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What if I were to tell you that America, in particular, is an extremely high risk population in regards to COVID-19? Am I just adding to the media pandemonium about the virus? Lets use some logic a take a look.

Recently in the media, COVID-19 is getting all the attention. Globally, schools are closing, public gatherings are being cancelled, even freaking Disney Land closed due to threats of the virus. These extreme measures have the American people thinking one of two things: 1.) THIS SHIT IS CRAZY, BUY ALL THE PURELL and/or 2.) is the media just blowing this up? How bad could it really be?

Is this nation-wide paranoia warranted within the United States? Surely the American people’s risk level of contracting COVID-19 cant’t be as high as, say, China or parts of Europe. Unfortunately, comparing risk levels to other countries can’t insulate us from a massive, exponential, and perpetuating elephant in the room.

The “Elephant in the Room” is actually a fitting saying as obesity, according to Michael Osterholm on the Joe Rogan Experience Podcast, makes America a prime, immunosuppressed society with extraordinary risk of contracting the disease.

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No matter what source you utilize, obesity is clearly a widespread and consuming epidemic of mass proportions. The CDC estimated that in 2017-2018 the prevalence rate of obesity was 42.4% of the American population (CDC). A 2016 study on the Economic Impact of Obesity stated that around two thirds of the North American population were overweight or obese and that associated healthcare costs were estimated to be as high as $209.7 billion (4).

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According to Honce and Shultz-Cherry (2019), during the 2009 H1N1 influenza A outbreak, obesity was first identified to be a significant risk factor for contracting the disease (2). This, at the time, was an unprecedented finding. Furthermore, global retrospective studies found obesity to be comorbid with the influenza A (IAV) infection in around one third of hospitalized patients (1, 5).

Obesity has been proven to alter not only the innate immune response in humans, but also the adaptive responses to any type of infectious agent to include viruses (2). An overweight state has shown to slow and inhibit antiviral immunity and leave areas of the lung susceptible to viral spread (2). Additionally, high body mass index (BMI) and obesity seem to increase the duration and amount of IAV viral shedding (6, 3).

What does this mean in regards to COVID-19? Leveraging how obesity effects IAV infection, it can be safely deduced that the astronomical obesity rates in America are cause for concern. The CDC announced that people with chronic medication conditions like heart disease, diabetes, and lung disease (all highly associated with being overweight and obese) are at increased risk for contraction of COVID-19 (CDC).

My question is this. Does it take a wide-spread viral pandemic to fully appreciate the problem of the obesity epidemic in America?

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We’ve known about it for decades to the point we’ve tracked, analyzed, and published peer reviewed studies regarding just how detrimental American obesity is. In 1990, obesity only made up 15% of the population in U.S. states. In 2010, that percentage exploded to 25% in 36 states and 30%+ in 12 (8).

Today, with about 2/3 American adults considered overweight or obese, the problem has spiraled out of control (8). With that said, the American population is most likely not physically prepared for a virulent pandemic such as COVID-19. Our population is potentially at extreme risk for not only contracting the disease, but transmission to other hosts due to higher rates and duration of viral shedding brought on by obesity.

Now, rather than at the conclusion of COVID-19’s global havoc, we should heed the wake-up call it provides us. We are a nation at risk from something that is largely preventable. American work, food, and exercise/recreation culture has morphed into a culture of sitting more and eating more (9). We know the risk factors. We understand that we eat too many calories, too much sugar, and rarely exercise. At this point, exploring, “why we get fat” is like beating a dead horse.

But, as obesity rates steadily rise with each decade, new and unexpected novel viruses become more and more dangerous to the American public. Nationally, our collective immune system is at an all-time low. Now, while the hysteria of COVID-19 will likely pass, it would behoove America to take note of just how susceptible the population really is to a global pandemic.

-Nik

Nik Roumell is an Emergency Room Nurse, Veteran, and former CrossFit Competitor. Nik studied at the University of Colorado, Colorado Springs attaining his Bachelors in Nursing Science. He is a researcher and currently developing a manuscript for his upcoming book, “America’s Health Disconnect.” Nik has a wealth of knowledge regarding medical applications of diet and fitness, physical training mentality, and chronic disease prevention.

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References:

Balanzat, A. M., Hertlein, C., Apezteguia, C., Bonvehi, P., Camera, L., Gentile, A., … & Chavez, P. R. (2012). An analysis of 332 fatalities infected with pandemic 2009 influenza A (H1N1) in Argentina. PLoS One, 7(4). Honce, R. R., & Schultz-Cherry, S. (2019). Impact of obesity on influenza A virus pathogenesis, immune response, and evolution. Frontiers in immunology, 10, 1071. Maier, H. E., Lopez, R., Sanchez, N., Ng, S., Gresh, L., Ojeda, S., … & Gordon, A. (2018). Obesity increases the duration of influenza a virus shedding in adults. The Journal of infectious diseases, 218(9), 1378-1382. Spieker, E. A., & Pyzocha, N. (2016). Economic impact of obesity. Primary Care: Clinics in Office Practice, 43(1), 83-95. Wieching, A., Benser, J., Kohlhauser-Vollmuth, C., Weissbrich, B., Streng, A., & Liese, J. G. (2012). Clinical characteristics of pediatric hospitalizations associated with 2009 pandemic influenza A (H1N1) in Northern Bavaria, Germany. BMC research notes, 5(1), 304. Yan, J., Grantham, M., Pantelic, J., de Mesquita, P. J. B., Albert, B., Liu, F., … & EMIT Consortium. (2018). Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community. Proceedings of the National Academy of Sciences, 115(5), 1081-1086. https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html https://www.hsph.harvard.edu/nutritionsource/an-epidemic-of-obesity/ https://www.health.harvard.edu/staying-healthy/obesity-in-america-whats-driving-the-epidemic