Covid Contiki Tour Part 2

Part 2 of our Covid Contiki tour is here! We're continuing our whirlwind trip around the world to see what the data tells us about the relationship between body size and COVID-19. Diet culture is busily creating a narrative that being larger is a huge risk factor for contracting, developing complications, and even dying from the virus, and our BS detectors are UP! Alongside my fellow travel guides Jess Campbell (nutritionist and medical student) and Fiona Willer (anti-diet dietitian and statistical warrior), we're diving deep into the data to reveal the real picture - and the truth is VERY DIFFERENT from the headlines! In Part 1 we visited China and the USA, and in this episode we're off to France, Italy, and the UK. What we find will blow your mind! This is a MUST LISTEN! CW - this episode discusses severe illness and death, and mentions the "O" word multiple times. If you're finding it all a bit much, wait until you've got some gas in the tank. But if you're ready to get totally fired up about how weight bias is impacting our understanding of this pandemic, let's go!

Shownotes

We’re back, and we’re heading to France! There’s a study out of France that’s again being used to push this idea of BMI being related to not just hospitalisation but seriousness of the COVID19 illness, such as the need for intensive interventions such as ventilation. It’s a small study with the title “Obesity is an independent risk factor for severe COVID 19”. So, it’s upping the ante in this article to claim that body size is an independent risk factor for severity, or how sick you get with COVID 19. The study is of 124 patients who were admitted to the ICU in a hospital in Lille, France. What the New York Times article mentioning this study said was that nearly half of the 124 patients in this study were ‘obese’ (Louise is feeling some fatigue at saying the ‘o’ word). They say that this is twice the obesity rate of a comparison group admitted to ICU for other reasons last year. It also claimed that as people's body weight went up, so did their need for ventilation. Things to look at in this paper - who were the people being admitted? 73% were male, average age 60. The study controlled for age, diabetes and hypertension, but didn’t control for other factors which have been found to be really important here - things like smoking, cardiovascular disease, cancer, chronic respiratory disease. There’s no mention either in this paper of social disadvantage. Lille in France is a working class city with a really high poverty rate, so 1 in 4 people in Lille live below the poverty line. That fact isn’t mentioned anywhere in the paper or in the New York Times article. If you read something about body size and COVID symptom severity, you are not being told the full picture when it comes to health and what impacts on our health and our ability to fight back and recover from an infection which we have no immunity for. Next stop, Italy! Italy has been hit so incredibly hard by COVID, we’re seeing a huge impact there and some horrible statistics on death rates. They’ve managed to get some data together and put out some papers, which is an amazing effort. A paper released recently on the 20th of April 2020 looks at outcomes (deaths) and is pretty heavy-going. It’s a large study, including 21,500 people who died. It digs into the relationship between body weight and death outcomes, seriousness of outcomes, demographics and things like that. Jess takes us through it - this study is of 21,551 COVID deaths, but the data that they had about coexisting conditions was based on a limited sample of 1,890 people. So, that’s the number of people they could access medical files for. We have no idea if what we’re seeing in this paper is actually representative of everyone who dies. There’s a lot of missing data, all we’ve got is 8.7% of the total reported. So, in the total (21,551), 35.5% were female. In the smaller coexisting conditions sample (n=1890), 31.9% were f