Statement submitted by WSO to the WHO SEAR Regional Committee Seventy-third Session

29 Sep 2020

The Seventy-third session of the WHO SEAR Regional Committee was held virtually on 9th and 10th September. WSO submitted a report on the topic "Sustaining Stroke Care Services amid COVID-19 pandemic in SEAR countries" to highlight the serious problem of stroke care services being disrupted by the COVID-19 pandemic. You can find the full report prepared by the Vice-President of WSO, Dr. Jeyaraj D Pandian below.

Agenda item: 8.2 - Annual report on monitoring progress on UHC and health-related SDGs

Sustaining Stroke Care Services amid COVID-19 pandemic in SEAR countries

Stroke diagnosis and treatment globally has been severely affected due to the current COVID-19 pandemic. A recent survey conducted by the World Stroke Organization (WSO) revealed a significant reduction in the number of stroke patients seeking acute treatments like thrombolysis and mechanical thrombectomies. Minor strokes and transient ischemic attack patients delay evaluation and treatment which can lead to a major stroke.

WSO has been monitoring experiences across the globe. While a small minority of countries are managing to maintain a full range of acute stroke services, most have seen significant service reorganization. WSO members report reallocation of neurology and stroke beds including Intensive Care Unit facilities to COVID-19 patients necessitating a move of stroke units to less optimal accommodation and redeployment of stroke physicians, nurses, and other stroke healthcare-related workers to look after COVID-19 patients.

There are many reports of a stroke occurring in COVID-19 patients. This could be multifactorial due to poor compliance of medications to control blood pressure, diabetes, etc. In addition, the hypercoagulable state seen in COVID infection can lead to large strokes.

Several countries in SEAR reports a high burden of stroke and stroke care services are fragmented. In the SEAR virtual meeting that was held on July 29th on Essential Health Services and Systems during the COVID-10 Pandemic, it was observed that the NCD services have been disrupted in the region. India, Indonesia and Bangladesh are the countries facing a heavy brunt in terms of the number of COVID cases. The health-workforce is stretched to capacity to address COVID-19 cases and maintain emergency health services.

Sustaining existing stroke services are essential during these difficult times. Healthcare systems have adapted very rapidly to implement systems for COVID-19 care, but it is important that we ensure that the highly effective stroke therapies continue despite these service reorganizations. Country-specific guidelines and protocols need to adhere to effective service delivery. Telemedicine could be used to monitor the treatment at home including stroke rehabilitation.

Dr Jeyaraj D Pandian Dr Michael Brainin
Vice-President, World Stroke Organisation President, World Stroke Organisation

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