Note: Thank you to Dr. Moskowitz for this thoughtful article. Part 1 drew heated comments, and we encourage lively debate. I will remind readers that contributors like Dr. M are guests of Age of Autism, and it's important for me to make them feel welcome. Please respond respectfully. Thank you.
By Richard Moskowitz, MD
The pandemic has thus exposed some sobering truths about our pre-existing state of health. Its striking predilection for the elderly, infirm, and chronically ill, especially those residing in crowded nursing homes and extended-care facilities, was evident from the start. By March, 2020, almost 2500 Italians had died with the COVID, and over 99% of them had chronic diseases: 25% with one, 26% with two, 49% with 3 or more, and less than 1% with none; their average age was 79.5.54,55 Already the outbreak was a warning to attend to the underlying state of our health, the terrain that gives it life.
As I witnessed repeatedly in my practice, making worse what's already there is a regular, built-in consequence of every vaccine,56 suggesting that the COVID illness is itself vaccine-like, and that the adverse effects of vaccines developed against it might travel much the same path.
In the countries hardest hit, the illness has similarly targeted the aged and chronically ill with remarkable consistency. In the U. S., residents of nursing-homes, assisted-living, rehab, and other extended-care facilities, comprising only 0.6% of the population, accounted for 42% of the deaths linked to COVID-19 in 2020, and 81.4% of those in Minnesota, 77.0% in Rhode Island, and 70.0% in Ohio.57
Similarly, a large majority of Americans dying with the COVID were already suffering from one or more chronic diseases. In New York State, 86.2% of the deaths involved one or more comorbidities,58 creating a similar confusion as to whether the virus was the primary cause of death, a precipitating factor, or merely a coincidence.
Other major factors are poverty, malnutrition, socioeconomic and political oppression, and the poor health, pollution, and lack of good medical care that so often accompany them, which are also huge systemic causes of chronic disease generally. These neediest, disproportionately non-white subpopulations comprise the other huge clustering of cases, hospitalizations, and deaths: low-wage workers who can't afford to stay home, the indigent and unemployed needing public assistance that isn't there, and asylum-seekers, detainees, prisoners, and homeless with nowhere else to go.59 Here, too, chronic ill-health and COVID go tragically and predictably hand-in-glove.
These two huge, overlapping reservoirs of chronic ill-health thus empower the COVID phenomenon, with an overall death rate in the neighborhood of a bad seasonal flu, to attain the outsized dimensions of a global pandemic, and to devastate a number of the most populous and powerful first-world countries, especially our own.
The shocking prevalence of chronic disease in America thus long predated the COVID, set the stage for it, and will doubtless assume even greater importance if and when it ends. In 2008, the CDC surveyed the incidence of 6 important chronic diseases, namely, diabetes, cardiovascular disease, COPD, asthma, cancer, and arthritis, and found that 60.0% of all adults had been diagnosed with 1 or more of them, as had 78.0% of those 55 and older, and 85.6% of those 65 and older, while 40.0% of adults had been diagnosed with 2 or more, as had 47.0% of those 55 and older, and 56.0% of those 65 and older.60
The commonest of the six, and the leading comorbidity in those dying of COVID, is hypertension, a subtype of cardiovascular disease, estimated in 2013 to affect 33.3% of all adults, 54.5% of those 55-64, 67.4% of those 65-74, and 76.1% of those 75-84.61 Other major chronic diseases included
1) obesity, very common in the worst COVID cases, and found in 42.4% of all adults;62
2) arthritis, diagnosed in 22.7% of all US adults;63
3) chronic lung diseases, especially asthma and COPD, in 15% of all adults;64.65
4) chronic kidney disease, in an estimated 15%;66
5) diabetes, diagnosed in 10.5% of the total US population;67
6) cancer, in an estimated 50% of males and 33% of females at some point in their lifetime;68 and
7) dementia, diagnosed in 13.9% of US adults 71 and older.69
Even more striking is the burden of chronic disease in children, supposedly our healthiest demographic, and contributing relatively few deaths from COVID so far. In 2008, a study of 91,000 children found that 43% of them suffered from at least 1 of the 20 chronic diseases surveyed, and that adding obesity and neuropsychiatric disturbances to the list raised the total to 54.1% of all children afflicted with some form of chronic disease.70