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 "We're
just sicker," said Rebekah Gee, who until January was the Health
Secretary for Louisiana and now heads up Louisiana State
University's healthcare services division. "We already had
tremendous healthcare disparities before this pandemic – one can
only imagine they are being amplified now."
Along with New York and Seattle, New Orleans has emerged as one of
the early U.S. hotspots for the coronavirus, making it a national
test case for how to control and treat the disease. Chief among the
concerns raised by doctors working in the Louisiana city is the
death rate, which is seven times that of New York and ten times that
of Seattle, based on publicly reported data.
New Orleans residents suffer from obesity, diabetes and hypertension
at rates higher than the national average, conditions that doctors
and public health officials say can make patients more vulnerable to
COVID-19, the highly contagious respiratory disease caused by the
coronavirus.
Some 97% of those killed by COVID-19 in Louisiana had a preexisting
condition, according to the state health department. Diabetes was
seen in 40% of the deaths, obesity in 25%, chronic kidney disease in
23% and cardiac problems in 21%.
New Orleans, which so far has reported more than 270 coronavirus
deaths, could be a harbinger for the potential toll the pandemic
could take in other parts of the South and Midwest that also have
high rates of obesity, diabetes, and hypertension.
A host of other factors could contribute to New Orleans' high death
rate for coronavirus, ranging from access to healthcare and hospital
quality, to the prevalence of other conditions including lung
disease, health officials say.
But they also add that it is clear that obesity-related conditions
are playing a role in the deaths. That could be a warning sign for
the United States at large, where chronic obesity is more common
than in other developed countries, they said.
Hospitals are reporting cases across the generations -mothers and
daughters, fathers and sons - being intubated and cared for in the
same intensive care units (ICUs), said Tracey Moffatt, the chief
nursing officer at Ochsner Health, the largest healthcare provider
in Louisiana. The prevalence of obesity, diabetes, hypertension and
heart disease in New Orleans and Louisiana plays into that, she
said.
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Those family members often suffered from the same medical conditions before
becoming sick, leaving them similarly vulnerable to the coronavirus despite
their age gaps.
"We had a case where a mom was already in the ICU and the daughter, who was
obese, came in," she said. "The daughter asked staff to wheel her by her mom's
room so she could say goodbye before she herself was intubated. We knew the
mother was going to pass away."
Both patients suffered from obesity.
'MORE VULNERABLE'
The Centers for Disease Control and Prevention released for the first time this
week a report showing that 78% of COVID-19 patients in ICUs in the United States
had an underlying health condition, including diabetes, cardiovascular disease,
and chronic lung disease.
The CDC report was based on a sample of under 6% of reported coronavirus
infections, but doctors in Louisiana said it was consistent with what they are
seeing, and it is in line with what other countries like Italy and China have
faced.
Those percentages, said Dr. Joseph Kanter, an emergency department doctor and
the top public health official in New Orleans, are likely similar in cities
across the United States.
"What we worry about here is that we have more people in our communities with
those conditions," he said. "We're more vulnerable than other communities, and
the number of deaths we've seen illustrates that."
The New Orleans metropolitan statistical area ranks among the worst in the
United States for the percentage of residents with diabetes, high blood
pressure, and obesity, a Reuters analysis of CDC data shows. An estimated 39%
have high blood pressure, 36% are obese and about 15% have diabetes.
Nationally, the median is 32% with high blood pressure, 31% obese and 11% with
diabetes.
"The burden of disease in Louisiana and the Deep South is higher than in rest of
the country," said Gee. "Invariably that means that the South is going to be
hard hit by this."
(Reporting by Brad Brooks in Austin, Texas, additional reporting by Ryan McNeill
in London; Editing by Scott Malone and Rosalba O'Brien)
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