Author: noorali

Are obese individuals at a higher risk of contracting and dying from COVID-19?

Yes. We know cardiac, respiratory and metabolic diseases (such as diabetes and hypertension) are more common among patients with obesity. These have been identified as risk factors for more severe disease or death from COVID-19. It is critical that people living with obesity, and especially people with a body mass index (BMI) over 40, take all possible precautions to avoid infection.

A BMI of 30 or higher is considered obesity. Your BMI should be checked at least once a year because it can help determine your overall health risks.

Your aim should be to keep your waist measurement less than half that of your height. That should be easy to measure compared to calculating BMI.

It is important to remember, although BMI is generally a good way to estimate how much body fat a person has, it does not measure body fat directly and therefore is not reliable in all cases.

For example, a person may weigh extra because he or she is athletic and has a lot of muscle, and not because he or she has excess body fat.

Your risk of diabetes increases as you build more fat around your waist line.

Women with a waist measurement of more than 90 centimeters, and men with a waist measurement of more than 100 centimeters may have more health risks than do people with smaller waist line. Your waist circumference should be checked at least once a year.

Abdominal fat or obesity has more severe health effects than fat in other parts of the body. Obesity is a chronic and often progressive disease, similar to diabetes or high blood pressure.

Many organizations including Obesity Canada, the Canadian Medical Association, the American Medical Association, and the World Health Organization now consider obesity to be a chronic disease.

COVID-19 has imposed restrictions on people’s movements and their capacity to be mobile and active. More people feel depressed and lonely. Outdoor activities are restricted. Gyms are closed. Many people find eating a source of pleasure.

How can you take control of your weight and your life?

First thing would be to categories your weight status. Are you of normal weight, overweight, obese or extremely obese? You can do this by choosing one of the methods described earlier.

Second, remember obesity is generally caused by eating too much and moving too little. Cut back on sweet and greasy food. Make healthy diet choices. Mediterranean diet is a good choice.

Third, increase your physical activity. The four main types of physical activities are aerobic, muscle-strengthening, bone-strengthening, and stretching. Aerobic activity is the type that benefits your heart and lungs the most.

Fourth, remember achieving a healthy weight through diet and physical activity is the best way most people can improve their health.

Fifth, it is no secret that most methods of treating obesity have failed. Some are good for a short duration but most people revert to their old habits. Habits are hard to get rid of. Habits that have been ingrained in your system since childhood. Be patient and persevere. You can do it!

Sixth, experts agree there is no single solution to the problem of obesity. We should help people make better choices. Avoid your enemies – sugar, fat, salt, overeating and lack of physical activity.

Take care.

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Globally, there have been more than 10 million confirmed cases of COVID-19, including 500,000 deaths (WHO statistics).

It is estimated, more than one billion people face increased risk of severe COVID-19. Can we control this terrible pandemic? Hopefully, yes. But there are few challenges.

First challenge:

People with illnesses like diabetes, heart and lung problems and other medical conditions form 20 per cent of world’s population. This population is at increased risk of severe disease.

Analysing data from 188 countries (A. Clark et al. Lancet Glob. Health) the authors of this article estimate 1.7 billion people worldwide have an elevated risk of severe illness. The researchers also estimate nearly 350 million people – some of whom do not have underlying conditions – would require hospitalization if infected.

With these facts in mind, experts around the world are trying to assess how many high-risk people will need a vaccine once it is developed. The number will be in billions.

How many hospital beds will be needed? How many doctors, nurses and all other health care workers who are stressed and overworked will need care? Who will look after them?

Second challenge:

There are currently no drugs licensed for the treatment or prevention of COVID-19. According to some reports, there are at least 254 treatments and 172 vaccines currently in development to fight COVID -19. U.S. taxpayers are funding six COVID vaccines currently being fast tracked and tested. If the results are promising it may take at least a year before people can take advantage of it.

Third challenge:

Recognising the illness is not easy. Although majority of the patients with COVID-19 have classical symptoms that can be mild to severe, some patients may not exhibit any symptoms. You may not know you have symptoms of COVID-19 because they are similar to a cold or flu.

COVID-19 can make some people very ill. More rarely, the disease can be fatal. Older people, and those with pre-existing medical conditions (such as high blood pressure, heart problems or diabetes) appear to be more vulnerable. Many experts believe this kind of illness has not been seen before in our lifetime.

