Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day two hundred
Speaker 1: and twelve since coronavirus was declared a global pandemic. Today's
Speaker 1: main story. While scientists have known for a while that
Speaker 1: obesity is a risk factor for COVID nineteen, the CDC
Speaker 1: put out guidance this week suggesting even more people should worry.
Speaker 1: It turns out that just being overweight could be enough
Speaker 1: to make you vulnerable to severe COVID complications. But first,
Speaker 1: here's what happened in virus News today. Today it brought
Speaker 1: more mixed messages about the status of a coronavirus relief
Speaker 1: bill in Washington. After shutting down talks earlier this week,
Speaker 1: President Donald Trump approved a revised economic stimulus offer that's
Speaker 1: according to its top economic advisor, Larry Cudlow, but it
Speaker 1: is unlikely Congress will agree to it. Senate Majority Leader
Speaker 1: Mitch McConnell said the differences are probably too big and
Speaker 1: the time is too short for Congress to agree on
Speaker 1: a new comprehensive stimulus package before the election. Despite President
Speaker 1: Donald Trump's renewed interest in striking a deal, the rate
Speaker 1: of coronavirus infection in England almost doubled in a week.
Speaker 1: It's adding to concerns that a fresh surge of the
Speaker 1: pandemic is spreading throughout the country. One in every two
Speaker 1: hundred and forty people is infected. That's up from one
Speaker 1: in four hundred and seventy a week earlier, according to
Speaker 1: the Office for National Statistics. The figures come as the
Speaker 1: UK government prepares to announce new restrictions for the worst
Speaker 1: hit parts of the country, potentially including the closing of
Speaker 1: restaurants and bars. Finally, the Spanish government declared a state
Speaker 1: of emergency for the Madrid region, as Europe's leaders step
Speaker 1: up efforts to contain an unrelenting surge in coronavirus cases
Speaker 1: across the continent. Prime Minister Pedro Sanchez's government made the
Speaker 1: decision at a special cabinet meeting on Friday. The premier
Speaker 1: is struggling to impose his authority on regional officials who
Speaker 1: have resisted restrictions on movement. Declaring a state of emergency
Speaker 1: gives the Spanish leader extraordinary powers to order new constraints
Speaker 1: and now for today's main story. Obesity is a known
Speaker 1: risk factor for severe complications of COVID nineteen, but scientists
Speaker 1: are learning that the link between extra pounds and severe
Speaker 1: COVID nineteen is even strong younger than they thought. This week,
Speaker 1: the US Centers for Disease Control and Prevention said that
Speaker 1: people who are merely overweight, not just the OBEs, maybe
Speaker 1: at high risk of serious disease from the infection. The warning,
Speaker 1: posted on the agency's website on Tuesday means about two
Speaker 1: thirds of Americans could face higher risks. I spoke with
Speaker 1: health reporter and a court about what it means that
Speaker 1: more people than previously thought could be vulnerable. So why
Speaker 1: would just having a few extra pounds make you that
Speaker 1: much more susceptible to serious complications from COVID nineteen. You know, Laura,
Speaker 1: it's a really good question. The evidence is still emerging,
Speaker 1: even on the subject of the risk of sort of
Speaker 1: having some extra pounds. You know, we already knew that
Speaker 1: people who were OBEs, you know, were at higher risk
Speaker 1: and are at higher risk for having severe cases of
Speaker 1: COVID nineteen. And this is something you know, doctors noticed
Speaker 1: pretty early in the pandemic that they were seeing obese
Speaker 1: people coming into the hospital, you know, being hospitalized at
Speaker 1: higher rates um And so this is something that's been
Speaker 1: established for a period of months. Now what's new is
Speaker 1: that the CDC is now saying we have some data
Speaker 1: to believe people who are overweight could also be at
Speaker 1: risk for serious forms of COVID nineteen. And I mean
Speaker 1: that's a pretty big deal because and we're talking about
Speaker 1: you know, nearly seventy two percent of American adults are
Speaker 1: overweight or obese. It's about forty of American adults are
Speaker 1: obese and then about or overweight. So that's a big
Speaker 1: population here, and that brings up a good point of
Speaker 1: how is the CDC assessing those who are defined as
Speaker 1: overweight or obese. Yeah, so we're going straight to b M. I.
Speaker 1: You know, body mass index, which is basically just a
Speaker 1: way of measuring your your weight and your height, you know,
Speaker 1: and coming up with an index. So it's overweight people
Speaker 1: have a body mass index of twenty five to thirty
Speaker 1: and obesity is a thirty and higher. So you know
Speaker 1: that example you could give us. You know, if you're
Speaker 1: a man, you're five ft eleven inches, you weigh two
Speaker 1: hundred pounds, you're considered overweight, you gain twenty five pounds.
