If you were lucky enough to have a high-paying job and some status within your community when the pandemic began, thank your lucky stars.
Your elevated socioeconomic status might have done as much as anything to make it so that you are alive to read this.
A peer-reviewed study of 16,000 hospitalizations in six U.S. states in the late spring of 2020 has concluded the well-to-do had about half the chance of hospitalization than the less well off.
The study was conducted by researchers from the Centers for Disease Control (CDC), the Yale School of Public Health, and the Colorado and Georgia departments of public health. It was published Friday at PLOS ONE.
Higher socioeconomic status has been shown to be protective against many kinds of diseases, but in this case, there might also have been a link to who was best able to work from home and avoid contacts with carriers of the SARS-CoV-2 virus that causes COVID-19.
Those who have observed that the best form of welfare is a good job might have been on to something.
In census tracts with the highest number of service industry workers, the researchers reported, “the COVID-19-associated hospitalization rate was 155.5 per 100,000 persons compared with a rate of 78.7” in census tracks with the lowest number of such workers.
Similar associations appeared in connection to public transportation.
In census tracks heaviest with people using public transportation, the hospitalization rate “was 142.9 per 100,000 persons compared with 77.4 in census tracts with the lowest” number of people using public transportation.
Most at risk
The study paints a picture of the U.S. citizens most susceptible to the disease as someone of limited education living in or on the edge of poverty who needs to use public transportation to get to and from work.
For those age 25 and over with a college degree, the researchers noted, the COVID hospitalization rate was a little more than half that (71.2 per 100,000) of those lacking such a degree (145.5 per 100,000).
The study was conducted at a time when many states had ordered lockdowns, and that might well have influenced who was suffering greater or lesser exposure to SARS-CoV-2.
“…Because all of these orders allowed essential work to continue, disproportionately high COVID-19-associated hospitalization rates in census tracts with lower socioeconomic indicators and among racial/ethnic minorities might represent cases in essential workers, particularly if these persons did not have access to properly fitted personal protective equipment.”
Essential workers were deemed essential because their jobs couldn’t be done from the safety of home, and there is no avoiding the fact that increased their chances of being exposed to the virus.
“…Many service industry occupations, such as restaurant work, require working onsite and sharing airspace with others,” the authors wrote. “Similarly, essential workers being exposed during commutes could explain the association between hospitalization rates and commuters using public transportation. Other data also suggest that the demand for public transportation during pandemic-related lockdowns occurred in communities serving essential workers and racial/ethnic minorities, the same two groups with increased hospitalization rates in this analysis.”
Then again, the authors noted, there could be still other factors that explain the disparities between those of differing socioeconomic status, including underlying health problems common in poverty-stricken neighborhoods.
So-called “comorbidities” have been a big issue in the pandemic. A study of nearly 5 million people hospitalized with COVID-19 between March 2020 and March 2021 reported that just under 96 percent of them had one comorbidity.
Unhealthy = risky
High blood pressure, “disorders of lipid metabolism, and obesity were the most common,” said that peer-reviewed study published in July in the Preventing Chronic Disease journal. “The strongest risk factors for death were obesity, anxiety and fear-related disorders, and diabetes with complication, as well as the total number of conditions.”
As the number of comorbidities increased, the study said, so did the risks of death.
Much has changed since – newly developed mRNA vaccines are proving amazingly effective at protecting people from fatal COVID-19 – but little has changed as well.
Deaths continue even among the vaccinated and the pattern remains much the same.
A study of breakthrough cases among the vaccinated published in The Lancet near the start of the month reported that the “pre-existing comorbidities in the 14 patients with severe or critical illness included overweight, cardiovascular disease, lung disease, malignancy, type 2 diabetes, and use of an immunosuppressive agent.”
The sample size for the study was small, but the pattern was so similar to that of the non-vaccinated that it is hard to ignore.
No matter one’s personal views on vaccination – pro or con – the data to date continue to argue strongly for losing any excess weight and improving general physical fitness.
This is especially true if you believe the prediction of Dr. Vinay Prasad that “everyone will meet with the virus eventually.”
An associate professor of medicine at the University of California San Francisco and a columnist for MedPage Today, Prasad has observed that the COVID-19 pandemic is going to end like the Spanish flu pandemic of 1918-19.
It will fade, but it will not die.
“The end (of the pandemic) is not when cases go to zero,” he writes, “but rather when we accept what has been true all along. Because of multiple animal reservoirs, because vaccinated people can still experience breakthrough infections, and because billions of people globally have yet to be vaccinated, the truth is clear: SARS-CoV-2 is an endemic virus.
“Over the next decade, give or take a few years, every single person on earth has a date with this virus. We will all be exposed, and the virus might replicate in some of our respiratory mucosae. A few of us might get very sick, while many of us may only get mild illness or not get sick at all from our encounter.”