In the last two posts, I laid out the scientific evidence demonstrating that a COVID-19 exit strategy based on the currently-available COVID-19 injections (commonly labelled as ‘vaccines’) cannot possibly succeed.
(In brief, these injections do not prevent infection with or transmission of SARS-CoV-2 and consequently can’t create herd immunity; they spur the development of highly-infectious strains through viral immune escape and the dominance of those strains through selection pressure; and through the phenomenon of ‘antigenic sin’, they put people who have received them at greater risk of both persistent infection and potentially lethal antibody-dependent enhancement.)
After I’ve explained these facts to my clients and correspondents, they almost inevitably ask me, “So what should I do instead, and what should the government do?”
The answer to the first part of this question is nuanced.
People at low risk of serious outcomes of infection (you can estimate your risk of hospitalisation and death here) can simply go about living their lives as normal, but may wish to familiarise themselves with evidence-based prevention and treatment protocols such as those here, here, here, here and here.
People at high risk of serious illness, hospitalisation and death from COVID-19 should definitely read the evidence on prevention and treatment, and discuss their options with a well-informed healthcare provider who prioritises the doctor-patient or practitioner-client relationship over conformity to groupthink.
However, there is one significant factor that places both the individual and the whole society at increased risk: obesity.
Obesity: Risks to individuals
From the very first case reports of a mysterious new respiratory illness in Wuhan, it was apparent that excess body fat increases the risk of becoming infected with SARS-CoV-2, developing severe COVID-19, being hospitalised, requiring admission to an intensive care unit, and dying from the infection. I summarised the mechanisms by which obesity exerts these harmful effects in a previous post, When Two Pandemics Collide: How obesity affects COVID-19.
Since that post was published in November 2020, even more compelling evidence of the COVID-obesity connection has emerged.
The US Centers for Disease Control and Prevention (CDC) published a report which assessed the association between body mass index (BMI) and risk for severe COVID-19 outcomes including hospitalisation, intensive care unit [ICU] admission, invasive mechanical ventilation, and death), in 148 494 adults who received a COVID-19 diagnosis during an emergency department (ED) or inpatient visit at 238 US hospitals during March–December 2020.
The findings were striking:
- The risk of being hospitalised for COVID-19 rose from 7% higher in people with mild obesity (BMI of 30–34.9 kg/m2) than in healthy-weight people, through to a 33% higher in the most obese (BMI over 45 kg/m2).
- The relationship between BMI and need for invasive mechanical ventilation was essentially linear, increasing over the full range of BMIs from 15 kg/m2 to 60 kg/m2. Those with a BMI greater then 45 kg/m2 had a startling 208% higher risk of needing to be put on a ventilator than healthy-weight people.
- Severe obesity was associated with a higher risk of ICU admission.
- Risk of death rose in a dose-response manner with degree of obesity, ranging from an 8% higher risk of dying in people with mild obesity, through to a 61% higher risk in those with the most severe obesity.
- The associations between obesity and risk for hospitalisation and death were most pronounced in those aged under 65 – otherwise a fairly low-risk category for severe outcomes of infection. Among the under 65s, those in the highest BMI category (over 45 kg/m2) were 60% more likely than healthy-weight adults to be hospitalised, and 201% more likely to die.
- Underweight individuals (BMI under 18.5 kg/m2) were on average 20% more likely to be hospitalised for COVID-19 than healthy-weight people, with the risk being highest in those aged less than 65 years.
There is also preliminary evidence that COVID-19 ‘vaccines’ are less effective at generating antibodies in obese people, in line with previous observations that obese people have a poor immune response to influenza vaccines.
Obesity: Risks to society
As hazardous as it is for an individual to be obese in the midst of a respiratory viral pandemic that targets people who are metabolically unhealthy, the dangers for societies with a high percentage of obese individuals may be even greater.
The suboptimal immune response to viral infection that occurs in obese people allows viruses to replicate within their bodies for extended periods of time. This prolonged replication, along with the altered environment within an obese individual’s cells, drives genetic mutations within viruses that increase their replication rate and virulence (disease-causing capacity).
In addition, viral shedding is more prolonged in obese individuals who develop an infection. One study found that obese people infected with influenza A shed the virus from their nasopharynx for roughly 40% longer then healthy-weight people if they were symptomatic, and for 104% longer if they had no or only one symptom of infection (excluding fever).
Furthermore, obese individuals exhale more infectious virus in their breath.
Based on these findings, some researchers have called for longer quarantine periods in obese individuals who become infected with SARS-CoV-2, to reduce the risk of viral transmission.
