MIDO COVID: A digital public health strategy designed to tackle chronic disease and the COVID-19 pandemic in Mexico

Screening, prevention, and management of non-communicable diseases (NCDs, including obesity, hypertension, and type 2 diabetes) is the core function of Integrated Measurement for Early Detection (MIDO), a digital strategy developed by the Carlos Slim Foundation in Mexico. An extension of this strategy, MIDO COVID, was developed to address the need for an integrated plan in primary health care during the COVID-19 pandemic. MIDO COVID facilitates planning, surveillance, testing, and clinical management of SARS-CoV-2 infections and the major NCDs and their pre-disease states, to streamline the continuum of care. MIDO COVID screening was applied in 1063 Carso Group workplaces in 190 municipalities of the 32 Mexican states. Staff were trained to screen healthy workers for NCDs using a questionnaire, anthropomorphic measurements, and blood work; healthy individuals returning to work also received a SARS-CoV-2 antibody test. Between June 26 and December 31, 2020, 58,277 asymptomatic individuals underwent screening. The prevalence of obesity, hypertension, and type 2 diabetes was 32.1%, 25.7%, and 9.7% respectively. Only 2.2%, 8.8%, and 4.5% of individuals, respectively, were previously aware of their condition. Pre-obesity was identified in 38.6%, pre-hypertension in 17.4%, and prediabetes in 7.5% of the population. Risk of SARS-CoV-2 infection was highest for individuals with multiple NCDs. Many Mexicans are unaware of their health status and potentially increased risk of COVID-19 and serious complications. As a universal strategy implemented regardless of social factors, MIDO COVID promotes equity in access to health care prevention and early stage detection of NCDs; the information gained may help inform decisionmakers regarding prioritising vulnerable populations for immunisation.