Is obesity a risk factor for coronavirus?
Writing about obesity is always difficult. People are overweight for different reasons, and often these are far-reaching and complex in nature. It is also unfair to group all overweight people into the same category, but for the purposes of this article, I will be looking at obesity as an individual risk factor for complications of COVID-19 from a strictly medical point of view.
We already know that patients with obesity-related conditions such as cardiovascular disease are at higher risk of diabetes, which can mean a higher risk of developing complications if you catch COVID-19. But can obesity itself be a risk factor for developing complications and, if so, why?
Last week, Diederik Gommers, chairman of the Dutch intensive care association, told TV reporters in the Netherlands that 66 percent to 80 percent of COVID-19 patients in intensive care wards that he had seen were overweight.
On the same TV news programme, Peter van der Voort, of Groningen University's teaching hospital, said of the higher numbers of overweight COVID-19 patients in ICU beds: "We don't know why, but it is very noticeable."
A Chinese study published last month looked at 112 COVID-19 patients and their outcomes. Sadly, 17 of these patients died. Fifteen of the deceased (88 percent) were classed as being overweight or more on the BMI scale. By comparison, only 18 of the 95 survivors (19 percent) were classed as overweight or above on the BMI scale.
This study prompted experts to question what it was about obesity that might make it a risk factor when it comes to coronavirus.
Obesity is defined as a disruption of energy balance that leads to weight gain and metabolic disturbances that cause tissue stress and dysfunction. This means that obesity is not just being overweight but also the adverse effect that being overweight has on your body's health.
One of these adverse effects is a disruption in a function of the immune system called the lymphoid and neutrophil line. These are cells that can tell infection from normal tissue and that need to be kept in careful balance in order to maintain a healthy immune system.
Obesity can disrupt this balance and lead to a low level of chronic inflammation of normal tissue, caused by these cells. This places the body under a constant low level of physical stress on a microscopic scale.
This imbalance in the immune system and chronic inflammation of normal tissue has put people with obesity at increased risk of complications of infections and higher rates of chronic diseases generally.
This is true of common infections such as skin or wound infections. Their immune systems are already working hard, even at rest. It comes as no surprise, then, that if people who are obese are struck down with the COVID-19 virus, they will also be at increased risk of its complications, including breathing difficulties and pneumonia.
There are significant challenges when it comes to managing patients with obesity in ICUs. They are physically more difficult to intubate - a procedure where an airway tube is fed down the throat to allow air to pass into the lungs - due to the fact that their neck tends to be thicker, putting pressure on the airways, especially when the patient is flat on his or her back.
People with obesity are harder to transport. Specialist beds and equipment are often needed for larger patients, equipment that is not widely available.
It is fair to say that most healthcare systems are not well set up to manage patients with obesity, and this pandemic may well highlight that fact and expose its limitations further.
Dr Amir Khan is an NHS doctor and a senior university lecturer in the United Kingdom.
Tokyo announces tighter restrictions as coronavirus spreads
People walking in Tokyo's entertainment district of Shinbashi on Wednesday. Credit: Kazuhiro Nogi/AFP via Getty Images
Tokyo's Metropolitan Government announced the highest one-day spike with 189 new cases, bringing the total to 1,708 on Friday.
The government will ask businesses to close starting this weekend as part of its measures to curb the spread of coronavirus. Entertainment facilities such as bars and internet cafes, universities & education centers, sports and amusement facilities, theaters, assembly halls & exhibition centers, and commercial facilities such as shopping centers, will all be asked to close from Saturday.
Restaurants will still be allowed to operate between 5 a.m. and 8 p.m. local time, but will be asked to stop service of alcohol after 7 p.m.
A Rush of Local News
A total of 46 new confirmed COVID-19 cases, 42 from abroad, three new deaths and 34 asymptomatic cases were reported in the Chinese mainland on Friday, according to China's National Health Commission (NHC).
Canton Fair to Take Place, Online
Vaccine Development: Five vaccines are being developed simultaneously in China. The fast one is adenoviral vector vaccine, which has been delivered to human body test. The fully inactivate vaccines would also be soon delivered but it still needs 1-2 year observation: top medical expert
Beijing will require all hotel guests to provide a negative nucleic acid report before check-in starting Sunday amid COVID-19 pandemic.
