It’s a given to say that the most important weapon to fight the corona virus is in our own hands – taking the onus to maintain optimum levels of health and fitness – only then can the vaccination work as a desirable adjunct to help combat the virus. It’s a rather unfortunate fact that health officials and pandemic response authorities, by and large the world over, are completely oblivious to the role a healthy lifestyle plays in the COVID-19 war, focusing instead, almost exclusively, on the necessity for a vaccine. 

I am most certainly in favour for the vaccine being developed, but is a vaccine really going to be the answer that we all are waiting for? Will the vaccine put an end to wearing masks? Or social distancing? Or complete return to pre-Covid life at work and at home? Excuse me for the spoiler, but a Vaccine will be in addition to what we are told to do now, not a replacement. If any of the vaccines reach 90% effectiveness – an extremely optimistic projection – people with high-risk health conditions will need to continue wearing masks as also continue the hygiene drill learnt and practiced to perfection in 2020. In addition, as most governments have given a nod to fast track vaccine development and trials, there will always be the danger of auto-immune disorders and other hazards from the novel mRNA vaccines.

Let’s accept the fact that the SARS COV2 is an addition in the medical syllabus to be studied by our future generations. The Atlantic succinctly states this truth of the matter in its August 4, 2020, article, ‘The Corona-virus Is Never Going Away’: “If there was ever a time when this corona-virus could be contained, it has probably passed. One outcome is now looking almost certain: This virus is never going away … We will probably be living with this virus for the rest of our lives …

What does the future of COVID-19 look like? That will depend on the strength and duration of immunity against the virus. Grad, an infectious-disease researcher at Harvard, and his colleagues have modeled a few possible trajectories… If immunity lasts only a few months, there could be a big pandemic followed by smaller outbreaks every year. If immunity lasts closer to two years, COVID-19 could peak every other year.

In SARS, the antibodies wane after two years. Antibodies to a handful of other corona-viruses that cause common colds fade in just a year. The faster protection goes away, the more difficult for any project to try to move toward eradication.”

I know many of you would not want me telling you this as it seems a road leading to nowhere. But, every cloud has a silver lining and so is true with Covid too. Sooner than later, the world of medicine is going to have a paradigm shift and will focus on health and wellness. Today’s treatment options are far from satisfactory but they however are the reality. Covid-19 seems unlikely to be eradicated in the near future, so if we haven’t contracted it already, chances are we all will at some point in the years to come. At present, it’s still unclear whether you can contract it more than once, but if that’s the case, then flu season will likely include the possibility of COVID-19 outbreaks as well. We may be able to hide from the virus, but we cannot hide the virus from us; as we simply cannot stop breathing! 

Facing reality head-on is the best way forward, and that means your best bet is to get yourself in your best health and immunity through nutritious diet and exercise. At this point, it may be worth reminding yourself that life involves the risk of illness and death. Every day of every year of your life, you face the possibility of illness, be it an infectious disease or chronic illness. Each year of your life, you’ve faced the possibility of influenza, for example. Maybe a mild case, maybe a really serious one. Regardless, you’ve probably never considered giving up on doing the things you love for fear you might die. The good news about Covid is, that much like with influenza, your chances of staying well, or only getting a mild case, are primarily dependent on your immune function, and this is something you can do a lot about. We now have a significant amount of data which shows that certain comorbidities raise your risk of severe COVID-19 illness and death. One amongst the top of the list is obesity, so addressing excess weight will go a long way towards lowering your risk.

In the UK, treating obesity is now a part of the country’s corona-virus prevention strategy. In an announcement, Prime Minister Boris Johnson said he intends to ban junk food advertising before 9:00 pm and limit in-store promotions. Johnson’s decision was in large part influenced by his own bout with COVID-19, which his doctors believe was made more serious by his excess weight. Several studies support their suspicion. A recent article in the Journal of Virology says, “Over the years, humans have adopted sedentary lifestyles and dietary patterns have shifted to excessive food consumption and poor nutrition. Over nutrition has led to the constellation of metabolic abnormalities that not only contributes to metabolic reprogramming but also limits host innate and adaptive immunity. Impaired immune responses and chronic inflammation in metabolically diseased micro-environments provide the ideal conditions for viral exploitation of host cells and enhanced viral pathogenesis.” 

Simply put, it means excess weight is ideal for a severe viral attack. We need to address the proverbial elephant in the room. Take utmost care of your diet because with COVID-19, you’re twice as likely to have a poor outcome if you’re overweight. Obesity has always killed us, albeit slowly; mixed with COVID, it kills you fast. It’s like you do not want to add one more killer in your glass full of liquor. I understand and resonate with the logic of the lockdown to prevent the spread of the virus but unfortunately, it has also increased its fatality amongst those whose weighing scales are feeling the excess burden.

