Quan The Dan
I watched as his last breath left the body. He was in his 20s, and would now forever be in his 20s.
After all efforts at resuscitation failed, I finally wiped the fluids and phlegm from his face. I saw no more pain and suffering, only peace. He fought hard, and so did we.
Only after getting to the frontlines against Covid-19 did I realize how devastating a war could be. Here at the Binh Duong Hospital, many of the deceased were not elderly or sick; they were young people with a full future ahead of them. One common denominator was that many were overweight or obese.
Vietnamese society lovingly regards chubby and plump people, considering them to be warm and kind. But the coronavirus is not so kind on them. They can go very quickly from merely coughing to needing oxygen canisters and ventilators to stay alive. Some last only a few days.
Taking care of overweight people is more difficult and takes more resources.
Simple hygiene tasks like turning them over to change their diapers often takes more people. Finding their veins for injections is well-nigh impossible. They labor to breathe, and they cannot lie on their stomach. Above all, some of their bodily reactions against Covid-19, particularly cytokine storms, can be especially dangerous and even lethal.
It is a known fact that obesity and Covid death rates are closely connected. Statistics show that of the 2.5 people who have died of the disease, 2.2 million were in countries with a high percentage of overweight people.
Around 80 percent of Covid patients in ICUs in the U.K. are overweight or obese, The Guardian newspaper reports.
In the U.S., that rate is 88 percent.
Last year Vietnam had one of the lowest death rates globally, probably because the outbreaks had not yet hit the most vulnerable populations. But when the fourth wave swept through key economic regions in southern Vietnam, which have the highest rate of overweight people in the country, death rates immediately jumped to 2.5 percent, or 0.4 percentage points higher than the global average.
In Ho Chi Minh City, the death rate could be even as high as 4 percent.
As the world learns more about the pandemic, how the virus kills is also being better understood.
Cytokine storms could be attributed to a large number of deaths, caused by the body’s drastic response to a coronavirus infection.
While around 80 percent of cases experience mild symptoms, the other 20 percent suffer from severe ones and need to be hospitalized, and even die.
So what makes overweight people so vulnerable to Covid-19?
A man crosses a road as pedestrians carrying food walk along the footpath in central Sydney, Australia. Photo by Reuters/David Gray
Studies have shown overweight and obese people often have metabolic disorders that disrupt the immune system. For decades now, scientists have understood that adipose tissues are not merely batteries, but also a major endocrine organ.
Back in the 1990s science figured out that fat tissues release several chemicals, including cytokines, which are responsible for the so-called cytokine storms.
Normally, cytokines are released in appropriate amounts, which helps with cell signaling and other functions. But in the face of certain diseases, adipose tissues could release huge amounts of cytokine, which overwhelm the body and trigger cascades of chemical reactions that wreck it.
All evidence points to one fact: obesity is correlated with a higher chance of dying from Covid.
This leads to a new public health issue that needs to be addressed. There must be a healthcare campaign that promotes healthier lifestyles and reduces obesity, especially in young people.
In the meantime, I believe overweight people should be prioritized for Covid vaccination.
*Quan The Dan is a doctor at the Becamex Binh Duong ICU Field Hospital. The opinions expressed are his own.