High risk conditions for COVID-19 span far and wide in Ohio

Photo of drive-through COVID-19 screening by Joe Raedle/Getty Images.

The underlying health conditions that lay a path for severe COVID-19 complications are widespread in Ohio, potentially affecting as much as half the population, according to experts, state data and government research.  

Take obesity: Ohio Department of Health 2017 survey data estimates that 34% of Ohioans are obese. Similarly, more than 74,000 Ohioans were diagnosed with cancer that same year.

“The statistics are about 60% of the public has one or more chronic diseases,” said Dr. Peter Pronovost, a University Hospitals physician. “Four in 10 have two or more diseases.”

The ubiquity of chronic disease in Ohio complicates any policy response when there’s no easy-to-draw line between people at low-risk for COVID-19 and those at higher risk levels.

It also illuminates the reality of a “herd immunity” strategy, as reportedly offered by an influential adviser to President Donald Trump. This would entail allowing the virus to run its course through the population unimpeded, purportedly allowing healthier people to develop antibodies at a large enough volume to break down chains of transmission.

The CDC lists eight diseases known to increase risk of severe illness from COVID-19. The list, coupled with data from the Ohio Annual Cancer Report, Behavioral Risk Factor Surveillance System annual report from 2018, and other state and federal sources, shows how deep chronic disease runs in the Buckeye state.

  • Cancer: 74,000 cases diagnosed in 2017
  • Chronic kidney disease: About 15% of U.S. adults have chronic kidney disease, per the CDC
  • COPD (chronic obstructive pulmonary disease): 8.3% of Ohio adults have COPD
  • Immunocompromised state from solid organ transplant: 1,916 Ohioans received organ transplants in 2019
  • Obesity: 34% of Ohio adults are obese. An additional 34% are overweight
  • Serious heart conditions: Heart disease is the leading cause of death in Ohio
  • Sickle cell disease: Not tracked population wide, but 181 newborns in 2019 tested for the disease, and another 3,444 newborns are carriers
  • Type 2 diabetes: 11.3% of Ohio adults are diabetic — about 1 million people

According to recent CDC research analyzing survey data from more than 3,000 U.S. counties, nearly half the population had at least one condition placing them at high risk for COVID-19 complications.

In rural counties, it’s even higher.  

“When we go beyond age as a risk factor … if we’re just thinking about these chronic diseases, they’re so prevalent, it’s hard to isolate a young, healthy cohort,” said Dr. Nirav Vakharia, a physician from the Cleveland Clinic.

Health care groups in Ohio are undertaking different efforts to help residents with some of these conditions to stay at home.

LifeCare Alliance, an in-home health care agency, has seen a spike in the number of meals it has delivered to the homes of its diabetic patients since the pandemic began.

“If you have diabetes, the chances of you having a mild case of the coronavirus is much less — you’re gonna have a harder case, because your immune system just can’t fight it off,” said CEO Charles Gehring. “Patients have been scared to death by coronavirus.”

Similarly, Pronovost, the chief clinical transformation officer with University Hospitals, said the health care network recently accelerated its efforts to provide proactive care for people with chronic diseases.

He said staff is reaching out to patients to ensure they’re properly managing and controlling their diseases, like keeping insulin or blood pressure at healthy levels.

Early data shows the network reduced hospital admissions of certain chronic disease patients by 28%, and emergency visits by 79%, he said. 

“The idea is we want to make sure chronic disease people are doing all they can to avoid being hospitalized and avoid needing to go to the [emergency room],” he said.

Along with diseases known to increase risk, the CDC lists 12 conditions that “might” increase the risk of people who have them. These include other massively common conditions like hypertension, liver disease, pregnancy, smoking and others.

As of Wednesday, COVID-19 has killed 4,176 Ohioans. The virus has infected nearly 120,000 state residents and put more than 13,500 in the hospital.