While some of these factors may not be within our control, e.g. being older or having existing chronic, underlying conditions, there are other issues that we should be aware of and that we can actually do something about to potentially improve our response to any infection:
People who are considered obese, defined as a body mass index (BMI) equal to or greater than 30 (approximately 30 pounds of excess weight), are TWICE as likely to experience a bad outcome with COVID. If your BMI is in the range of 25 to 34.9 and your waist size is over 40” (men) or 35” (women), you are considered to be at an especially high risk for any health problems.
A few other concerning statistics:
• Obesity is linked to every autoimmune disease in America and is in itself a pandemic given that one out of every five people in this country has a diagnosed immune disorder.
• Two of every three Americans are overweight and one of three is obese.
• One of every five children age four years old is obese – that’s truly an unbelievable figure.
• For children and adolescents aged 2-19 years:
The prevalence of obesity was 18.5% and affected about 13.7 million children and adolescents.
Obesity prevalence was 13.9% among 2- to 5-year-olds, 18.4% among 6- to 11-year-olds, and 20.6% among 12- to 19-year-olds. Childhood obesity is also more common among certain populations, including vulnerable populations with less access to fresh (vs. processed) foods, lack of nutrition education, inactivity, lower socioeconomic status and behaviors that contribute to being overweight.1
In the face of these alarming trends – including the recent news that 40% of our nation is now considered obese – it is no wonder that the quarantine periods and lockdowns along with reduced activity have contributed to even more of us gaining weight. And it’s why we must do something now to reverse this epidemic of obesity.
The available evidence suggests that smoking is associated with increased severity of disease and death in hospitalized COVID-19 patients and there are risks related to passive smoke as well as active smoking. Smoking is linked to every autoimmune disease as it essentially tanks your immune system by increasing inflammatory cytokines, destroying the microbiome and disrupting our blood-brain barrier (BBB).3 If you need help quitting, talk to your doctor or check out the American Cancer Society’s resources at https://smokefree.gov/.
The sales of alcoholic beverages have gone up 54% since COVID and the corresponding stay-at-home orders began. Excessive drinking can increase the risk for liver disease, obesity, breast cancer, accidents and a wide range of cardiovascular problems, including high blood pressure, atrial fibrillation, stroke and heart attack. And conversely to what many people think, alcohol can have a depressive effect on our nervous system, causing a host of mental health issues and suicide ideation. Excessive drinking can also suppress our immune response and “impair the body’s ability to defend against infection, contribute to organ damage associated with alcohol consumption, and impede recovery from tissue injury.” 4
Almost 80% of the body’s immune function is in our microbiome. An unhealthy microbiome results from years of low-quality nutrition, environmental toxins, chemicals, stress, antibiotics, and even the medications we take for reflux and other digestive ailments (both prescribed and OTC). Disruption of our gut barrier may be responsible for severe COVID reactions especially in older patients whose natural microbiome is simply weakened by age. Improving our gut health is not only good for our general wellbeing, it could be an indicator of prognosis in the event of COVID transmission.5
As we have often written about, stress is clearly a health hazard regardless of the circumstances with a clear link between unchecked stress and illness. With the isolation, economic concerns due to millions of unemployed workers, lifestyle adjustments and many additional worries imposed by COVID 19, managing our stress is even more critical now – and also seemingly impossible. But it’s just as important as washing our hands!
It’s likely too early to draw a direct correlation between things like air pollution or other contaminants with which we may come into contact – but what we do know is that exposure on a regular basis to dirty air, chemicals in our water or food supply and even in our homes and at work are all taxing to our immune system. So limiting our exposure to these elements as much as that’s controllable is just a sound measure that ideally may help us stay healthier.
Other considerations we should heed.
Recognizing the things we can control to some degree, we also realize that there are factors that may be difficult if impossible to change. But, these are no less important as far as knowing what can affect the course of COVID 19. According to the Centers for Disease Control and Prevention (CDC), people with greater risk factors may be more likely to need hospitalization or intensive care if they have COVID-19, or they may be more likely to die of the infection. As such, it is important to learn about and prepare for the implications of severe COVID-19 illness:
-Take precautions as you go about your daily life or attend events.
-Understand how a medical condition could affect your own health if you do contract COVID.
-Anticipate medical treatment that you might need if you get sick.
-Reduce your risk for severe COVID-19 illness by managing any conditions you have that are risk factors.6 These conditions include, but are not limited to kidney or heart disease and cardiomyopathies, severe asthma, COPD or other lung disorders, cystic fibrosis, cancer, diabetes or sickle cell disease.
While COVID has affected all age groups, being older may predict the severity of disease, with 80% of related deaths in the U.S. occurring in people age 65+. But, why is the outcome for our elder population so much worse compared to that of other countries? You likely won’t find COVID patients living in one of the world’s “Blue Zones,” where the virus seems to be absent and health, wellness and longevity abound. If you are not familiar with the transformative tenets of the Blue Zones, please be sure to visit their site when you have the time – we have many lessons to be learned from this information that we should be reinforcing especially at this time!
Unfortunately due to the emphasis on staying home and avoiding going out combined with the barrage of news that is often conflicting and confusing from one day to the next, many people are simply not staying on top of the health services they need. Whether that’s an annual wellness exam, a follow-up visit, screening test or laboratory work, patients are putting off staying well for fear of getting sick. But every health care facility, like our offices, has extensive measures in place and have taken extra precautions to ensure the safety of patients and staff alike. And most physicians are offering telehealth appointments, if applicable to your need.
This is the information that should be front and center alongside the guidance regarding facial coverings and clean hands. Getting out in nature should also be emphasized – walking or hiking, etc. outdoors in an uncrowded setting where you can still maintain the recommended distance is not only safe, it’s highly advantageous for your physical and mental health. Leaving your sofa or desk chair for even a half hour outside can give your spirits a lift and break the monotony of isolation. Connecting with others via the phone or the internet and reaching out to people who are alone is good for them and good for you too! For more ideas and links, please see https://www.suzannegazdamd.com/blog/our-brain-in-isolation-what-to-know-what-we-can-do.
We believe we should hear more of an emphasis from our public experts on the measures beyond masks or distancing and focus on the ways we can overcome some of the health issues that plagued our nation long before COVID. And perhaps this can be the beginning of our health quest together that will take our active participation toward affecting positive changes. That’s our hope as much as it is our goal every day through integrative medicine – and as always, we are here to help you in any way we can!
Dr. Suzanne Gazda
References and additional reading:
1 National Heart, Lung and Blood Institute, National Institutes of Health
2 Centers for Disease Control and Prevention, Obesity data
4 Sarkar, D., Jung, M. K., & Wang, H. J. (2015). Alcohol and the Immune System. Alcohol Research : Current Reviews, 37(2), 153–155.
5 Aktas, B., & Aslim, B. (2020). Gut-lung axis and dysbiosis in COVID-19. Turkish journal of biology = Turk biyoloji dergisi, 44(3), 265–272. https://doi.org/10.3906/biy-2005-102
National Heart, Lung and Blood Institute: Calculate your BMI
Childmind.org: Resources for parents
Healthy Kids, Happy Kids
American Academy of Pediatrics:
Resources for Helping Kids and Parents Cope Amidst COVID-19