1 00:00:01,280 --> 00:00:06,160 Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day two hundred 2 00:00:06,200 --> 00:00:11,520 Speaker 1: and twelve since coronavirus was declared a global pandemic. Today's 3 00:00:11,560 --> 00:00:15,440 Speaker 1: main story. While scientists have known for a while that 4 00:00:15,520 --> 00:00:19,560 Speaker 1: obesity is a risk factor for COVID nineteen, the CDC 5 00:00:19,760 --> 00:00:24,480 Speaker 1: put out guidance this week suggesting even more people should worry. 6 00:00:25,480 --> 00:00:29,479 Speaker 1: It turns out that just being overweight could be enough 7 00:00:29,560 --> 00:00:35,360 Speaker 1: to make you vulnerable to severe COVID complications. But first, 8 00:00:36,360 --> 00:00:45,280 Speaker 1: here's what happened in virus News today. Today it brought 9 00:00:45,360 --> 00:00:49,240 Speaker 1: more mixed messages about the status of a coronavirus relief 10 00:00:49,240 --> 00:00:53,640 Speaker 1: bill in Washington. After shutting down talks earlier this week, 11 00:00:53,960 --> 00:00:59,320 Speaker 1: President Donald Trump approved a revised economic stimulus offer that's 12 00:00:59,320 --> 00:01:03,720 Speaker 1: according to its top economic advisor, Larry Cudlow, but it 13 00:01:03,800 --> 00:01:08,720 Speaker 1: is unlikely Congress will agree to it. Senate Majority Leader 14 00:01:08,760 --> 00:01:12,640 Speaker 1: Mitch McConnell said the differences are probably too big and 15 00:01:12,680 --> 00:01:16,120 Speaker 1: the time is too short for Congress to agree on 16 00:01:16,160 --> 00:01:22,320 Speaker 1: a new comprehensive stimulus package before the election. Despite President 17 00:01:22,360 --> 00:01:28,080 Speaker 1: Donald Trump's renewed interest in striking a deal, the rate 18 00:01:28,160 --> 00:01:32,399 Speaker 1: of coronavirus infection in England almost doubled in a week. 19 00:01:33,480 --> 00:01:36,319 Speaker 1: It's adding to concerns that a fresh surge of the 20 00:01:36,360 --> 00:01:40,920 Speaker 1: pandemic is spreading throughout the country. One in every two 21 00:01:41,000 --> 00:01:45,320 Speaker 1: hundred and forty people is infected. That's up from one 22 00:01:45,360 --> 00:01:49,920 Speaker 1: in four hundred and seventy a week earlier, according to 23 00:01:49,960 --> 00:01:54,800 Speaker 1: the Office for National Statistics. The figures come as the 24 00:01:54,920 --> 00:01:59,120 Speaker 1: UK government prepares to announce new restrictions for the worst 25 00:01:59,240 --> 00:02:03,920 Speaker 1: hit parts of the country, potentially including the closing of 26 00:02:04,000 --> 00:02:09,920 Speaker 1: restaurants and bars. Finally, the Spanish government declared a state 27 00:02:09,919 --> 00:02:13,760 Speaker 1: of emergency for the Madrid region, as Europe's leaders step 28 00:02:13,840 --> 00:02:18,080 Speaker 1: up efforts to contain an unrelenting surge in coronavirus cases 29 00:02:18,120 --> 00:02:23,600 Speaker 1: across the continent. Prime Minister Pedro Sanchez's government made the 30 00:02:23,639 --> 00:02:27,679 Speaker 1: decision at a special cabinet meeting on Friday. The premier 31 00:02:27,760 --> 00:02:31,440 Speaker 1: is struggling to impose his authority on regional officials who 32 00:02:31,440 --> 00:02:36,400 Speaker 1: have resisted restrictions on movement. Declaring a state of emergency 33 00:02:36,720 --> 00:02:41,400 Speaker 1: gives the Spanish leader extraordinary powers to order new constraints 34 00:02:45,000 --> 00:02:49,400 Speaker 1: and now for today's main story. Obesity is a known 35 00:02:49,520 --> 00:02:54,280 Speaker 1: risk factor for severe complications of COVID nineteen, but scientists 36 