Other infectious diseases may surge as vaccination campaigns hit pause.

As the Covid-19 pandemic grinds the world to a halt, it may be easy to forget the other dangerous infectious diseases that plague humans across the globe. But today, we’re reminded that they haven’t gone anywhere.

In a media briefing on Friday, World Health Organization (WHO) director-general Tedros Ghebreyesus announced a new case of Ebola in Congo. The agency was just two days away from declaring the end of the Ebola outbreak in eastern Congo, which began in 2018. And just two weeks ago, Reuters reported that measles was also surging through Congo, where it has been spreading since January 2019.

The resurgence of established infectious diseases like Ebola and measles is likely to intensify as the pandemic wears on. Not only are health resources being diverted to dealing with Covid-19, but routine vaccinations for deadly, vaccine-preventable diseases like polio, measles, meningitis, cholera, and yellow fever have also stopped. Vaccination campaigns are crucial for containing outbreaks of these diseases, especially in developing countries.

Today in Science Magazine, journalist Leslie Roberts described what the head of the Vaccine Alliance called “A devil’s choice:” In the past month, the World Health Organization had to choose whether to protect communities and frontline health care workers from becoming infected or to continue mass vaccination campaigns in poor countries. It chose suspension, halting polio vaccinations first. Then, on March 26, a WHO committee of immunization experts recommended suspending all campaigns against vaccine-preventable diseases. “Any mass campaigns would go against the idea of social distancing,” said the chair of WHO’s Strategic Advisory Group of Experts on Immunization.

In addition to creating opportunities for other diseases to spread, the Covid-19 pandemic also complicates how to treat them. In the Guardian, physicians in Africa raised concerns that people with HIV risked infection with Covid-19 when coming to facilities for treatment, while others warned that the symptoms of malaria and Covid-19 could be easily confused, creating even more opportunities for infection as people head to clinics. People with tuberculosis, meanwhile, are expected to be at higher risk of severe Covid-19.

Writing about Congo’s ongoing measles outbreak for Nature, Roberts noted: “Health workers are stretched thin at the best of times, and the DRC has been battling Ebola, outbreaks of cholera and yellow fever — and now the coronavirus.” Suspending mass vaccinations to preserve these health workers and their communities was a devil’s choice indeed, one where there’s only one grim guarantee: protecting everyone is simply not possible.

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