Covid-19 is a Co-morbid Topic

As the pandemic rolls on and the numbers keep climbing, there are a few things that you should consider before reaching a conclusion as to the veracity of Covid-19 data. The numbers are most likely inaccurate, to begin with. Oh, CV is certainly deadly, but it's mostly deadly to select groups of people. The young and healthy, as a whole fare much better than the old and infirm. If you die of any other cause than CV, but tested positive prior to dying, you are now a Covid death. Doesn't matter if you leap off a building or die in a car crash ... doesn't matter if you were asymptomatic or not. You are counted as a Covid death, and that is one of the reasons the numbers are practically meaningless. We don't really know if CV did them in or not, or if it was even a contributing cause. We (John Q. Public) are not being told this rather important piece of information; all we're being told is how many tested positive and how many died. Without more detailed data, this information is meaningless.

Italy was one of the early European nations to be hit with CV, and it ravaged the country rather quickly. But as we look at the numbers and assign them a weight, certain truths are emerging. Their aged population that was clustered suffered the most. But what was not initially factored into the equation was how many of them had comorbidities to begin with.

Comorbidity is a $50 medical term that simply means there are one (or more) co-existing medical conditions in a person, none of which are instantly fatal by themselves. Many are common diseases that are controllable such as diabetes, hypertension and such. And many are more severe, such as heart conditions, COPD and cancer. Combined in one person they are a lethal mix, usually with a rather short fuse.

Italy's death rate among comorbid people was extremely high; the chart below paints a grim picture. If you had one or more co-existing conditions, your risk went up significantly. If you were in the red section of the pie chart, your odds of survival were rather low.

Comorbidity and the pre-covid death rate are calculable; Dr. Mary Charlson came up with the Charlson Comorbidity Index (CCI) a few years ago and it simply computes the 10-year survival rate in people with comorbidities. The more diagnosed medical problems you have, the higher the risk is that you will not live another 10 years. Other doctors have taken her work, refined it and added their name to her version of the CCI. But the result is pretty much the same; click on the highlighted link above to compute your own numbers if you want to assess where you stand in survivability. If you have 2 or 3 comorbidities and contract CV, I suggest you make sure your affairs are in order. You're in for a rough ride.

I note the high CV death rate in Italy is predominantly tied to comorbidity. This doesn't offer comfort to those that lost a loved one, but it does paint it in different color: Without sounding hard or uncaring, it is obvious most of these people were on the short list already. Covid may have finished them off, or removed the ability of medicine to delay the inevitable, but nonetheless, their medical problems as computed in the CCI put them at high risk.

I suspect numbers won't be all that much different in other countries including the US as the data is refined. And there are lessons to be learned here: Those with existing conditions and the aged/infirm should continue to shelter in place to the point of quarantine as much as possible.

The rest of the world should return to some form of normalcy and business should resume. We can't continue to isolate from each other forever, and I'll even go a step further by telling you I'm a firm believer in how the immune system in healthy people needs to be exercised regularly to keep its defenses active. Yes, as we grow older immunosenescence (the gradual weakening of the immune system's ability to fight) is a factor, and we should be mindful of that. But in the younger population, we should return to normalcy.

About 100 years ago, a poet named Strickland Gillilan wrote a very short poem about germs. It is entitled Lines on the Antiquity of Microbes and it goes like this:

Adam
Had'em.

As do we all.