00:02:54,320 --> 00:02:57,600 Speaker 1: are learning that the link between extra pounds and severe 37 00:02:57,680 --> 00:03:03,000 Speaker 1: COVID nineteen is even strong younger than they thought. This week, 38 00:03:03,200 --> 00:03:06,440 Speaker 1: the US Centers for Disease Control and Prevention said that 39 00:03:06,639 --> 00:03:11,160 Speaker 1: people who are merely overweight, not just the OBEs, maybe 40 00:03:11,200 --> 00:03:16,200 Speaker 1: at high risk of serious disease from the infection. The warning, 41 00:03:16,480 --> 00:03:20,480 Speaker 1: posted on the agency's website on Tuesday means about two 42 00:03:20,639 --> 00:03:25,120 Speaker 1: thirds of Americans could face higher risks. I spoke with 43 00:03:25,160 --> 00:03:28,400 Speaker 1: health reporter and a court about what it means that 44 00:03:28,440 --> 00:03:33,919 Speaker 1: more people than previously thought could be vulnerable. So why 45 00:03:33,960 --> 00:03:36,480 Speaker 1: would just having a few extra pounds make you that 46 00:03:36,560 --> 00:03:42,200 Speaker 1: much more susceptible to serious complications from COVID nineteen. You know, Laura, 47 00:03:42,280 --> 00:03:46,240 Speaker 1: it's a really good question. The evidence is still emerging, 48 00:03:46,240 --> 00:03:48,680 Speaker 1: even on the subject of the risk of sort of 49 00:03:48,720 --> 00:03:52,240 Speaker 1: having some extra pounds. You know, we already knew that 50 00:03:52,400 --> 00:03:56,480 Speaker 1: people who were OBEs, you know, were at higher risk 51 00:03:56,560 --> 00:04:00,080 Speaker 1: and are at higher risk for having severe cases of 52 00:04:00,120 --> 00:04:03,160 Speaker 1: COVID nineteen. And this is something you know, doctors noticed 53 00:04:03,240 --> 00:04:06,200 Speaker 1: pretty early in the pandemic that they were seeing obese 54 00:04:06,240 --> 00:04:09,720 Speaker 1: people coming into the hospital, you know, being hospitalized at 55 00:04:09,800 --> 00:04:12,600 Speaker 1: higher rates um And so this is something that's been 56 00:04:12,760 --> 00:04:15,960 Speaker 1: established for a period of months. Now what's new is 57 00:04:16,000 --> 00:04:18,920 Speaker 1: that the CDC is now saying we have some data 58 00:04:19,000 --> 00:04:22,840 Speaker 1: to believe people who are overweight could also be at 59 00:04:22,920 --> 00:04:26,240 Speaker 1: risk for serious forms of COVID nineteen. And I mean 60 00:04:26,480 --> 00:04:29,480 Speaker 1: that's a pretty big deal because and we're talking about 61 00:04:29,839 --> 00:04:32,720 Speaker 1: you know, nearly seventy two percent of American adults are 62 00:04:32,839 --> 00:04:37,920 Speaker 1: overweight or obese. It's about forty of American adults are 63 00:04:37,920 --> 00:04:41,719 Speaker 1: obese and then about or overweight. So that's a big 64 00:04:41,760 --> 00:04:45,760 Speaker 1: population here, and that brings up a good point of 65 00:04:46,000 --> 00:04:51,039 Speaker 1: how is the CDC assessing those who are defined as 66 00:04:51,200 --> 00:04:55,919 Speaker 1: overweight or obese. Yeah, so we're going straight to b M. I. 67 00:04:56,240 --> 00:04:58,880 Speaker 1: You know, body mass index, which is basically just a 68 00:04:58,880 --> 00:05:02,360 Speaker 1: way of measuring your your weight and your height, you know, 69 00:05:02,760 --> 00:05:05,599 Speaker 1: and coming up with an index. So it's overweight people 70 00:05:05,600 --> 00:05:08,000 Speaker 1: have a body mass index of twenty five to thirty 71 00:05:08,040 --> 00:05:11,760 Speaker 1: and obesity is a thirty and higher. So you know 72 00:05:11,800 --> 00:05:13,520 Speaker 1: that example you could give us. You know, if you're 73 00:05:13,520 --> 00:05:16,160 Speaker 1: a man, you're five ft eleven inches, you weigh two 74 00:05:16,240 --> 00:05:20,640 Speaker 1: hundred pounds, you're considered overweight, you gain twenty five pounds. 