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Letter to the Editor| Volume 120, P44-45, July 2022

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The Russia-Ukraine war could bring catastrophic public-health challenges beyond COVID-19

Open AccessPublished:April 11, 2022DOI:https://doi.org/10.1016/j.ijid.2022.04.016

      Keywords

      Dear Editor,
      • Dahl V
      • Tiberi S
      • Goletti D
      • Wejse C.
      Armed conflict and human displacement may lead to an increase in the burden of tuberculosis in Europe.
      recently warned in this journal that armed conflict and human displacement by the Russia-Ukraine conflict may increase the burden of tuberculosis in Europe, but there could be more public health problems ahead. Since last 2 years, the COVID-19 pandemic has been an important catalyst for international collaboration on public health (
      • Jit M
      • Ananthakrishnan A
      • McKee M
      • Wouters OJ
      • Beutels P
      • Teerawattananon Y.
      Multi-country collaboration in responding to global infectious disease threats: lessons for Europe from the COVID-19 pandemic.
      ). This collaboration has not been error-free, especially in relation to an equitable distribution of diagnostic tests, treatments, and vaccines between high-income and low-middle-income countries (
      • Javed S
      • Chattu VK.
      Strengthening the COVID-19 pandemic response, global leadership, and international cooperation through global health diplomacy.
      ).
      The pandemic has been, at least temporarily, a kind of freezer of major war conflicts worldwide owing to the joint efforts to mitigate its impact. A better understanding of the virus, growing herd immunity produced by COVID-19 vaccines and/or previous infection (
      • Randolph HE
      • Barreiro LB.
      Herd immunity: understanding COVID-19.
      ;
      • Radbruch A
      • Chang HD.
      A long-term perspective on immunity to COVID.
      ), and the transition to less lethal variants (
      • Petersen E
      • Ntoumi F
      • Hui DS
      • et al.
      Emergence of new SARS-CoV-2 Variant of Concern Omicron (B.1.1.529) - highlights Africa's research capabilities, but exposes major knowledge gaps, inequities of vaccine distribution, inadequacies in global COVID-19 response and control efforts.
      ) have coincided with the beginning of a warfare in East Europe. The immediate consequences for Ukraine and surrounding regions are COVID-19 surges, unattended chronic diseases, emerging infections and lower vaccination rates, including anti-COVID-19 vaccination.
      The risk of an escalation is latent and consequences are unimaginable if nuclear weapons are used. All simulators of a nuclear war conclude in the inevitable figure of millions of deaths and an incalculable number of people affected by radiation (

      Nuclear Princeton, Princeton Science and Global Security Nuclear War Simulation https://nuclearprinceton.princeton.edu/news/princeton-science-and-global-security-nuclear-war-simulation, 2019 (accessed 22 March 2022).

      ). We already know about the immediate- and long-term aftermath of the Chernobyl disaster and the Hiroshima and Nagasaki nuclear bombings in World War II (
      • Douple EB
      • Mabuchi K
      • Cullings HM
      • Preston DL
      • Kodama K
      • Shimizu Y
      • Fujiwara S
      • Shore RE.
      Long-term radiation-related health effects in a unique human population: lessons learned from the atomic bomb survivors of Hiroshima and Nagasaki.
      ).
      Another threat is the use of biologic and chemical weapons that disseminate biologic agents or toxins to cause harm, disease, and death of humans or animals and harm the environment (
      • Jansen HJ
      • Breeveld FJ
      • Stijnis C
      • Grobusch MP.
      Biological warfare, bioterrorism, and biocrime.
      ;
      • Ekzayez A
      • Flecknoe MD
      • Lillywhite L
      • Patel P
      • Papamichail A
      • Elbahtimy H.
      Chemical weapons and public health: assessing impact and responses.
      ). In no way can this type of warfare be local or easy to contain. The global scientific community must warn the world leaders about the abyss into which humanity can fall if consensus is not reached in a timely manner to avoid self-destruction.
      After the use of nuclear weapons, there will be no winners among survivors. The health systems, especially in the countries most affected by radiation, will have to deal with its short-, medium-, and long-term effects on the population. It is time that states directly or indirectly affected by the Ukraine and Russia conflict cooperate bilaterally or multilaterally to stop the ongoing war.

      Declarations

      Founding source

      Universidad Tecnológica Centroamericana, Honduras.

      Ethical approval

      Not applicable

      Authors’ contribution

      CR and RMD developed the concept, reviewed the literature, and wrote the manuscript.

      Declaration of Competing Interest

      All authors declare no competing interest related to this paper.

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