Fourth challenge:

Getting the facts from reliable sources versus the stories getting ahead of the science. This causes sheer confusion.

It is estimated between 1,500 and 2,000 articles per week are published on the subject. Majority of the articles are considered of poor quality by many experts. But there is some outstanding work going on at a speed not seen before in scientific research. That is extremely positive.

Fifth challenge:

Long term effects of COVID-19. COVID-19 affects individuals in many different ways. Scientists are only starting to understand the vast array of health problems caused by the virus, some of which may have long-term effects on patients and health systems.

Coronavirus is not only a respiratory virus, the virus can affect your brain, heart, liver, kidneys and other organs. Some patients experience blood clotting disorders that can lead to strokes, and extreme inflammation that attacks multiple organ systems. The virus can also cause neurological complications that range from headache, dizziness and loss of taste or smell to seizures and confusion.

Sixth challenge:

Getting people to follow preventive measures. For example, getting them to wear a mask. But mask alone will not prevent the spread of COVID-19. You must consistently and strictly adhere to good hygiene and public health measures, including frequent hand washing and physical distancing. Stay at home. Go out only for essential things and keep yourself mentally and physically active at home.

Take care. Be safe. Be patient. It’s not over yet!

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

COVID-19 pandemic took us by surprise and hit us hard, spreading from country to country and continent to continent. It has been with us for the last six months or so and shows no sign of stopping. In fact, we are warned to be ready for the second wave.

In the meantime, scientists all over the world are working round the clock to find an appropriated vaccine and antibiotic that would help. Most urgent focus has been to increase access to tests to diagnose people with current infections.

The possibility of COVID-19 should be considered primarily in patients with new-onset of fever and/or respiratory tract symptoms like cough and difficulty breathing. In some ways, COVID-19 is similar to influenza.

However, there are some key differences between COVID-19 and the flu. COVID-19 causes severe disease in a higher percentage of cases than seasonal influenza.

We need to do a laboratory (microbiology) test to establish COVID-19 diagnosis. Sensitivity of testing depends on the type and quality of the specimen obtained and the duration of illness at the time of testing.

In case of COVID-19, the virus that causes the disease – SARS-CoV-2 – is detected through a test known as a reverse-transcription polymerase chain reaction test, or RT-PCR. This is the most common type of test used in Canada.

A study of the accuracy of RT-PCR testing for COVID-19 found the test did not detect the virus on day one of infection and produced false-negative results 38 per cent of the time on day five and at least 20 per cent of the time after day eight. If patient has symptoms but the test is negative then test result should be ignored and patient should be kept in quarantine and tested again.

Types of testing

I have been curious to know how accurate are the tests done to diagnose COVID-19. Here is what I learnt.

Nucleic acid-based testing – for detecting nuclear acid specific to the virus. This is the preferred initial diagnostic test for COVID-19.

Scientifically speaking, this is a nucleic acid amplification testing (NAAT), most commonly with a reverse-transcription polymerase chain reaction (RT-PCR) assay to detect SARS-CoV-2 RNA from the upper respiratory tract.

This test is the gold standard used in Canada and abroad to diagnose active COVID-19 infection in patients with symptoms. There are very few false positive results. False negative results depend on timing of the sample in relation to the stage of the illness.

False negatives can occur up to 30 per cent of the time if we swab people who are asymptomatic and swab them too soon after they’ve been exposed to COVID-19.

False positives depend a lot on the machine itself, but also how much COVID-19 is in a town or community that is being assessed. It is hard to nail down a rate that applies to every machine that is used.

Test sensitivity depends on timing of sample collection. According to Centre for Disease Control and Prevention (CDC) proper collection of specimens is the most important step in the laboratory diagnosis of infectious diseases. A specimen that is not collected correctly may lead to false negative test results.

Serology-based testing – for detecting antibodies to the virus.

Serologic tests are blood tests that look for antibodies in the blood. They can involve a number of laboratory techniques. This test is not intended for use in clinical diagnosis. Serological tests do not detect the virus itself. Instead, they detect the antibodies produced in response to an infection.

Health Canada confirms that authorized COVID-19 tests are well supported by evidence indicating they will provide accurate and reliable results. That means very few false positive results. In Alberta, any person who wants to be tested can now be tested, even if they don’t have symptoms.

I hope this information helps. Take care. Be safe.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!