75 00:05:20,720 --> 00:05:23,280 Speaker 1: Let's say you're you're considered obese and you know, there 76 00:05:23,279 --> 00:05:25,080 Speaker 1: are a lot of issues with b m I as 77 00:05:25,120 --> 00:05:27,320 Speaker 1: a as a measure, but it is the measure that 78 00:05:27,360 --> 00:05:31,039 Speaker 1: we have right now for for thinking about people's weight. Um. 79 00:05:31,120 --> 00:05:33,800 Speaker 1: And that's what the studies that the CDC used to 80 00:05:33,880 --> 00:05:37,560 Speaker 1: make this determination looked at. They looked at COVID nineteen 81 00:05:37,560 --> 00:05:40,839 Speaker 1: outcomes and b m I and they found this connection, 82 00:05:41,320 --> 00:05:44,039 Speaker 1: you know, as b m I went up between that 83 00:05:44,080 --> 00:05:47,680 Speaker 1: and more severe COVID nineteen outcomes. And and how does 84 00:05:47,720 --> 00:05:51,640 Speaker 1: this differ, say from some of the other comorbidity ease 85 00:05:51,880 --> 00:05:56,400 Speaker 1: of COVID nineteen. What what is actually the risk? You know? 86 00:05:56,480 --> 00:05:59,680 Speaker 1: We we do know just in general that having you know, 87 00:05:59,680 --> 00:06:02,440 Speaker 1: a little extra weight or or you know, a good 88 00:06:02,480 --> 00:06:05,080 Speaker 1: amount of extra weight can be tied to these negative 89 00:06:05,120 --> 00:06:08,760 Speaker 1: health outcomes. And that's what's made actually untangling this question 90 00:06:08,800 --> 00:06:13,200 Speaker 1: about obesity so complicated because people who are are obese 91 00:06:13,320 --> 00:06:16,920 Speaker 1: often have other medical conditions right that we know put 92 00:06:16,960 --> 00:06:20,880 Speaker 1: you at risk for COVID nineteen. UM. You know, things 93 00:06:20,920 --> 00:06:24,880 Speaker 1: like maybe uh, you know, diabetes, for instance, But we 94 00:06:24,880 --> 00:06:27,080 Speaker 1: we know that obesity seems to put you at even 95 00:06:27,160 --> 00:06:29,760 Speaker 1: higher risk than even just looking at those medical conditions 96 00:06:29,760 --> 00:06:33,320 Speaker 1: a person may have. In general, we know that these 97 00:06:33,400 --> 00:06:37,320 Speaker 1: metabolic changes tie to access weight can reduce the immune 98 00:06:37,360 --> 00:06:41,200 Speaker 1: systems ability to fight disease. Um. That's what I spoke 99 00:06:41,279 --> 00:06:43,880 Speaker 1: to nutrition professor about. And you know that there are 100 00:06:43,920 --> 00:06:46,279 Speaker 1: other reasons that people who who are obese could have 101 00:06:46,400 --> 00:06:49,760 Speaker 1: worse health outcomes with COVID nineteen, things like reduced lung 102 00:06:49,760 --> 00:06:52,760 Speaker 1: capacity and sleep apnea. You know, I think the scientists 103 00:06:52,920 --> 00:06:56,080 Speaker 1: is still emerging on this one, but there has been 104 00:06:56,160 --> 00:07:00,719 Speaker 1: this concerning trend identified by researchers, which is at people 105 00:07:00,800 --> 00:07:02,680 Speaker 1: with higher b m I s do seem to have 106 00:07:03,080 --> 00:07:07,640 Speaker 1: these more difficult experiences with COVID nineteen. And I think 107 00:07:07,680 --> 00:07:10,320 Speaker 1: what we should really take away from from this, even 108 00:07:10,320 --> 00:07:13,280 Speaker 1: though the science is still emerging, as I've said, is 109 00:07:13,320 --> 00:07:15,600 Speaker 1: that you know, this idea of who is at risk, 110 00:07:15,680 --> 00:07:18,200 