A Tale of Two Outbreaks: How Conditions Like Obesity Affect COVID-19 Recovery

As the tragic reality of COVID-19 becomes ever clearer, a pattern has begun to emerge: different communities will experience very different impacts. As Reuters journalist Brad Brook reported earlier this month, nowhere has this become more terribly apparent than in New Orleans (The National Post).

With only a fraction of confirmed cases compared to New York City, New Orleans has been experiencing significantly higher mortality rates. Although differences between the Big Apple and the Big Easy range from economic realities to government policy and quality of healthcare, health authorities have revealed a variable that seems to have even greater impact on the awful toll: diabetes, high blood pressure and obesity — statistics that New Orleans rank highest for in the US. Nearly all the people who have died from COVID-19 in the Louisiana city lived with one or more of these chronic health conditions, and roughly a quarter suffered from obesity. A state healthcare policy expert put it more simply: “We’re just sicker.”

It’s the perfect storm, a combination of dietary traditions that celebrate sugary, fatty foods with healthcare systems that are frequently overstretched and under-supported even in good times. But while it may be a worst-case scenario, what New Orleans teaches us is fundamental: people living with “co-morbidities,” underlying health conditions that increase the risk of death from other illnesses, are more likely to contract disease, get sicker, experience more morbidity and mortality, and recover slower than healthier counterparts. It would follow then, that reducing co-morbidities is one of the most effective responses we can take to the pandemic.

Imagine a pot of water that’s constantly simmering but not quite boiling. Due to the constant and multisystem strain caused by obesity, that’s the reality for an individual living with such a co-morbidity: carefully managing their health on the edge of potential danger. Now an illness such as COVID-19 presents a rapid spike in heat of that that water. A healthy person can withstand the change without tipping over the edge because their boiling point is naturally lower. But in New Orleans, we’re seeing what happens when an already simmering community reaches its boiling point.

The crucial takeaways from Brook’s report are twofold. First, our priority must be to protect the most vulnerable people in our communities including those suffering from obesity. This means that self-isolation and social distancing are all the more important for people with these co-morbidities, their families and their friends.

But the second lesson is easily overlooked in the midst of a crisis. By only addressing the new illness, in this case COVID-19, without dealing with the underlying conditions, we stay near the boiling point. This means that improving our fundamental health — lowering that temperature — becomes one of the best steps we can take to protect ourselves and our loved ones in any pandemic. It’s true for this one and it will remain true for those that may follow. Just as critical as social distancing, masks or gloves are healthy habits, diet and exercise.

The good news is that it’s never too late to reduce our co-morbidities and become more resilient. Even in self-isolation, a shift to a healthier diet can show immediate positive effects. From a boosted immune system to lower blood pressure, what we choose to eat can ultimately save our (or someone else’s) life.