Coronavirus: Statistics from around the world show that overweight victims of COVID-19 are more at risk

Like American’s, Australians are losing the national fight for fitness. Picture: iStock

To represent the Chinese Communist Party abroad would be an unlovely task; its reputation is in tatters. Nonetheless, Chinese deputy ambassador to Australia Wang Xining attributed his country’s apparent recovery from COVID-19 to one-party state discipline.

Communists are using the crisis to discredit Western democracy by way of comparison. I had heard the absurd argument before from a doctor with a disconcerting devotion to erasing Chinese Communist Party culpability for the epidemic. She too contended that the one-party state system proved superior to democracy in a time of crisis. But the severity of the Western pandemic has less to do with democracy than demography.

The Western world has been laid low by COVID-19 because of our ageing population and appetite for sloth. When the virus monstered northern Italy, news clips showing scenes from intensive care unit wards inspired sympathy. But they revealed something more; many of the dying patients were visibly overweight.

In a January study of 99 patients from Wuhan, researchers Nanshan Chen et al concluded that the characteristics of patients who died with COVID-19 were similar to those who died from viral pneumonia. The Lancet study found 51 per cent of the cohort had chronic diseases. Citing an earlier avian flu study, the researchers suggested old age, obesity and comorbidities could be associated with a higher risk of mortality.

By March, the association between obesity and severity of illness among infected patients was confirmed in a large observational study. In the Journal of the American Medical Association, Safiya Richardson et al studied 5700 patients with COVID-19 admitted to hospitals in New York City, Long Island and Westchester County. Forty-one per cent were obese. While there was no control, the obesity rate in the studied cohort was significantly higher than the rates by county: New York City, 21.6 per cent; Long Island, 24 per cent; and Westchester County, 21 per cent.

In May, the first large-scale study on the relationship between lifestyle factors and COVID-19 was published in the journal Brain, Behaviour and Immunity. Mark Hamer et al considered specific factors: smoking, physical inactivity, obesity and excessive alcohol intake. The researchers found that excessive weight posed the greatest risk followed by smoking. They concluded that unhealthy behaviours increased the risk of complications from the coronavirus.

Other studies in France, Britain and the US found higher rates of obesity among patients with COVID-19 who required intensive care. More recent research indicates the severity of illness in COVID-19 patients is relative to body mass index. Taking regular, moderate exercise and eating less could contribute to reducing the risk of severe symptoms.

In July, the British government released a national obesity strategy. The press release read: “Lose weight to beat COVID-19 and protect the NHS.” British Prime Minister Boris Johnson led the charge after being admitted to ICU with COVID-19 in April and recognising that obesity could have cost him his life.

The British government cited consistent evidence that overweight people with the virus were likelier to be hospitalised and to require intensive care than people with a healthy body mass index.

The Public Health England report Excess Weight and COVID-19 stated that almost two-thirds of English adults were overweight, with BMI scores over 25. It is higher for people aged between 55 and 74 and those from some of the black or ethnic minority groups.

The evidence to date is compelling but preliminary. The biological mechanism of the relationship between excess body weight and severity of virus symptoms is unknown. As better research is conducted, the pathology will become clearer.

Despite the health opportunity presented by the pandemic, some medics are concerned by the idea that we can reduce the burden on public health by making better personal choices.

An editorial in the Lancet praised the British government for the goal of creating a healthier nation but claimed it was using guilt and shame in pursuit of the objective. It suggested that targeting some people in “the obesogenic environment” failed to “take into account the intricacy of biological, societal, and psychological factors that underpin obesity”.

Concerned academics have spent a long time discussing the complexities of obesogenic environment, but the Western appetite is undaunted.

Like Americans, Australians are losing the national fight for fitness. The Australian Institute for Health and Welfare reports that 25 per cent of children and adolescents were overweight or obese in 2017-18.

Among Indigenous youth, the figure rose to 38 per cent. Australians aged 15 to 24 in 2017-18 were likelier to be obese than the youth of 1995. Young people aged two to 17 in low socio-economic status areas were likelier to be overweight and 2.4 times as likely to be obese (11 per cent) than those in the highest SES areas (4.4 per cent).

The Australian government has not given due emphasis to the risks posed by excessive weight among COVID-19 patients.

The federal Department of Health lists conditions that increase the risk of severe illness from the virus.

However, only severe obesity with a BMI of 40 or more is listed as a risk factor. Yet a study published last week sets the threshold for serious complications at the lower BMI of 30 or over.

The University of North Carolina led a systemic review of literature and selected data. Researchers Barry Popkin et al. found that among people with a BMI of 30 or more, there was a 113 per cent increased risk of being hospitalised with COVID-19, a 74 per cent increased risk of needing intensive care and a 48 per cent risk of death.

They also studied the mechanistic pathway of risk and said they believed central adiposity was a source of the problem. The fat distribution pattern may explain why male COVID-19 patients with excess weight tend to suffer worse symptoms than their female counterparts.

The COVID crisis soon will pass. What will remain is an obesity epidemic that lowers individual quality of life and the health of nations.