Speaker 1: I think people like to downplay it and like to 111 00:07:18,360 --> 00:07:20,840 Speaker 1: silo it and say, oh, it's just people with other 112 00:07:20,920 --> 00:07:25,480 Speaker 1: medical conditions. I'm healthy, it's all good. And I think 113 00:07:25,800 --> 00:07:28,640 Speaker 1: you know, first of all, people who have medical conditions, 114 00:07:28,760 --> 00:07:32,280 Speaker 1: you know, like diabetes, are people, and it's concerning that 115 00:07:32,320 --> 00:07:34,880 Speaker 1: they would be more at risk for this number one. 116 00:07:34,920 --> 00:07:38,000 Speaker 1: But number two, you know, we're now talking about potentially 117 00:07:38,040 --> 00:07:42,120 Speaker 1: the near vast majority of Americans who could be at 118 00:07:42,160 --> 00:07:45,360 Speaker 1: greater risk from COVID nineteen. So you know, to say, oh, 119 00:07:45,400 --> 00:07:47,880 Speaker 1: it's just you know this person or that person, like 120 00:07:48,080 --> 00:07:50,280 Speaker 1: this is a lot of people we're talking about now here. 121 00:07:52,080 --> 00:07:56,280 Speaker 1: And what about the inverse argument that now everyone, it seems, 122 00:07:56,440 --> 00:08:00,160 Speaker 1: is at high risk for serious complications from COVID nineteen. 123 00:08:00,840 --> 00:08:03,520 Speaker 1: If you look at how the CDC has presented this information, 124 00:08:03,600 --> 00:08:07,560 Speaker 1: they're saying, we know that obese people are at increased 125 00:08:07,640 --> 00:08:10,680 Speaker 1: risk of having serious COVID nineteen. You know, along in 126 00:08:10,720 --> 00:08:13,880 Speaker 1: that category as people with cancer, people with cp D, 127 00:08:14,400 --> 00:08:18,440 Speaker 1: you know, heart conditions, people who are immun compromise, smokers, 128 00:08:19,000 --> 00:08:22,200 Speaker 1: people with type two diabetes. Right. Uh. And then if 129 00:08:22,240 --> 00:08:25,320 Speaker 1: you look at being overweight, which they say there's a 130 00:08:25,360 --> 00:08:27,960 Speaker 1: little bit less data for, and so they're you know, 131 00:08:27,960 --> 00:08:30,960 Speaker 1: people who are overweight maybe at increased risk, it's not 132 00:08:31,280 --> 00:08:34,160 Speaker 1: a certainty at this point. You know, they also included 133 00:08:34,200 --> 00:08:39,200 Speaker 1: that category people with asthma, cystic fibrosis, liver disease, people 134 00:08:39,200 --> 00:08:42,400 Speaker 1: who are pregnant, people with type one diabetes. So you 135 00:08:42,440 --> 00:08:45,320 Speaker 1: know the reality is, yeah, a lot of people are 136 00:08:45,360 --> 00:08:48,079 Speaker 1: at risk for this thing, and and we may only 137 00:08:48,120 --> 00:08:53,240 Speaker 1: know later you know, exactly who and you know exactly 138 00:08:53,280 --> 00:08:56,800 Speaker 1: what the consequences are for people who survive COVID nineteen 139 00:08:56,840 --> 00:09:00,520 Speaker 1: as well. So the jury is still out now. As 140 00:09:00,559 --> 00:09:06,040 Speaker 1: you mentioned, population numbers of those who classify as overweight 141 00:09:06,240 --> 00:09:09,480 Speaker 1: or obese are actually quite high in the United States, 142 00:09:09,520 --> 00:09:13,360 Speaker 1: including the President of the United States himself, President Trump. 143 00:09:14,040 --> 00:09:19,520 Speaker 1: How has President Trump's weight potentially affected his experience of 144 00:09:19,679 --> 00:09:24,360 Speaker 1: or recovery from COVID nineteen. It's that's a good point. 