Epidemic Supplies Exports: From March 1 to April 4, China exported 10.2 billion Yuan ($1.45 billion) worth of epidemic prevention supplies, including 3.86 billion masks, 37.52 million pieces of protective clothing, and 16,000 ventilators: Customs
Hubei said on Fri that major public entertainment venues including movie theaters, karaoke, dance halls, indoor swimming pools, and bars will stay closed as COVID-19 epidemic control measures have not been lifted.
Heilongjiang: A temporary hospital built in Suifenhe, a border town near Russia in NE Chinas Heilongjiang Province, will be put into use Saturday, providing 600 beds and 400 medics to treat COVID-19 patients as the province reported 28 new imported cases Friday, bringing total to 155.
A Rush of News
Senegal's government said in a statement that companies will be forbidden to sack employees during the pandemic, except in cases of gross negligence, starting from April 14.
Turkey's interior ministry said it imposed a two-day lockdown in 31 cities, including Istanbul and Ankara, starting at midnight.
Italy extended a weeks-long lockdown until May 3.
The Spanish government has announced plans to hand out out masks at metro and train stations on Monday as some companies re-open after a two-week "hibernation" period.
Ireland extended stay-at-home restrictions designed to slow the spread of coronavirus until May 5, Prime Minister Leo Varadkar said.
France: Fifty crew members on board France's sole aircraft carrier, the Charles de Gaulle, have tested positive for the new coronavirus and parts of the ship have been put in lockdown, the armed forces ministry said on Friday.
Italy: The 100th doctor to die on Italy's front lines as the country struggles to contain the coronavirus epidemic was Samar Sinjab, a 62-year-old Syrian woman who was born in Damascus. According to the Association of Foreign Doctors in Italy, there are around 20,000 doctors of ancestry in other countries. Of these, 3,700 are from the Middle East. Since the 1960s, young Arabs have studied medicine in Italy.
South Korean officials have reported 91 patients thought cleared of the new coronavirus had tested positive again. South Korean health officials said it remains unclear what is behind the trend, with epidemiological investigations still under way.
Air Zimbabwe, the state-owned airline, will put workers on indefinite unpaid leave after revenue dried up with the new coronavirus outbreak virtually grounding global air travel.
Malaysia has extended movement and travel restrictions that have been put in place to contain a coronavirus outbreak for two more weeks, until April 28.
Kazakhstan will extend the state of emergency declared over the coronavirus outbreak until the end of April, Interfax news agency has reported.
Argentine lockdown measures in the country will be extended through April 26.
Countries Confirming First Case/death
Yemen has reported its first coronavirus case in Hadhramaut Governorate, supreme national emergency committee tweeted early on Friday.
Hard-Hit Countries/Regions Official Announcements
France confirmed 987 more deaths registered in hospitals and nursing homes in a day, bringing the total toll to 13,197. Top health official Jerome Salomon said a child aged under 10 infected with COVID-19 died, but the causes of the death were "multiple". In encouraging news, Salomon said there were now 62 fewer people in intensive care, continuing a trend first seen on Thursday.
Germany's death toll has increased by 266 in the past day, according to the country's disease and control centre, marking the largest 24 hour increase in fatalities since the country's coronavirus outbreak began. Overall, 2,373 people have now died form the virus in Germany, the Robert Koch Institute said. The total number of confirmed cases in the country has reached 113,525, which marks an increase of 5,323 in the past 24 hours.
UK: The death toll from coronavirus in the United Kingdom rose by 980 to 8,958 people as of 16:00 GMT on April 9, health minister Matt Hancock said on Friday.
Netherlands: The number of confirmed coronavirus cases in the Netherlands has risen 1,335 to 23,097, health authorities said, with 115 new deaths. The total death toll is now 2,511, the Netherlands' Institute for Public Health (RIVM) said in its daily update.
Switzerland: The Swiss death toll from coronavirus has reached 805, the country's public health ministry has said, rising from 756 people on Thursday. The number of positive tests also increased to 24,308, up from 23,574 on Thursday, it said.
Iran's total death toll has risen to 4,232 with 122 new dead in the past 24 hours, according to a health ministry spokesman. The total number of cases increased by 1,972 in the past 24 hours to a total of 68,192, the spokesman, Kianoush Jahanpur, said on state TV, adding that 3,969 people were in critical condition. More than half of the coronavirus patients have "recovered," announced Friday.
