Whatever we think we know, we should still question

I keep coming back to my mantra:

We still don't know what is going on with Covid-19.  

Two years in, things are still broadly unsettled.

I had accepted that as a general rule, Covid-19 had a tendency to claim those with co-morbidities, especially those associated with obesity such as diabetes and high blood pressure.  Not completely proved but a lot of evidence to support it.  

Then along comes Neo to call into question even somewhat settled conclusions.

From Obesity and COVID death rates by Neo.

Here’s some recent research on the relation between COVID deaths and obesity:

To identify potential patterns in data, the researchers employed cutting-edge techniques of statistical analyses.

“The main finding from the analysis is a statistically significant positive association between COVID-19 mortality and the proportion of the overweight in adult populations spanning 154 countries,” Beladi said. “This association holds across countries belonging to different income groups and is not sensitive to a population’s median age, proportion of the elderly, and/or proportion of females.”

Beladi added that when the proportion of the overweight people in a country’s adult population is one percentage point higher than the proportion of the overweight in a second country’s adult population, based on this study, it is reasonable to predict that COVID-19 mortality would be 3.5 percentage points higher in the first country than it would be in the second…

They added that on average, the COVID-19 pandemic has been more fatal for adult populations residing in parts of the world characterized by excess body weight.

When I read about this study, something struck me as odd. I once did some research on what the world’s fattest countries are, and the answers surprised me at the time. Those countries are for the most part not places with high COVID tolls. If this research is true, why would that be?

One reason is, of course, that weight is only one factor in COVID deaths and there are many others (including, for example, method of defining and reporting). But still, isn’t it odd that the countries with the fattest populations aren’t the highest in COVID deaths per million? Some of them of course, are small islands such as Tonga and Samoa, which are relatively isolated. But many are Arab countries such as Kuwait, Jordan, Saudi Arabia, the UAR, and Qatar, as well as Turkey, Egypt, and Libya.

Then compare that list of obese countries to this list of COVID deaths per million/population (scroll down a bit to find the chart, and then look at the “Deaths/1M pop” column), country by country. Better yet, compare this much longer and more complete list of countries ranked on obesity (scroll down about 2/3 of the way to find it) to that COVID death rate chart. Your should be able to immediately see that it seems far more haphazard than the study might indicate. Just to take a few examples, Peru has the highest COVID death rate in the world, but it’s on the thinner side as countries go. Bosnia and Herzegovina, next on the list in terms of COVID deaths per million, is even thinner. Hungary, Bulgaria, and Czechia have extremely high COVID death rates and are more or less middling in terms of European obesity rates, which are not all that high to begin with. As for those Arab countries that have very high obesity rates, such as Saudi Arabia, Egypt, and Qatar, their COVID death rates are very low.

Perhaps there’s something I’m missing, but this seems odd to me.

Good questions.  She has some more.

She concludes with this finding.

There’s another clue towards the end of the article, where it says this: “our findings call for immediate and effective regulations (e.g. restrictions on ‘serving’ the market for food and beverages with items, the intake of which can result in the accumulation of excess body weight) that are long overdue.” 

The study was well designed or not (seemingly not).  Regardless, it seems it was, as so often happens, an ideologically biased study.  They found what they were hoping to find.

So, this research indicates that obesity is a driver of lethality rates in the context of Covid-19?  Neo offers some evidence weakening that argument.  

I decide to dig a bit as well.  It is my impression that obesity does correlate with death rates, as this study sought to do.  The issue of badly compromised data quality makes international comparisons difficult.  What counts as a Covid death?  What counts as obese?

We can look within the US.  Doesn't reduce the fact that our data collection, as with most everyone else, is pretty sloppy.  It is claimed that African-Americans,  a demographic with markedly higher obesity rates are also markedly more likely to die of Covid-19 even though they are a somewhat younger demographic than the average.  Using that information we can do a back of the envelope check.

What is the distribution of the American population by race?  From the Census.

Whites - 61.2% of the population

 

Hispanics - 18.7%

 

Blacks - 12.4% 

Asians - 6.0%

Next, obesity rates straight from the CDC, June of 2021.

Whites - 42.2% obese

 

Hispanics - 44.8% obese

Blacks - 49.6% obese

Asians - 17.4% obese

African Americans are the highest, then Hispanic, then whites, then Asian Americans

OK.  What is the distribution of Covid-19 deaths by race?  From Statista:

Whites - 61.5% of Covid deaths versus the population share of 61.2%

 

Hispanics - 17.9% of Covid deaths versus the population share of 18.7%

 

Blacks - 15.1% of Covid deaths versus the population share of 12.4%

Asians - 3.6% of Covid deaths versus the population share of 6.0%

White Covid deaths are basically in line with their population share as are Hispanics (on average a younger demographic).  Asian Americans are significantly underrepresented.  Blacks are materially overrepresented.

So there is a correlation between obesity, race and covid mortality but it is not near as strong as I had presumed.  

So is Covid-19 lethality strongly associated with obesity?  I think so but

We still don't know what is going on with Covid-19.