145 00:09:24,400 --> 00:09:27,520 Speaker 1: This is a high profile example of exactly what we're 146 00:09:27,520 --> 00:09:30,880 Speaker 1: talking about, right, and um, you know, Trump's position has 147 00:09:30,920 --> 00:09:32,840 Speaker 1: said that he is you know, on the up and 148 00:09:32,960 --> 00:09:35,560 Speaker 1: up here, but it is worth noting that when his 149 00:09:35,640 --> 00:09:38,280 Speaker 1: diagnosis was announced, there was a lot of concern. He's 150 00:09:38,360 --> 00:09:41,400 Speaker 1: pretty squarely in terms of the high risk groups. He's 151 00:09:41,440 --> 00:09:43,960 Speaker 1: pretty squarely there. Right. It's not just b M I, 152 00:09:44,000 --> 00:09:47,839 Speaker 1: although he's you know, clinically considered obese, but it's also 153 00:09:48,200 --> 00:09:50,440 Speaker 1: his age, it's the fact that he's a male. You know. 154 00:09:50,559 --> 00:09:52,280 Speaker 1: I'm not sure we know that much more about the 155 00:09:52,280 --> 00:09:56,240 Speaker 1: President's health, but I think it's important to note, you know, 156 00:09:56,320 --> 00:10:00,000 Speaker 1: he had a pretty aggressive treatment regiment, and it's sparked 157 00:10:00,040 --> 00:10:03,120 Speaker 1: concerns that maybe he was sicker than we were being told. 158 00:10:03,160 --> 00:10:05,120 Speaker 1: You know, he was taken to the hospital. You know, 159 00:10:05,200 --> 00:10:07,920 Speaker 1: we know he was treated with pretty much almost all 160 00:10:07,960 --> 00:10:11,080 Speaker 1: the drugs you can treat a COVID nineteen patient with 161 00:10:11,320 --> 00:10:15,600 Speaker 1: its DECKS and Methodzone, which is a steroid uh from Dezevie, 162 00:10:15,760 --> 00:10:18,880 Speaker 1: which is a drug that's it's shown to help people 163 00:10:18,920 --> 00:10:22,760 Speaker 1: who are who are hospitalized. Um, and an experimental drug 164 00:10:22,800 --> 00:10:26,400 Speaker 1: from Regeneron that's an antibody cocktail. How might this new 165 00:10:26,520 --> 00:10:31,600 Speaker 1: risk of being overweight factor into the development and even say, 166 00:10:31,640 --> 00:10:36,600 Speaker 1: the efficacy of a COVID nineteen vaccine. Yeah, it's an 167 00:10:36,679 --> 00:10:40,240 Speaker 1: important subject, right. We've been talking about vaccine development for 168 00:10:40,280 --> 00:10:44,160 Speaker 1: so many months now, and what we know is that 169 00:10:44,240 --> 00:10:48,920 Speaker 1: vaccines can be less effective for obese people. So we 170 00:10:48,960 --> 00:10:51,920 Speaker 1: know that specifically with the flu vaccine for instance, And 171 00:10:51,960 --> 00:10:54,920 Speaker 1: this does raise questions about, you know, how should development 172 00:10:54,960 --> 00:11:00,839 Speaker 1: be handled of these vaccines for certain subgroups like these people? Right? 173 00:11:00,920 --> 00:11:03,240 Speaker 1: You know, is there a need for vaccine developers to 174 00:11:03,320 --> 00:11:06,320 Speaker 1: look more specifically at how obese people do in these 175 00:11:06,360 --> 00:11:09,840 Speaker 1: trials and see if these vaccines actually work as well 176 00:11:09,880 --> 00:11:13,000 Speaker 1: for them? Um? You know, we are still far from 177 00:11:13,040 --> 00:11:16,280 Speaker 1: having a clear answer that any vaccine really works at all. Um. 178 00:11:16,320 --> 00:11:18,640 Speaker 1: But that's going to be an important part in rolling 179 00:11:18,640 --> 00:11:22,000 Speaker 1: out this whole thing, because this is a large segment 180 00:11:22,040 --> 00:11:25,040 Speaker 1: of the American population. Again, as as I've said a 181 00:11:25,040 --> 00:11:29,079 Speaker 1: couple of times now, now many pharmaceutical companies have announced 182 00:11:29,120 --> 00:11:32,320 Speaker 1: that they are in trials and late stage trials of 183 00:11:32,400 --> 00:11:36,720 Speaker 1: a potential vaccine, and they have been testing this vaccine 184 00:11:36,840 --> 00:11:42,160 Speaker 1: on numerous groups. Do we know if they are specifically 185 00:11:42,200 --> 00:11:46,880 Speaker 1: testing their proposed vaccine on groups that are overweight or 186 00:11:46,920 --> 00:11:51,280 Speaker 1: even obese. It's a good question. We know that they're 187 00:11:51,360 --> 00:11:54,160 Speaker 1: at least thinking about it. Um. You know, along with 188 00:11:54,200 --> 00:11:58,640 Speaker 1: this question of diversity of clinical trial population and an 189 00:11:58,679 --> 00:12:02,160 Speaker 1: age of clinical trial population, it's not totally clear that 190 00:12:02,200 --> 00:12:04,680 Speaker 1: companies are going to say we need to have you know, 191 00:12:04,800 --> 00:12:09,520 Speaker 1: sevent of clinical trial participants be obese for instance. Um, 192 00:12:09,559 --> 00:12:13,040 Speaker 1: But you know, I spoke with someone involved in the 193 00:12:13,080 --> 00:12:15,960 Speaker 1: work to recruit for these clinical trials and and you know, 194 00:12:16,000 --> 00:12:19,480 Speaker 1: he said, it is likely that because so much of 195 00:12:19,520 --> 00:12:23,400 Speaker 1: the population is obese, that that's going to be represented 196 00:12:23,400 --> 00:12:27,559 Speaker 1: in the trials. In other words, like hopefully, because you 197 00:12:27,600 --> 00:12:31,000 Speaker 1: know so many Americans are obese, this will also translate 198 00:12:31,080 --> 00:12:33,160 Speaker 1: over into into the trials. But you know, we we 199 00:12:33,240 --> 00:12:35,520 Speaker 1: do have reason to worry about this because we know 200 00:12:35,800 --> 00:12:39,440 Speaker 1: pharmaceutical companies try to make their products look as good 201 00:12:39,440 --> 00:12:43,240 Speaker 1: as possible, right, and they want someone who's healthy as 202 00:12:43,240 --> 00:12:46,160 Speaker 1: healthy as possible to be in this trial in order 203 00:12:46,200 --> 00:12:49,040 Speaker 1: to show their their products work. So there is a 204 00:12:49,080 --> 00:12:53,240 Speaker 1: concern that they may be screening for for you know, 205 00:12:53,280 --> 00:12:56,200 Speaker 1: to keep fewer obese people in the in these trials. 206 00:12:56,200 --> 00:12:58,800 Speaker 1: We we don't really have date on that, unfortunately, but 207 00:12:59,000 --> 00:13:01,280 Speaker 1: you know, there's reason to be hopeful and the reason 208 00:13:01,320 --> 00:13:09,880 Speaker 1: to be concerned. I would say that was Emma Cord, 209 00:13:10,360 --> 00:13:12,959 Speaker 1: and that's it for our show today. For coverage of 210 00:13:13,000 --> 00:13:15,600 Speaker 1: the outbreak from one D and twenty bureaus around the world, 211 00:13:16,000 --> 00:13:20,440 Speaker 1: visit Bloomberg dot com slash coronavirus and if you like 212 00:13:20,520 --> 00:13:22,840 Speaker 1: the show, please leave us a review and a rating 213 00:13:23,080 --> 00:13:26,560 Speaker 1: on Apple Podcasts or Spotify. It's the best way to 214 00:13:26,600 --> 00:13:31,880 Speaker 1: help more listeners find our global reporting. The Prognosis Daily 215 00:13:32,000 --> 00:13:36,600 Speaker 1: edition is produced by Tover foreheads Jordan Gaspore, Magnus Hendrickson 216 00:13:36,800 --> 00:13:41,120 Speaker 1: and me Laura Carlson. Today's main story was reported by 217 00:13:41,120 --> 00:13:45,920 Speaker 1: Emma Cord. Original music by Leo Sidrin. Our editors are 218 00:13:46,040 --> 00:13:50,800 Speaker 1: Rick Shine and Francesco Levi. Francesco Levi is Bloomberg's head 219 00:13:50,800 --> 00:13:53,079 Speaker 1: of podcasts. Thanks for listening.