- Biologic environments introduce variability in the system. Therefore, the HCDS efficiency will need to be flexible to diversity. Unfortunately, flexibility and efficiency counteract each other at industrial levels (Adler et al., 1999; AHRENS & CHAPMAN, 2004), and thus inefficiency is to be expected.
- Efficiency can be measured at two points:
- Efficiency of delivery
- Efficiency of outcome
There is evidence emerging of Covid-19 mutation. This may explain the difference between the severity and intesity of the disease presented in the those geographical locations where the disease first.
Scientists from The Scripps Research Institute, Jupiter, Florida have identified changes in the Spike protein. This protein is used to bind the virus to host membranes. As we now know Florida is one of the few hot spots of the Covid-19 pandemic.
This has significant implications for the long term strategy needed to control transmission and manage resurrgence.
Until there is effective vaccination or effective treatment available for everyone, prevention by wearing face mask is the most efficient form to avoid transmistion.
The facts are that the most consistent effective preventive measures are wearing face masks and physical distancing.
There are those who may feel invincible and think that you will 1. either not get the disease or even if you get it it will 2-not affect your health. Lets first remind ourselves that wearing a mask is more to prevent passing the virus that getting it. We should all assume that someone that we come in contact with may already have it. Would you like them to breath the virus toward you ? This then brings the second issue: We do not know what the long term health effect of the virus is for those who develop significant symptoms and those who are asymtphomatic.
Let’s look at other viral infections that provide either no or minimal disease condition at the time of initial exposure only to result in long term health conditions that may result in death. These include hepatitis and HIV exposures and infections. Admitedly Coronavirus is a differnt family of virus. I am not suggesting that this will behave like other family of the viruses. We just do not have enough information to know what happens to those exposed to the virus (regardless of being asymptotic or not). Could the virus become dormant and over time result in organ injury (lung) like in the case of hepatitis (liver). Or make a home in our body and have recurrent debilitating infections and symptoms as it is seen with Varicella-zoster virus (VZV) which causes chickenpox and the time of the initial infection and makes residence in our body to reappear later on as herpes zoster (shingles). Will we need a new strain of vaccine every year similar to the flu vaccine?
That is the crux. We do not know because the COVID virus is new and we do not know the long term effects.
We have now seen several articles with data collection regarding patients with obesity and COVID-19 being at greater risk of hospitalization. We can look at metabolic syndrome associated with obesity as a risk factor also.
We have all been in physical isolation due to Covid-19 pandemic. The strategy of minimizing contact has worked. The data is clear when comparing information from states that instituted an aggressive containment plans compared to those who have not. This shows a sigifnicat flattening of the curve in California for example.
The CDC publishes the Morbidity and Mortality Weekle Report (MMWR) . The latest publushed summary (as of date of publucation of this blog) provides an insight to the risk factors of hospitalization.
Concerning to see that a respiratory virus is more likely to hospitalize those with Obesity, Diabetes and hypertension at a higher rate than lung and pulmonary related conditions.
Let us recognize that this is only a summary collected data. Therefore, there are limitatation to making any assumption of conclusion based on this information.
With those limitation aknowldged, and relying on our obesity related comobidities, we can make a few conclusions:
Not surprising, Obesity as with other diseases, compounds Covid-19 exposure and infection. Diabates is also a risk factor. There are no indepth information available on the diabetic patients. There is now data showing superior outcome of diabetes resoultion with weight loss surgery compared ro medical treatment.