Chapter 1
Body
It happened on a public bus in Detroit.
A woman coughed repetitively. She didnât cover her mouth. She didnât seem to have any concern for others.
Jason Hargrove was driving that bus in March 2020. He was so angered by the incident that afterward he posted an eight-minute-long video on Facebook about what happened, pleading with people to take seriously what we were calling the novel coronavirus.
Eleven days later, Jason was dead from COVID-19. The fifty-year-old father of six died alone in the hospital, without his wife or any of his children by his side.
Days later, his widow, Desha Johnson Hargrove, appeared on Good Morning America to share his story, which had already made headlines around the world. Speaking exclusively with correspondent T. J. Holmes, she begged people to stay at home and take the recommended precautions so that her husbandâs death wouldnât be in vain.
Months later, Desha told me that she still felt people werenât taking the pandemic seriously. âThis is not a norm that anyone thought weâd see, but this is where we are,â she told me by phone. âAnd I want to help anyone from being in the spot that I am right now.â
Desha is right. This is not a norm any of us ever thought weâd see. Itâs a new normal. But we now know a lot more than we did in March 2020. And we know that there are specific, impactful steps we can take to avoid ending up in the same spot Desha has found herself in: severely impacted by COVID-19. We can take precautions like wearing masks and physically distancing to help prevent others from getting seriously ill or dying from the disease. We can also take precautions that go way beyond wearing a cloth face covering to keep ourselves from getting very ill.
From a doctorâs perspective, I know that Jason had several risk factors that made him more vulnerable to serious illness with COVID-19. He was a black man, and we now know that people of color and men, in general, are more likely to develop severe complications from the virus. He also worked an essential job that put him at risk during the height of the early outbreak.
While Jason couldnât change his gender or his color, he had other risk factors that we have since learned likely made him more vulnerable to the virus. Desha told me that her husband was overweight and diabetic and had high blood pressureâthree of the biggest predictors of serious COVID-19 complications that people can potentially change. By the time researchers discovered this about the virus, it was too late for Jason. But itâs not too late for everyone else.
âThis virus is taking no prisoners,â she told me. âAnd if you have these underlying issues, you could be affected. People who are obeseâwe can manage that. We can take control of that.â
Desha told me she is also overweight and now doing everything she can to make sure her story doesnât end like her husbandâs did. âGet out there and go for a walk. Drink your water. Eat healthier,â she told me. âAnd Iâm talking to me, Desha, because I donât want to be another Jason story. I canât just give a messageâI have to be the message.â
Deshaâs story is powerful. Itâs also all too common. The majority of coronavirus patients featured on Good Morning America have been overweight or obese. Many have suffered from diabetes, high blood pressure, or other chronic conditions. Similarly, the majority of those whom Iâve known personally whoâve been hospitalized or died from the disease were black, overweight or obese, and/or had underlying conditions.
Itâs a difficult truth to face, but as more time has passed, and living with the virus has become our new way of life, we have a clearer understanding of the preexisting health issues that are most available to exploitation by the virus. Now that we know what will make us more susceptible to the virus, itâs up to us to do something about it and try everything in our power to get these conditions under control. Health risks like diabetes and obesity donât mean the same things that they used toânow they are much more concerning. Jason didnât have a choiceâthe science didnât exist when he became infected. But you do, and nowâs the time to be proactive about your health and your ability to survive and thrive in the worldâs new normal.
One of the most critical lessons Iâve learned after almost a year of reporting daily on national TV about COVID-19 is this: Doing everything you can to be as healthy as you can possibly be right now is one of the best ways to pandemic-proof your body and adapt physically to the additional health risks that COVID-19 carries. As a practicing doctor for the past twenty years, I know that every single person on the planet, you included, has ways and means of mitigating disease risk, whether weâre talking about cancer, coronavirus, or some other microorganism that makes up the worldâs next pandemic. I donât need to know everything about a specific pathogen or your individual medical history per se to know ways in which to help you minimize the negative effects of disease.
That said, after incessant reading of the top studies conducted on the coronavirus to date, talking with the worldâs top infectious disease specialists, and distilling what I find to millions of ABC News viewers almost daily, I know that there are specific conditions that make us much more vulnerable to COVID-19âand specific steps we can take to significantly reduce our risk.
If youâve been lucky enough to avoid the virus so far, thatâs fantastic. But if weâve learned anything since New Yearâs Eve of 2019, when the first case of COVID-19 was identified in Wuhan, China, itâs that the coronavirus works in mysterious ways, striking in widely disparate degrees of severity at any time, no matter who you are, where you live, or how much money you make.
I often use analogies on air when I talk about healthcare because medicine is complicated. So here are some others ways to look at it. Letâs say that, in one or two monthsâ time, youâre asked to do something that will take all your energy, like run an Olympic race, give a high-stakes presentation at work, or take a final exam. If you know that youâll be put to the test in this way, would you start doing everything now to prepare? Or would you wait until you were toeing the starting line, standing in front of your entire office, or sitting down for the test to start getting ready?
