022 (World Health Organization, https://covid19.who.int/).
Several geopolitical, economic, infrastructural, and health consequences have been
associated with the Russo-Ukraine war. Furthermore, the implications of this war,
notably in terms of healthcare services both within and beyond Ukraine, will last
long even after the physical battle has ended [3,4]. It is essential to notice that
the Ukrainian healthcare system is already under extreme strain as a result of the
rising number of casualties and negative repercussions on the socio-economic system.
Furthermore, the scarcity of water resources and sanitation infrastructure, low vaccine
coverage, overcrowding, and lack of access to primary medical treatment are all expected
to exacerbate these issues. It is important to remember that all these issues are
most likely to increase the other infectious diseases such as measles, typhoid, malaria,
polio, tuberculosis (TB), human immunodeficiency virus (HIV), and also gastrointestinal
disorders of parasitic origin. The rapid spread of these diseases has been associated
with overcrowding in refugee containment camps. Furthermore, the interruption in the
immunization programs in war regions can play an essential role in the spread of other
infectious diseases [4]. Additionally, a considerable increase in non-communicable
diseases, notably cardiovascular disease, diabetes, and cancer mortality will occur
from further disruption of medical supply chains and health services. The absence
of access to obstetric care will also raise maternal and newborn morbidity and mortality
[5]. Till now, more than six million Ukrainian individuals escape from the fires of
the war in their country, which constitutes the fastest-growing refugee crisis in
Europe since World War Two. Undoubtedly, the health care and well-being of the Ukrainian
people are now at severe risk. UNICEF, the UN children’s agency, believes hundreds
of thousands of Ukrainian refugees were youngsters. A vital question has been raised
in our mind, and it needs an urgent answer; How do the hosted countries enable them
to keep their health, social and emotional stability? Community organizations, such
as civil society organizations, could develop programs to help them with their economic,
social, educational, and health requirements, based on family and individual needs
(Bergman et al. 2017 [6]). Schoolwork and college are among the concerns in their
mind, and consequently, teachers in schools and physicians in clinics should adopt
education of these war crisis-undergoing children resilience-building strategies (Bergman
et al. 2017 [6]).
Given the ongoing war in Ukraine and enormous economic penalties faced by Russia,
the world economy, which has already been damaged by the COVID-19 pandemic, has been
adversely affected. Nations throughout the world are experiencing significant interruptions
in the supply of energy and raw materials as well as soaring costs for commodities,
oil, and food, as well as one of the greatest interruptions to wheat availability
in history. As Ukraine and Russia combined account for a third of worldwide wheat
and barley exports and more than seventy percent of sunflower oil exports, the war
might have a catastrophic effect on starvation throughout the globe. Large proportions
of agricultural imports from Russia and Ukraine are consumed by conflict-affected
nations and areas, such as Lebanon, the Democratic Republic of the Congo, Syria, Iraq,
Afghanistan, North Africa, and West Africa. Such an invasion, according to the International
Monetary Fund, could throw the world's food supply into destruction owing to increase
food prices and Ukraine's failure to plant crops, such as wheat, because 70% of the
country's land is devoted entirely to agriculture-the so-called breadbasket of Europe-is
unable to plant crops, which include wheat [5]. In addition to food and water deprivation,
there are several environmental challenges that should be considered seriously. Some
of these concerns include chemical wastes, heavy metals, and radioactive materials
infiltrating into natural water sources from destroyed industrial sites, water dam
damage, gasoline and hydrocarbon leakage from conflict regions, weapons combustion,
and leakage in underground coal mines.
Ukraine, wherein Russia has been at war with the country since 2014, is facing a unique
double hazard: a catastrophic reaction to conflict and a fatal contagious illness.
Increased North Atlantic Treaty Alliance (NATO) integration across Ukraine's disaster
response structures within the Ministries of Health, Defense, and Interior, must be
augmented and increased to effectively serve biosurveillance, aid in pandemic disaster
response, and bolster health security in Europe, across the NATO and Black Sea regions,
to mitigate the COVID-19 global crisis [7].
Furthermore, there are critical short- and long-term deleterious repercussions on
mental and physical health due to mass migrations. Depression, social withdrawal,
and anxiety are just a few of the long-term psychological and physical health repercussions
that will afflict subsequent civilizations [[4], [5], [7]]. To cope with the deleterious
consequences of war, mental health and psychosocial services are critically needed.
Additionally, Funding and research focused on populations affected by the ongoing
Russia-Ukraine conflict is desperately needed for those who have fled and for those
who remain to fight. Besides providing the social and educational sides, the need
to vaccinate Ukraine children against COVID-19, particularly since Ukraine had had
high vaccine hesitancy before the Russian invasion (Zaprutko et al. 2022 [8]).
Ultimately, vaccination is still critical, and it is essential to vaccinate the maximum
number of people, especially the vulnerable groups, as just a third of adult Ukrainians
are completely immunized. To augment the resiliency of the Ukrainian population and
to contain the associated negative repercussions of the war, worldwide interventions
and public health support are required right away.
Provenance and peer review
Not commissioned, internally peer-reviewed.
Ethical approval
This article does not require any human/animal subjects to acquire such approval.
Sources of funding
This study received no specific grant from any funding agency in the public, commercial,
or not-for-profit sectors.
Author contributions
Manish Dhawan: Conceptualization, Data Curation, Writing - Original Draft, Writing
- review & editing. Om Prakash Choudhary: Conceptualization, Data Curation, Supervision,
Writing - Original Draft, Writing - review & editing. Priyanka: Writing - Original
Draft, Writing - review & editing. AbdulRahman A. Saied: Writing - Original Draft,
Writing - review & editing. All authors critically reviewed and approved the final
version of the manuscript.
Trial registry number
1.
Name of the registry: Not applicable.
2.
Unique Identifying number or registration ID: Not applicable.
3.
Hyperlink to your specific registration (must be publicly accessible and will be checked):
Not applicable.
Guarantor
Om Prakash Choudhary, Assistant Professor (Senior Scale), Department of Veterinary
Anatomy and Histology, College of Veterinary Sciences and Animal Husbandry, Central
Agricultural University (I), Selesih, Aizawl-796015, Mizoram, India. Tel: +91–9928099090;
Email: dr.om.choudhary@gmail.com.
Data statement
The data in this correspondence article is not sensitive in nature and is accessible
in the public domain. The data is therefore available and not of a confidential nature.
Declaration of competing interest
All authors report no conflicts of interest relevant to this article.