The children with COVID-19 in Dr. Eugene Daugherty鈥檚 pediatric intensive care unit often have one thing in common: obesity.
鈥淎t least 9 out of 10 patients that we鈥檙e seeing who are sick enough especially to be in the ICUs throughout the state, obesity plays a part in this,鈥� said Daugherty, who is with Novant Health鈥檚 Children鈥檚 Hospital in Charlotte.
Since the start of the pandemic, there have been numerous studies worldwide showing the heightened dangers that COVID-19 poses to people who are overweight. The World Obesity Federation, for instance, has shown have been ten times higher in countries where more than half of the population is overweight.
But some doctors and health experts are questioning whether public health officials have done enough to convey that message, especially to younger people.
鈥淚t feels like 鈥� at least in the messaging that I鈥檝e seen 鈥� as though it鈥檚 being treated as more of a footnote than anything else and something I feel like a lot of people have missed,鈥� said Dr. Daniel Donner, a physician at Novant鈥檚 Pediatric SouthPark Clinic.
Donner says it鈥檚 particularly important because the number of obese children he鈥檚 seeing is increasing, with roughly 1 in 5 children six and older that comes to his practice having obesity. He believes it鈥檚 due to stay-at-home orders that closed schools and kept children indoors.
A recent Centers for Disease Control and Prevention found that the rate of increase in body mass index in a group of roughly 432,000 children doubled during the pandemic compared to a pre-pandemic period, possibly due to the impact of stay-at-home orders and school closures.
The rate of obesity among the general population .
鈥淪o I think obesity has been fascinatingly ignored in this pandemic,鈥� said Monica Gandhi, an infectious disease specialist, and professor of medicine at the University of San Francisco.
With nearly 90% of North Carolinians 65 and over fully vaccinated, .
And that鈥檚 shifted the disease鈥檚 toll to a younger population, who often have underlying health conditions. That鈥檚 often obesity, according to a WFAE review of death reports from the Mecklenburg County health department.
Silence On Obesity For Six Months
In North Carolina, Health and Human Services Secretary Mandy Cohen is the state鈥檚 top messenger about COVI D-19. She often appears with Gov. Roy Cooper during bi-monthly or even weekly news conferences about the disease.
Cohen has talked often about the greater risk that COVID - 19 poses to elderly people. And she has discussed disparities in vaccination rates among racial and ethnic groups.
But a review of her media briefings with Cooper shows she last mentioned the word 鈥渙besity鈥� in mid-March when she was listing underlying health conditions that allowed people to get vaccinated early. In those briefings, she has not made a special point to encourage people who are overweight to get vaccinated.
She has instead taken a blanket approach, urging everyone to get a shot.
The Centers for Disease Control and Prevention Web site lists obesity as one of . It ranks them in alphabetical order 鈥� not by the danger posed by each.
鈥淚t could be there鈥檚 an element of 鈥榃ell, let鈥檚 not blame the victim,鈥�" Gandhi said. 鈥淲ith obesity, it seemed like it was simply not discussed. And it鈥檚 so important.鈥�
What Mecklenburg County Death Reports Show
To try and determine the role obesity plays in deaths f rom the disease, WFAE requested six months of data on COVID-19 deaths in Mecklenburg County.
It鈥檚 often difficult to determine an exact underlying condition since many are connected, like being a smoker and lung cancer. And the records are dependent on the notes of physicians at the hospital and could vary depending on who filled them out.
But the data shows:
- There were 136 COVID-19 deaths among people ages 65 and younger during that time in which an underlying cause of death was listed.
- Of those deaths, 76 had either obesity or diabetes listed as an underlying risk factor.
- Asthma was only listed as an underlying cause in five deaths among people 65 and younger. In one of those cases, the person was also described as morbidly obese.
- Tobacco use was listed as an underlying cause in five deaths.
- Cancer was listed as a risk factor in six deaths.
- Being immunocompromised was a risk factor in two deaths.
The data also shows that among younger people, obesity is more often cited as a risk factor in a COVID-19 death than among the elderly.
Among people older than 65, obesity was listed as a risk factor in 9% of the COVID-19 deaths. For people younger than 65 it was a risk factor in 34% of COVID-19 deaths.
Earlier this month, Mecklenburg Health Director Gibbie Harris spoke at a meeting of county commissioners and discussed the profile of recent COVID-19 deaths.
鈥淎nd many of those (deaths) 鈥� 95% 鈥� were among people with underlying chronic conditions,鈥� Harris said. 鈥淪o we know how important the vaccines are especially for those with underlying chronic conditions. And the one thing I want to emphasize is that we have children that fit into that category that have underlying chronic conditions.鈥�
She did not mention any chronic underlying health condition by name.
In an interview, Mecklenburg County Medical Director Meg Sullivan said the health department might have done more to make sure people understand different risk factors for COVID-19.
鈥淭he honest answer is I鈥檓 not sure if there has been that specific messaging to the extent that it needs to be,鈥� Sullivan said.
, who was Food and Drug Administrator from 2017 to 2019, said that public health officials could be more specific.
鈥淚t鈥檚 a fair point,鈥� Gottlieb said. 鈥淏ecause this is the challenge with public health messaging. So it鈥檚 true that a lot of the dialogue is around risk factors broadly and they haven鈥檛 been clearly enumerated.鈥�
With boosters now being available, Gottlieb said it鈥檚 important that people speak with their physicians about whether they are at high risk.
鈥淲hen public health officials go out and speak about COVID they speak about risk factors generally because it鈥檚 difficult to enumerate all of them,鈥� he said. 鈥淎nd a lot of them are nuanced. If you are diabetic and obese you are at higher risk than someone who is just obese or just diabetic.鈥�
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