As a public health physician and epidemiologist, I’ve learned a lot of lessons during this pandemic. But the importance of preventive health was probably the most striking. It became clear relatively early on, that countries with healthier populations, with fewer underlying conditions like obesity, were much more likely to weather the pandemic without high levels of hospitalization and death. Because when it came to coronavirus, regardless of age, a person’s underlying health mattered: people with pre-existing underlying conditions had worse outcomes if they became infected with COVID-19. In other words, this pandemic was the epitome of “survival of the fittest.” And unfortunately, the U.S. population just wasn’t that fit to start with.
To begin with, the United States has one of the highest obesity rates in the world. Even in younger people, obesity is not only associated with worse COVID outcomes, but it can also lead to high blood pressure, diabetes, cancer, heart disease, and a variety of other conditions that worsen COVID (or are deadly on their own).
On top of that, many people with high blood pressure, diabetes, or cancer don’t even know they have the condition. For example, according to the CDC’s 2020 report on diabetes, nearly one in five adults living with diabetes in the U.S. didn’t know they had the condition. In addition, of the estimated 88 million American adults with pre-diabetes (abnormally high blood sugars bordering on the diabetic range), nearly 85 percent were unaware of their condition. As for hypertension, CDC estimates that 45 percent of adults in the United States have high blood pressure, and about 20 percent of them don’t know it.
So these people likely had no idea that they were at higher risk for severe COVID illness. This could have impacted how seriously they took coronavirus prevention measures like mask-wearing and distancing, or getting vaccinated. And now, with the Delta variant, the situation is becoming more dire. While the vast majority of those getting severely ill with Delta are unvaccinated, we see more and more breakthrough infections among the fully vaccinated. And one recent study in Israel examined characteristics of fully vaccinated people who were hospitalized and found that the majority had chronic co-morbidities, like hypertension and diabetes.
In other words, we need to focus on preventive health – and fast. We need this not only to get through the rest of the pandemic, but to prevent terrible outcomes once it’s over.
Here are some preventive health measures to consider right now:
1. Control your weight. Many of us gained the proverbial “COVID-19” in terms of weight during the pandemic – due to the stockpiling of processed, non-perishable foods and restricted access to gyms. If this describes you, then then it’s time to proactively lose that weight. Excess weight gain puts you at risk for diabetes, high blood pressure, and a whole host of other conditions. And of course, it can be difficult and confusing to figure out how to lose weight, so reaching out to your primary care provider can help you get referrals to nutritionists or other support that may work best for you.
2. Get screened. Many people skipped their routine screenings last year because of the pandemic, but this is the time to do it. Could you possibly have high blood pressure or be pre-diabetic and not know it? It’s certainly possible if you experienced a lot of weight gain over the pandemic. Talk to your doctor about getting screened for these conditions and others (think cancer screenings you may have missed). If you got the COVID vaccine, be sure to tell your doctor before getting a mammogram because the vaccine can cause some swelling that could cause a false reading on your mammogram. Also, note that a federal panel recently lowered the age of recommended colonoscopies to 45 from 50, so talk to your doctor about what’s right for you.
3. Get social. Mental health suffered during the pandemic, and social isolation was a leading contributor. Ending that social isolation can be a big relief. So if you are vaccinated, and have vaccinated friends and family, visit them! Hang out with them outdoors! If you are not vaccinated, strongly consider getting the vaccine to increase your ability to socialize with others. And don’t be afraid to reach out for professional help if you need it. And if you’re having trouble getting an appointment, look to the many virtual mental health options that have emerged to meet the growing demand. Or consider talking to your employer or your health plan since many are now offering virtual behavioral health services as well.
As a country, we can no longer give lip service to preventive health. The time to take care of ourselves is now. As an individual, each person should take charge of his/her own preventive health. And health care providers should more proactively address the importance of prevention with their patients. Because there will be another pandemic or health crisis in the future, and the healthier we are now, the better we’ll be able to handle it.
Tista S. Ghosh is an internal medicine physician and epidemiologist.
Image credit: Shutterstock.com