Speaker 1: Let's say you're you're considered obese and you know, there
Speaker 1: are a lot of issues with b m I as
Speaker 1: a as a measure, but it is the measure that
Speaker 1: we have right now for for thinking about people's weight. Um.
Speaker 1: And that's what the studies that the CDC used to
Speaker 1: make this determination looked at. They looked at COVID nineteen
Speaker 1: outcomes and b m I and they found this connection,
Speaker 1: you know, as b m I went up between that
Speaker 1: and more severe COVID nineteen outcomes. And and how does
Speaker 1: this differ, say from some of the other comorbidity ease
Speaker 1: of COVID nineteen. What what is actually the risk? You know?
Speaker 1: We we do know just in general that having you know,
Speaker 1: a little extra weight or or you know, a good
Speaker 1: amount of extra weight can be tied to these negative
Speaker 1: health outcomes. And that's what's made actually untangling this question
Speaker 1: about obesity so complicated because people who are are obese
Speaker 1: often have other medical conditions right that we know put
Speaker 1: you at risk for COVID nineteen. UM. You know, things
Speaker 1: like maybe uh, you know, diabetes, for instance, But we
Speaker 1: we know that obesity seems to put you at even
Speaker 1: higher risk than even just looking at those medical conditions
Speaker 1: a person may have. In general, we know that these
Speaker 1: metabolic changes tie to access weight can reduce the immune
Speaker 1: systems ability to fight disease. Um. That's what I spoke
Speaker 1: to nutrition professor about. And you know that there are
Speaker 1: other reasons that people who who are obese could have
Speaker 1: worse health outcomes with COVID nineteen, things like reduced lung
Speaker 1: capacity and sleep apnea. You know, I think the scientists
Speaker 1: is still emerging on this one, but there has been
Speaker 1: this concerning trend identified by researchers, which is at people
Speaker 1: with higher b m I s do seem to have
Speaker 1: these more difficult experiences with COVID nineteen. And I think
Speaker 1: what we should really take away from from this, even
Speaker 1: though the science is still emerging, as I've said, is
Speaker 1: that you know, this idea of who is at risk,
Speaker 1: I think people like to downplay it and like to
Speaker 1: silo it and say, oh, it's just people with other
Speaker 1: medical conditions. I'm healthy, it's all good. And I think
Speaker 1: you know, first of all, people who have medical conditions,
Speaker 1: you know, like diabetes, are people, and it's concerning that
Speaker 1: they would be more at risk for this number one.
Speaker 1: But number two, you know, we're now talking about potentially
Speaker 1: the near vast majority of Americans who could be at
Speaker 1: greater risk from COVID nineteen. So you know, to say, oh,
Speaker 1: it's just you know this person or that person, like
Speaker 1: this is a lot of people we're talking about now here.
Speaker 1: And what about the inverse argument that now everyone, it seems,
Speaker 1: is at high risk for serious complications from COVID nineteen.
Speaker 1: If you look at how the CDC has presented this information,
Speaker 1: they're saying, we know that obese people are at increased
Speaker 1: risk of having serious COVID nineteen. You know, along in
Speaker 1: that category as people with cancer, people with cp D,
Speaker 1: you know, heart conditions, people who are immun compromise, smokers,
Speaker 1: people with type two diabetes. Right. Uh. And then if
Speaker 1: you look at being overweight, which they say there's a
Speaker 1: little bit less data for, and so they're you know,
Speaker 1: people who are overweight maybe at increased risk, it's not
Speaker 1: a certainty at this point. You know, they also included
Speaker 1: that category people with asthma, cystic fibrosis, liver disease, people
Speaker 1: who are pregnant, people with type one diabetes. So you
Speaker 1: know the reality is, yeah, a lot of people are
Speaker 1: at risk for this thing, and and we may only
Speaker 1: know later you know, exactly who and you know exactly
Speaker 1: what the consequences are for people who survive COVID nineteen
Speaker 1: as well. So the jury is still out now. As
Speaker 1: you mentioned, population numbers of those who classify as overweight
Speaker 1: or obese are actually quite high in the United States,
Speaker 1: including the President of the United States himself, President Trump.
Speaker 1: How has President Trump's weight potentially affected his experience of
Speaker 1: or recovery from COVID nineteen. It's that's a good point.