Experiments on mice have shown that viral variants that develop within obese individuals are more dangerous to normal-weight mice who are deliberately infected with them.
Taken together, these research findings imply that more infectious and virulent viral variants are likely to develop in populations with high rates of obesity, posing an increased risk of severe illness and death not just to the obese individuals themselves, but to healthy-weight people who are in contact with them.
Eyeballing the differences in COVID-19 death rates between countries with high and low obesity rates suggests real-world confirmation of this hypothesis. As of the day of writing this article, for example, South Africa (obesity rate 28.3%) has suffered 1303 COVID-19 deaths per million of population, while fellow African nation Ethiopia (4.5% obesity) has racked up just 38 deaths per million. Russia (23.1% obesity) has had 1184 COVID-19 deaths per million, while across the Sea of Japan, one of the world’s oldest populations, the famously thin Japanese (4.3% obesity) have only seen 123 deaths per million.
By no means should these findings be twisted into endorsement of “fat shaming”.
Obesity is a complex condition, with multiple genetic, socioeconomic, cultural and environmental contributing factors. Obesity researchers have been urging policy makers to adopt a whole-of-society approach to obesity that addresses the obesigenic environment rather than stigmatising individuals for their body size, for many years.
The COVID-19 crisis gives new urgency to these calls. Unfortunately, virtually every element of current public health policy is contributing to driving obesity rates upward. Stay-at-home orders, travel restrictions, closure of gyms and other exercise facilities, and the sky-high stress levels resulting from the constant barrage of media fear-porn, rising unemployment, small business bankruptcies and coercive vaccination policies have all resulted in increased consumption of alcohol, overeating and decreased exercise levels.
The good news is that individuals can reduce their risk of infection, serious illness and death remarkably quickly, by increasing their physical activity levels and making healthier dietary choices.
Physical activity and COVID-19
As the authors of a review on the effects of obesity on respiratory viral infection point out,
“The strongest, non-pharmacological, positive immunomodulatory intervention is physical exercise.”
Influenza and obesity: its odd relationship and the lessons for COVID-19 pandemic
Even mild to moderate exercise, such as walking, rapidly improves immune function, increasing our resistance to pathogen invasion, enhancing the antioxidant defence system and reducing oxidative stress, which in turn lowers the risk of cytokine storm.
A study of over 212 000 Korean adults found that those who met national guidelines for both aerobic (≥150 min/week of moderate intensity activity or ≥75 min/week of vigorous intensity activity or greater than an equivalent combination) and muscle strengthening activities (≥2 times/week) had a 15% lower risk of becoming infected with SARS-CoV-2; a 58% lower risk of severe COVID-19 illness; and a 76% lower risk of COVID-19 related death than those who engaged in insufficient aerobic and muscle strengthening activities.
Likewise, a study of over 48 000 US adults found that patients with COVID-19 who were consistently physically inactive had 2.26 times the odds of hospitalisation, 1.73 times the odds of admission to the ICU, and 2.49 times the odds of dying of COVID-19 than patients who were consistently meeting physical activity guidelines.
Even patients who were doing some physical activity, but not enough to meet guidelines, were better off than COVID-19 patients who were consistently inactive. Those who were consistently inactive had 1.2 times the odds of hospitalisation, 1.1 times the odds of admission to the ICU and 1.32 times the odds of death than people who engaged in some physical activity.
Diet and COVID-19
A survey of nearly 3000 healthcare workers in 6 countries found that those who reported following ‘plant-based diets’ had 73% lower odds of experiencing moderate-to-severe COVID-19 disease, while those who followed ‘plant-based diets or pescatarian diets’ had 59% lower odds.
On the other hand, those who reported following ‘low carbohydrate, high protein diets’ had 3.86 times greater odds of moderate-to-severe COVID-19 than participants who reported following ‘plant-based diets’.
Another study, involving almost 600 000 participants in the smartphone-based COVID Symptom Study, examined the link between a healthful plant-based diet score, which emphasises healthy plant foods such as fruits and vegetables, and the likelihood of developing COVID-19. Compared with individuals with the poorest diets, those with the highest diet quality had a 9% lower risk of developing any symptoms of COVID-19 and a 41% lower risk of developing severe COVID-19.
Importantly, both physical activity and improved diet quality decrease the risk of infection and severe disease even before substantial weight loss occurs.
So no matter what point you’re starting at, every baby step toward healthier living makes a positive difference. And since hell is likely to freeze over before you see an intelligent public health policy response from either State or Federal governments, the time to take that first baby step is right now.
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