More than half of county residents may face complications if they contract SARS-CoV-2, the virus that causes the COVID-19 illness. Data analysis by county epidemiologists found 57% of San Diegans have at least one factor, such as age, heart or — not surprisingly — lung disease, that increases their risk during the pandemic.
Local pulmonologist Dr. Ni-Cheng Liang said lung diseases like asthma and chronic bronchitis restrict airways that can become further inflamed by coronavirus.
“That is a fabulous set up for another viral respiratory infection to basically take hold and cause even more inflammation, even more airway constriction, narrowing the opening of that airway, even more mucus secretion, causing more blockage in that airway opening,” said Liang, a volunteer physician and regional committee member for the American Lung Association chapter in San Diego.
Liang, director of pulmonary integrative medicine at Scripps Health partner Coastal Pulmonary Associates, said impact can be minimized if people manage their conditions well, but inflammation is also a risk factor for patients with obesity or disorders of other organs and that can weaken the body’s defense.
“Some of the times that underlying inflammation can go beyond that particular organ and so the protoplasm of the person who has that chronic underlying condition isn’t as strong, so the immune system becomes affected,” she said.
San Diego County’s top public health official Dr. Wilma Wooten says a large part of the local population is walking around with disorders that make them more vulnerable.
“Nearly 6 out of every 10 San Diegans, and these are particularly adults 18 years of age and older, have a pre-existing condition, including hypertension as well as obesity,” Wooten said.
Wooten pointed to a recent report from the Centers for Disease Control and Prevention that found 40.7% of American adults suffered from at least one of five medical issues: chronic obstructive pulmonary disease or COPD, heart conditions, diabetes, chronic kidney disease and obesity.
The CDC said it has strong evidence that these five conditions, plus cancer, sickle-cell and being immunocompromised because of an organ transplant, greatly increases a person’s risk of being hospitalized from COVID.
The federal health agency also said there may be a slight increase in risk caused by a handful of other factors, including asthma, smoking, pregnancy and hypertension, but research is mixed or limited.
The county said its calculation included cancer, COPD, diabetes, high blood pressure, diseases of the heart, kidneys and liver and those who are immunocompromised/immunsupressed or overweight/obese. A spokesman said staff also included those aged 65 years or older and smoking/vaping behavior in their analysis.
The information comes from local surveys and databases, a spokeswoman said.
The county doesn’t regularly provide whether the hundreds of San Diegans currently hospitalized for COVID have underlying conditions, but it has reported that about 95% of people who died from the illness had other medical issues.
Back in May, county officials provided data that showed high blood pressure was one of the top conditions among people who died. Federal estimates project the condition afflicts almost half of the adults in the country and more than 60 million people don’t have it under control.
County Supervisor Jim Desmond has been critical of COVID fatalities among patients with underlying conditions and has said those who died and without pre-existing disorders are the only “pure, solely coronavirus deaths.” Still, he said vulnerable populations should be protected, especially to reopen the region’s economy.
“We need to learn to live with the virus and we have to protect those that are most susceptible,” Desmond said. “People that are elderly are passing away...we can't do anything about age, but we can do something about these underlying conditions.”
He said he wants to better raise awareness about how people with chronic diseases can protect themselves during the age of COVID. He plans to introduce a proposal at next week’s county board of supervisors meeting.