There’s little doubt that processed foods, junk snacks and sugar laden drinks are key culprits in the rise of obesity and chronic diseases that also inflates the risk of death from COVID-19. As such, they should be the first to be eliminated. India is a land of festivals and every few days we celebrate some or the other festivity. With it, people send ‘Mithai’ or sweetmeats to their loved ones. This tradition needs to be changed. Someone needs to tell Big B to stop saying ‘Kuch mitha ho jaaye’ otherwise ‘aap lambe ho jaaoge’! (pun intended)

If anything good is to come of this pandemic, it would be the widespread recognition of the impact obesity has – not just on chronic diseases, but also on viral contagions such as SARS-CoV-2. A recent editorial published in the most reputed British Medical Journal (BMJ) highlights the importance of diet and the significant yet hidden influence the processed food industry has had in the COVID-19 pandemic. It is now clear that the food industry shares the blame not only for the obesity pandemic but also for the severity of COVID-19 disease and its devastating consequences.

During the COVID-19 pandemic lockdown, fears about food scarcity due to disruptions in distribution chains and limited access to fresh foods have caused consumers to tilt towards buying and stocking up on processed foods with a long shelf life, which are usually laden with salt, sugar and trans-fat, apart from chemical formulations that are good tongue twisters. Moreover, since the start of the COVID-19 pandemic the food industry has launched campaigns and corporate social responsibility initiatives, often with thinly veiled tactics using the outbreak as an excellent marketing opportunity. Take for example, a popular milk brand in India advertising its sugar and chemical laden milk as an immunity booster tonic.

In my opinion, there should be a mass movement to not only call on the food industry to immediately stop promoting unhealthy food and drinks, but also call on governments to enforce reformulation of junk foods to better support health, as compelling research shows that being obese doubles the risk of being hospitalized for COVID-19. Scientific studies also very strongly suggest that modification of lifestyle may help to reduce the risk of COVID-19 and could be a useful adjunct to other interventions, such as social distancing and shielding from high risk.

Research by Johns Hopkins University has suggested that ‘obesity’ eventually shifts the burden of COVID-19 onto younger patients. According to this research, even mild obesity can influence COVID-19 severity, as obese youngsters need hospitalisations much more frequently and many a times succumb to fate. Researchers from the University of Bologna, Italy, analyzed 482 COVID-19 patients, who were hospitalized between March 1 and April 20, 2020, concluding in their research, “Obesity is the only risk factor for respiratory failure, admission to the ICU and ultimately causing death among COVID-19 patients.”

Thus, health care practitioners should be made aware that people with any grade of obesity, not just the heavily obese, are a population at risk. Extra precautionary measures should be used for hospitalized COVID-19 patients with obesity, as they are likely to experience a quick deterioration towards respiratory failure, and to require an immediate intensive care unit.

Inflammation triggered by obesity is thought to be responsible for the threefold greater risk of pulmonary embolism (dislodged blood clot reaching the lungs) seen in obese COVID-19 patients. Obesity-related dysregulation of lipid synthesis (fat metabolism) can also aggravate lung inflammation (injury), thereby contributing to increased disease severity in viral respiratory infections such as Covid. In addition to that, excess body weight and fat deposition around the internal organs put pressure on your diaphragm, which makes it more difficult to breathe when you have a respiratory infection. Patients with mild obesity have a 2.5 times greater risk of respiratory failure and a five times greater risk of being admitted to an ICU compared to non-obese patients. But get this, those with severe obesity are 12 times more likely to die from COVID-19.

The take-home message here is that if you are obese, even on the mild side, focus on achieving your healthy weight which will help you against viral illnesses, including COVID-19. Losing weight will also help you avoid other obesity-related health problems such as diabetes, high blood pressure and heart disease — all of which, by the way, raise your risk of COVID-19 complications and a certain death.

Please ensure more movement with regular exercise routine and decrease the typical ‘khavanu pivanu’ sedentary lifestyle. As I write this, there is additional data pouring in on the role Vitamin D plays in the prevention and fight against the Corona infection. Since I’ve already dwelled at length on the sunshine vitamin in my previous writings, will only make a passing remark as a reminder to keep your Vitamin D levels in the optimum range. Make sure you’re getting sufficient sleep (seven to eight consecutive hours) and reflecting on your emotional health as an important factor that can influence your general health and well-being. Chronic stress, for instance, may increase your risk for visceral fat gain over time, which means addressing your stress levels is imperative for maintaining your ideal weight. Taking steps to lead a healthy lifestyle overall will have a snowball effect, helping you to reach a healthy weight while also reinforcing your resilience and well-being.

My intention to write this article today is not to grip you with fear but to genuinely help you in your resolve to walk the journey towards your wellness. After-all, being forewarned is being forearmed!

God bless!!

(Remember to keep writing in with your comments, suggestions and questions as always to me at: daneshchinoy@gmail.com / 8454800869.)