What is the most sensible scientifically informed response to a virus that attacks the obese and unfit? Sit at home next to the fridge for a year. Could this kill us? “Inactivity Drives 1 in 14 Deaths Globally, New Data Suggest” (Medscape, March 31):
The high cost of a sedentary lifestyle just became a bit more evident ― a new global study shows that inactivity drives up to 8% of noncommunicable diseases and mortality.
Physical inactivity, defined as engaging in less than 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity per week, is estimated to have caused 7.2% (95% CI, 5.4 – 9.0) of all-cause deaths and 7.6% (95% CI, 6.1 – 9.3) of cardiovascular disease (CVD) deaths, according to investigators led by Peter T. Katzmarzyk, PhD, associate executive director for population and public health sciences, Pennington Biomedical Research Center, Baton Rouge, Louisiana.
Note that the study was done using 2016 data. See “Physical inactivity and non-communicable disease burden in low-income, middle-income and high-income countries” (BMJ)
What about the expectations that Americans would die from the disruption in non-Covid health care ordered by governors? “The Untold Toll — The Pandemic’s Effects on Patients without Covid-19” (NEJM, June 2020) had anecdotes, but no numbers. “Surge in Advanced Cancers Follows COVID-19 Into 2021” (MedPage Today, March 31, 2021) offers some survey data:
Two-thirds of radiation oncologists said new patients more often have advanced-stage disease at their initial clinic visit as compared with prior years. Consistent with data from multiple other sources, three-fourths of respondents said patients have skipped routine cancer screening, and two-thirds said COVID has interrupted treatment for existing patients.
“What we have learned one year into the COVID-19 pandemic is that radiation oncologists continue to see the harmful effects of the pandemic on our patients,” said Thomas J. Eichler, MD, chair of ASTRO’s board of directors, during a webinar to discuss the survey findings. “The data are clear that people with cancer are facing additional burdens in these difficult times.”
(bonus points to this doc for including the phrase “in these times”)
The same publication reminds us that feeling safe is not just about Covid-19. The director of abortion services at a clinic in Bangor, Maine writes “It’s Time for You to Be More Inclusive — Yes, You.”:
Small steps to support transgender patients go a long way in their healthcare
I recently saw a new patient seeking help addressing substance abuse issues. It was our first time meeting, so when I entered the exam room, I introduced myself with my name and my pronouns, as I always do. Before I even offered any advice or asked a question, the patient’s face lit up with a smile. She explained that she was a transgender woman, and hearing me introduce myself with my pronouns was a huge relief, because it showed her that I would treat her with respect.
She quickly opened up to me, describing how she was grappling with a host of challenges and stresses that were made even worse because other people in her life — including other doctors — didn’t understand, didn’t respect, or outright rejected her identity.
Something as simple as including your pronouns when you introduce yourself can indicate that you are an ally and contribute to a sense of safety and inclusion.
I say that I provide abortions, prenatal care, birth control or other resources to pregnant people, not just pregnant women, because all people deserve the right to make their own decisions about if, when, or how they want to have children, without facing judgement.
Separately, if there is a person on this planet who can get through a winter in Bangor, Maine without drinking heavily, consuming drugs, and considering a gender change, I would love to meet him/her/zir/them.