This year marks the 102nd anniversary of the most fatal event in human history. The 1918, global influenza pandemic caused an estimated 50–100 million deaths and yet almost a century later there seems to be similarities between the pandemic we face today. In 1918 there was no vaccine and no antibiotics to treat the secondary infections that followed. There were limited control efforts used and limited pharmaceutical options. The main methods of control were quarantine and isolation, improved personal hygiene, disinfectant, and limited public gatherings.

But there is one large difference between this pandemic and all others humanity has faced. This one has occurred at a point in time where humans have the highest burden of chronic, non-communicable diseases (NCDs) we have ever seen as a species. The highest levels of childhood and adult overweight/obesity, the highest number cardiovascular disease cases occurring at an early age and the highest number of diabetes cases in low and middle-income countries.

We are all in the same storm, however we are in different boats. We are all susceptible to COVID-19 however those with NCDs and NCD risk factors are at a higher risk of developing hard to manage COVID-19. Given that chronic NCDs play an important role in determining the survival of those infected, it is imperative that we avoid COVID-19 myopathy and raise our line of sight to look at the wider picture.

The impacts of COVID-19 and the measures put in place to mitigate the risk of being infected might also have contributed to reduced access to healthy food, an increase in alcohol consumption, less physical activity and an increase in poor mental health. This in addition to a lack of access to health care services for prevention and treatment have led to what can only be described as an impending second and third wave of NCDs and mental health cases within the next months, or even years.

The 14th of November marks World Diabetes day. With COVID-19, diabetes prevention and treatment is critical. When people with diabetes develop a viral infection, it can be harder to treat due to fluctuations in blood glucose levels and, possibly, the presence of diabetes complications. Therefore, regularly checking our blood glucose levels and paying attention to risk factors such as healthy diet and physical activity are key.

COVID-19 is like an unwanted house guest that showed up when we least expected it. This houseguest is likely to stay with us for the next few years. We have to stop waiting for the guest to leave to restart our life and start thinking of how we are going to adapt. That means evolving in our coping strategies and reworking our lives to include new ways to eat healthy, stay active and become resilient.

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