Possibility of Covid-19 being Syndemic | 19 May 2020

Why in News

The possibilities of Covid-19 being syndemic have been raised in the backdrop of the World Health Organization (WHO) announcement that Covid-19 less likely to be eliminated (i.e. may become endemic).

  • The rapid spread of Covid-19 across the world has been characterised as ‘Pandemic’ by the WHO.


  • Pandemic: A pandemic is declared when a new disease for which people do not have immunity spreads around the world beyond expectations.
  • Epidemic: An epidemic is a large outbreak, one that spreads among a population or region. It is less severe than pandemic due to a limited area of spread.
  • Endemic: A disease is called endemic when the presence or usual prevalence of its infectious agent is constant within a given geographical area or population group.

Key Points

  • Description:
    • A syndemic is a situation when two or more epidemics interact synergistically to produce an increased burden of disease in a population.
    • A situation of syndemic was first described by medical anthropologist Merrill Singer in the mid-1990s.
  • Possibility of Syndemic in the Current Scenario:
    • Covid-19 Pandemic and Presence of Dengue, Malaria:
      • The least possibility of elimination of Covid-19 pandemic and warning about the second wave of Covid-19 infections worldwide have reinforced the presence of Covid-19 for the long term.
      • Meanwhile, the alarm is being raised about diseases like dengue and malaria emerging with the upcoming monsoon season in tropical South Asia.
      • Thus, there is a possibility that the world will face increased burden of the diseases and thus the situation of syndemic.
    • Presence of Antibiotic Resistance:
      • The second wave of infection due to Covid-19 is suspected to be seen in those with weakened immunity.
      • At the same time, the world already faces antibiotic resistance and if Covid-19 deepens as a syndemic in populations with antibiotic resistance, the world will face comorbidities.
      • Comorbidity is the presence of one or more additional conditions co-occurring with a primary condition.
      • Antibiotic resistance is the ability of bacteria or other microbes to resist the effects of an antibiotic. Antibiotic resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of drugs, chemicals, or other agents designed to cure or prevent infections.
  • Past Instances of Syndemic:
    • The 1957 Asian influenza pandemic observed deaths not only due to the primary viral infection, but also due to secondary bacterial infections among influenza patients. In short, it was a viral/bacterial syndemic.
    • Meanwhile, researchers have shown that in Kenya, 5% of Human Immunodeficiency Virus (HIV) infections are due to higher HIV infectiousness of malaria-infected HIV patients.
  • Possible Solutions:
    • Whole world will need to implement large-scale population testing for Covid-19 (such as PCR and antibody testing) to contain it at its base level.
    • The societies around the world will also have to consider innovations in population health surveillance technology and develop creative business models at a scale.