Over the past 2 weeks or so, I've been researching and sending e-mail inquiries on how EA charities (specifically global health) are responding to COVID-19 in an effort to assess how my donation allocation should change. I personally donate to GiveWell's discretionary fund and am waiting to hear their official recommendations.
Here are some e-mail responses I received, with some including links to their website describing their response to COVID-19.
E-mail response
There are several ways in which reducing malaria – both morbidity and mortality – helps reduce the impact of COVID-19.
First, if people are ill with malaria their immune system is less able to cope with the effect of COVID-19 so the impact of COVID-19 can be expected to be greater. This is consistent with those most at risk being people with ‘underlying health issues’. Increased malaria leads to a greater strain on already fragile health systems including taking up more intensive care beds.
Second, if people are ill will malaria, whose symptoms are very similar to those of COVID (high fever), (“….the early symptoms of COVID-19, including fever, myalgia, and fatigue, might be confused with malaria and lead to challenges in early clinical diagnosis.” Source: Lancet article) the identification and management of COVID-19 is made more difficult. There is a greater risk of mis/under-diagnosis (treated as malaria when in fact COVID-19) or over-diagnosis (treated as COVID-19 and perhaps a bed in a hospital allocated, when malaria is the illness), which makes the management of COVID-19 more challenging.
Third, if we delay desperately needed universal net coverage campaigns, and bednets are the most effective mechanism of preventing malaria, as well as other malaria control interventions, there is a significant risk, indeed a likelihood, that malaria will increase leading to further loss of life, illness, a greater strain on health systems trying to deal with COVID-19 as well as increased negative economic impact - if people are ill, they cannot farm, drive, teach, function.
For these reasons and as the WHO advises, it is important that malaria control activities continue. These activities are likely to require sensible operational adjustments, including increased sanitizing measures and social distancing, to limit transmission risk.
They are providing standard cash transfers to households and families in both the US and Africa that are adversely impacted by COVID-19.
Malaria Consortium
E-mail response
In line with WHO recommendations, Malaria Consortium believes that delivery of essential health services should continue in the context of the COVID-19 pandemic and that SMC is an essential health service.
We are currently working on a range of adaptations to the delivery model to minimise the risk of infection for implementers and beneficiaries. In 2020, we plan to deliver SMC to more than 11 million children in Burkina Faso, Chad and Nigeria. In all three countries, the malaria burden in terms of morbidity and mortality is high and we believe that the risk of increasing malaria illness and deaths (and, as you rightly point out, the resulting strain on already overburdened health systems) as a result of not providing SMC outweighs the risk of contributing to the spread of COVID-19.
However, the risk-benefit relationship is complex. For example, our assumptions with regard to COVID-19 are almost exclusively based on data from Asia, Europe and America. The epidemiology in Africa, with different climatic conditions, a different population profile, different co-morbidities etc. might be very different. We are working on a detailed risk-benefit analysis to support the case for continued SMC implementation, including a modelling exercise looking at the direct and indirect effects of COVID-19 on malaria and vice versa (e.g. changes in care seeking behaviour, case management capacity, etc.).
At present we would not be comfortable with statements that assign a monetary value to a particular impact on COVID-19 or malaria – there are just too many variables that are, as yet, unknown.
The Life You Can Save compiled the COVID-19 responses from their charities. Here are some highlights that stood out to me.
Development Media International
Our main aim is to help health ministries to reach communities with key messages relating to COVID-19, using our existing relationships with radio stations as well as our ability to rapidly produce high-quality radio spots. The radio spots will cover a range of topics in line with WHO guidance and national priorities, for example the promotion of handwashing and social distancing.
Helen Keller International Vitamin A Supplementation Program
This is particularly relevant in the current epidemic, because vitamin A deficiency has been extensively shown to impair immunity against viral infection, including viral pneumonia. Vitamin A specifically improves a child’s ability to neutralize viruses in membranes in the gut and lungs. In the COVID-19 pandemic, we have seen enormous differences in the clinical course, from little or no symptoms, to severe illness and death, based in large part of pre-existing immunity. In the increasingly likely scenario of large-scale infection in areas of Africa and Asia with poor nutrition, vitamin A capsules provided by Helen Keller in the last few months could be the difference between life and death for thousands, and potentially millions, of young children.