Spain has reported 605 new coronavirus deaths, continuing a downward trend, and 4,566 new cases. The death toll in the European country with the most reported cases now stands at 15,843 with a total of 157,022
Russia has reported 1,786 more coronavirus cases, its largest daily rise so far, which took the national tally of confirmed infections to 11,917. The number of coronavirus-related deaths rose by 18 to 94, the Russian coronavirus crisis response center said in a statement.
Boris Johnson able to do short walks
St Thomas' Hospital in London, where British Prime Minister Boris Johnson is being treated for coronavirus, is pictured on April 10. Matt Dunham/AP
British Prime Minister Boris Johnson has been able walk short distances as part of the care he is receiving to aid his recovery, his office said.
Johnson came out of intensive care after three nights and is recovering on a hospital ward.
"The prime minister has been able to do short walks, between periods of rest, as part of the care he is receiving," a Downing Street spokesman said. "He has spoken to his doctors and thanks the whole clinical team for the incredible care he has received."
Global Increase in Coronavirus Cases
Google and Apple In rare cooperation to track spread of coronavirus with smartphone tech
Apple and Google, usually fierce rivals, announced a partnership Friday to try to use technology to trace the spread of the coronavirus pandemic. The new tool would enable people and health authorities to track the virus using Bluetooth proximity data from their smartphones.
In the first stage, next month, application programming interfaces (APIs) would be released, so that apps created by public health authorities could work on both iPhones and Googles Android operating system. Then, in the second stage over the coming months, they would build a voluntary tracing system directly.
Versions of coronavirus tracking apps already exist in China, Singapore, Israel and elsewhere, but efforts have been slower in the U.S. and Europe, because of concerns about privacy and because contact tracing must be combined with widespread testing in order to work.
The idea is that an app could remember, via anonymous Bluetooth signals, which other phones have been nearby. If someone you had coffee with two days ago tests positive for the coronavirus, you would get a notification along the lines of "you may have recently been exposed" and advising temporary isolation.
Brazil: Yanomami indigenous boy, 15, dies in Brazil
A Yanomami youth, 15, has died after testing positive for coronavirus, health officials have said, raising fears that the epidemic will spread among the largest indigenous tribe in northern Brazil.
Anthropologists and health experts warn that coronavirus could have a devastating impact on Brazil's 850,000 indigenous people who are vulnerable to external diseases and whose lifestyle in tribal villages rules out social distancing.
More than 26,000 Yanomami live on Brazil's border with Venezuela on a reservation the size of Portugal. The Yanomami youth was the third indigenous person to die in the epidemic now sweeping Brazil with force. Two previous deaths were of indigenous people who were living in urban areas, including an 87-year-ol woman in Para state and man in Manaus.
Number of dead buried in NYC mass grave increases
The number of bodies buried daily at a mass grave in New York City, where the unclaimed bodies from the city are buried, has increased during the coronavirus pandemic, according to authorities.
Before the outbreak, about 25 bodies were buried at the site on Hart Island a week, according to authorities. That number has been increasing since March, officials said. Currently, about about two dozen bodies buried in the grave every day, five days a week, according to a spokesman for the New York City Department of Corrections, which oversees the burials.
French chocolatiers make Easter bunnies decorated with surgical masks
French chocolatiers are making Easter bunnies this year decorated with surgical masks. They're also making chocolate nurses in masks, and "eggs" fashioned to look like the novel coronavirus.
With the nation on lockdown, many chocolate shops have offered online orders for delivery. And some top chefs posted recipes online for Easter delicacies to make at home.
Videoconferencing skyrockets on Microsoft's Teams software
The number of calls made using Microsoft's Teams videoconferencing software surged 1,000 percent last month as people collaborated online due to the coronavirus pandemic, the company said Thursday. It also said a new record of 2.7 billion "meeting minutes" in a single day had been reached on the platform.
Videoconferencing has become the go-to platform for work and social life as people around the world hunker down at home to avoid spreading the deadly virus.
Teams competes with online video and meeting services hosted by competitors including Google, Cisco, Facebook and Zoom.
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