Speaker 1: This is a high profile example of exactly what we're
Speaker 1: talking about, right, and um, you know, Trump's position has
Speaker 1: said that he is you know, on the up and
Speaker 1: up here, but it is worth noting that when his
Speaker 1: diagnosis was announced, there was a lot of concern. He's
Speaker 1: pretty squarely in terms of the high risk groups. He's
Speaker 1: pretty squarely there. Right. It's not just b M I,
Speaker 1: although he's you know, clinically considered obese, but it's also
Speaker 1: his age, it's the fact that he's a male. You know.
Speaker 1: I'm not sure we know that much more about the
Speaker 1: President's health, but I think it's important to note, you know,
Speaker 1: he had a pretty aggressive treatment regiment, and it's sparked
Speaker 1: concerns that maybe he was sicker than we were being told.
Speaker 1: You know, he was taken to the hospital. You know,
Speaker 1: we know he was treated with pretty much almost all
Speaker 1: the drugs you can treat a COVID nineteen patient with
Speaker 1: its DECKS and Methodzone, which is a steroid uh from Dezevie,
Speaker 1: which is a drug that's it's shown to help people
Speaker 1: who are who are hospitalized. Um, and an experimental drug
Speaker 1: from Regeneron that's an antibody cocktail. How might this new
Speaker 1: risk of being overweight factor into the development and even say,
Speaker 1: the efficacy of a COVID nineteen vaccine. Yeah, it's an
Speaker 1: important subject, right. We've been talking about vaccine development for
Speaker 1: so many months now, and what we know is that
Speaker 1: vaccines can be less effective for obese people. So we
Speaker 1: know that specifically with the flu vaccine for instance, And
Speaker 1: this does raise questions about, you know, how should development
Speaker 1: be handled of these vaccines for certain subgroups like these people? Right?
Speaker 1: You know, is there a need for vaccine developers to
Speaker 1: look more specifically at how obese people do in these
Speaker 1: trials and see if these vaccines actually work as well
Speaker 1: for them? Um? You know, we are still far from
Speaker 1: having a clear answer that any vaccine really works at all. Um.
Speaker 1: But that's going to be an important part in rolling
Speaker 1: out this whole thing, because this is a large segment
Speaker 1: of the American population. Again, as as I've said a
Speaker 1: couple of times now, now many pharmaceutical companies have announced
Speaker 1: that they are in trials and late stage trials of
Speaker 1: a potential vaccine, and they have been testing this vaccine
Speaker 1: on numerous groups. Do we know if they are specifically
Speaker 1: testing their proposed vaccine on groups that are overweight or
Speaker 1: even obese. It's a good question. We know that they're
Speaker 1: at least thinking about it. Um. You know, along with
Speaker 1: this question of diversity of clinical trial population and an
Speaker 1: age of clinical trial population, it's not totally clear that
Speaker 1: companies are going to say we need to have you know,
Speaker 1: sevent of clinical trial participants be obese for instance. Um,
Speaker 1: But you know, I spoke with someone involved in the
Speaker 1: work to recruit for these clinical trials and and you know,
Speaker 1: he said, it is likely that because so much of
Speaker 1: the population is obese, that that's going to be represented
Speaker 1: in the trials. In other words, like hopefully, because you
Speaker 1: know so many Americans are obese, this will also translate
Speaker 1: over into into the trials. But you know, we we
Speaker 1: do have reason to worry about this because we know
Speaker 1: pharmaceutical companies try to make their products look as good
Speaker 1: as possible, right, and they want someone who's healthy as
Speaker 1: healthy as possible to be in this trial in order
Speaker 1: to show their their products work. So there is a
Speaker 1: concern that they may be screening for for you know,
Speaker 1: to keep fewer obese people in the in these trials.
Speaker 1: We we don't really have date on that, unfortunately, but
Speaker 1: you know, there's reason to be hopeful and the reason
Speaker 1: to be concerned. I would say that was Emma Cord,
Speaker 1: and that's it for our show today. For coverage of
Speaker 1: the outbreak from one D and twenty bureaus around the world,
Speaker 1: visit Bloomberg dot com slash coronavirus and if you like
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Speaker 1: help more listeners find our global reporting. The Prognosis Daily
Speaker 1: edition is produced by Tover foreheads Jordan Gaspore, Magnus Hendrickson
Speaker 1: and me Laura Carlson. Today's main story was reported by
Speaker 1: Emma Cord. Original music by Leo Sidrin. Our editors are
Speaker 1: Rick Shine and Francesco Levi. Francesco Levi is Bloomberg's head
Speaker 1: of podcasts. Thanks for listening.