UPHE fully supports the calls from our state and local government to reduce potential exposure to the virus by any and all means of “social distancing.” Avoiding group activities, keeping a six foot distance from others as much as possible, extremely diligent hand washing, are all very important. And not just for your own protection, but because of the extreme contagiousness of the virus, it is for everyone’s protection. Think of it this way–you are only as safe as the most careless or the most vulnerable among us.
Please read these accounts from Italy here, where healthcare workers are trying to warn us what is in store for us if we don’t immediately cease all non-essential social interaction. Italy has a very sophisticated healthcare system, comparable to what the US has. Italy is being forced to warehouse patients because they don’t have enough hospital beds, equipment, or healthcare workers. They have described it as worse than a gigantic bomb going off, because bombs are not contagious, and are a one time event. This is a rapidly evolving, potential public health disaster. It is a threat to everyone! Everyone behaving appropriately is essential to getting it under control.
Young People are at Risk
You have heard that young healthy people have little to worry about, and that is not true. Young people are more likely to be asymptomatic, but can still be carriers. The incubation period, the time between the infection onset and the onset of symptoms, can be anywhere from 3 to 10 days. It is therefore impossible to identify everyone that can be spreading the virus. Anyone can be a carrier, young people can infect those who are at much higher risk. Moreover, testing is still very limited. There is little question that the actual number of infected people is one to two orders of magnitude greater than what has been identified so far.
The most common pathway of a fatal outcome is respiratory failure from fulminant pneumonia. Young healthy people have a better chance of surviving that. However, we know that severe pneumonia can leave people with scarring and fibrosis of the lungs which can permanently impair lung function. Early indications are that at least some of the young people that survive a serious COVID-19 infection are left with permanently impaired lungs. There are few things that correlate better with ultimate life expectancy than lung function.
Reports from France indicate that about half of the coronavirus victims that are critically ill are younger than 65. The common assumption that serious outcomes and fatalities are primarily only a concern for the elderly is not correct. Young people need to take the same isolation precautions that the elderly do, not just so that they don’t spread it to the elderly, but for their own protection as well.
When we hear reports that people in the US are still going to crowded restaurants and bars we are shocked–shocked that such places are still allowed to remain open, and shocked that people are still going there. “Coronavirus denial” puts all of us at risk!
Air Pollution and COVID-19
There are numerous connections between air pollution and COVID-19 morbidity and mortality.
The evidence is overwhelming that air pollution makes virtually all lung diseases worse — increases bacterial activity in the lungs, increases the duration and severity of pneumonia, decreases lung function and breathing capacity, and the ability of the lung to heal itself. It is only common sense that would increase a person’s risk of dangerous pneumonia from the coronavirus, which is the most common cause of death from COVID-19.
At our press conference a last week we mentioned that air pollution, acutely and chronically, damages the lungs making them more susceptible to further damage from the coronavirus. Others have picked up on the connection, as per this article from the Washington Post. However, we take issue with the title. Experts don’t really “wonder” if “bad air makes it worse.”
Air pollution is well known to suppress the immune system. A healthy immune system is essential to warding off the serious consequences of a COVID-19 infection. The healthier immune system of young patients is one reason they usually do better. Air pollution also impairs the pumping capability of the heart, responsible actually for enlarging the heart muscle even of people with otherwise no known heart disease. The heart is one muscle where increased size is proportional to impaired function. Compromised heart function will decrease a person’s ability to survive any serious lung infection.
There is also a connection between increasingly common inflammatory bowel diseases, air pollution, and COVID-19. Dozens of recent studies have shown air pollution increases the risk of diabetes, obesity, and inflammatory bowel diseases (IBD), all of which increase the severity of a COVID-19 infection. A common denominator for these outcomes is air pollution’s effect of changing the microbial population of the GI tract. The COVID-19 virus may attack the GI tract as well adding to the microbial disruption. Furthermore, many IBD patients are taking medications that suppresses the immune system to help manage their IBD, which, again, increases a person’s susceptibility to a serious COVID-19 infection.
In short, we can add COVID-19 to the long list of reasons to clean up our air, and certainly not allow it to become worse–we’re talking to you dirty energy inland port and its cheerleaders.
Observing what has happened in other countries, our entire healthcare system could easily be overwhelmed very quickly. This pandemic is everyone’s problem and everyone is at risk. Please take it seriously.