Preparation is the name of the game in pandemic times, as we have no idea if and when we could get infected and how severely we might react. While doctors like me have been warning people for years that we should focus on our overall health and weight, the need has never been more urgent. I know youâve heard beforeâlikely many times over the yearsâhow important it is to prioritize your health and take better care of yourself, but that advice means something different today than it did in 2019. We have to do everything possible nowâtrain for that race, prepare for the presentation, study for the finalâin order to improve our chances of not only performing our best but also crushing it, if and when our day ever comes.
Consider this your wake-up call. Itâs time to train and to help pandemic-proof your body as much as possible, and Iâm here to show you how.
Weight Loss
Where to start? The single most effective thing you can do to help pandemic-proof your body is to lose weight. Thatâs because being overweight or obese is the biggest chronic risk factor to developing severe COVID-19 complications. Obesity is a bigger risk factor than cancer, heart disease, and other serious illnesses. Itâs even a bigger risk factor than respiratory conditions like asthma, emphysema, and lung disease.
Here are the facts: In August 2020, a meta-analysis that included nearly 400,000 patients found that those who were obese and contracted COVID-19 were 113 percent more likely than people of healthy weight to be hospitalized, 78 percent more likely to be admitted to the ICU, and 48 percent more likely to die.1 Similarly, an April 2020 study conducted on 4,100 people with COVID-19 in New York City found that obesity was the primary predictor after age of whether someone would get seriously sick from the virus.2 Young people who were obese were also much more likely to be hospitalized with COVID-19, even if they had no other risk factors.3 Subsequent studies have reached the same conclusion, over and over again.
But what is it about obesity thatâs so incendiary for the virus? The truth is, carrying too much weight is a chronic disease state in and of itself, as qualified by the American Board of Obesity Medicine. What this means is that being overweight or obese acts like most other diseases in the body, increasing inflammation, weakening the immune system, and thwarting the bodyâs ability to fight infection. Thatâs all bad news for you if you happen to contract coronavirus, which menaces the body by also driving up inflammation. When you add more inflammation onto chronic inflammation, the body canât take itâit simply starts to shut down.
Compounding this issue is that, if the scales arenât tipping in your favor, youâre more likely to have or to develop type 2 diabetes, high blood pressure, and heart disease, all of which also put you at a much greater risk for severe illness or death from COVID-19.
This is not good news for most people, I understand. Two-thirds of all Americans are overweight or obese. The condition is so widespread, in fact, that if you are overweight, you may think youâre perfectly healthy because everyone around you looks the same. Some of my patients fall into this mindset, and itâs a real problem. Because if you donât realize that youâre walking around with a potentially deadly disease, youâre likely not taking all the precautions you need to now.
I want to make something crystal clear about obesity, however: If you are overweight or obese, you are not to blame. Obesity is not a disease brought on by laziness or lack of discipline. There are genetic, metabolic, nutritional, hormonal, and behavioral components to the condition, along with many other complex factors. Sometimes prescription medication alone can cause excess weight gain. Iâve seen so many of my own patients struggle with this, and I know how difficult the issue can be. And Iâm here to help. I know it may seem like a futile effort or an uphill battle. I know the âIâve tried it all, and nothing worksâ history of many with the conditions of obesity or overweight. This is not a character flawâitâs a medical condition, and now is the time to address it as such, without judgment, blame, or shame.
Being overweight or obese isnât your fault. But no matter what your experience has been like in the past, I want to help you try to continue to make strides to change your situationânow more than ever before, because your life may depend on it. And if you havenât paid attention to your weight, nutrition, or fitness levels before, now is also the time to start doing something about itâSTAT.
Weight loss isnât easyâif it were, there wouldnât be a multibillion-dollar diet industry built around helping people drop anywhere from three to three hundred pounds. But losing weight to lower your risks from COVID-19 is unlike any kind of weight loss youâve tried. Thatâs because dropping pounds for a pandemic isnât the same as getting ready for summer swimsuit season. You donât need to be a size 2 or look like a model to survive and thrive in our new normal. The goal shouldnât be huge, dramatic, and unattainable weight loss. Instead, it should be to get your BMI in a healthy range. If youâre motivated to lose moreâespecially once you get started and realize how good losing weight can feelâthatâs a bonus that will only strengthen your physical and mental arsenal.
Here are ten steps to take to help pandemic-proof your body:
- 1. Assess whether your weight is a problem. If you think you may be overweight or obese, you probably are. In our heart of hearts, most of us know whether our weight is a health problem. To be sure though, go online and calculate your body mass index (BMI)âthe measurement and accompanying scale will indicate if youâre overweight or obese. Your BMI isnât a perfect assessment by any meansâmuscle weighs more than fat, which is why some athletes have immoderately high BMIs. But the measurement has been clinically correlated to specific health outcomes hundreds of times, and itâs one of the best free, readily available measurements we have.
If youâd feel better with a medical diagnosis that youâre overweight or obese, make an appointment with an obesity-medicine physician, your primary-care doctor, or a healthcare provider. You may want to see a doctor at this time anyway, especially if you havenât been to one in more than a year (learn more about a pandemic physical here).
- 2. Drop the blame game. If you are overweight or obe...