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The Cook County Medical Examiner’s shows COVID-19 as the primary cause of death for 2,303 people. Of those, more than 2,112 appear to have at least one underlying condition as a secondary cause of death. There were no secondary causes reported for 191 deaths.

Hypertension affected 1,070 victims or more than 46% of all deaths. Diabetes impacted 973 victims or 42% of the death total. Pulmonary disease was part of 397 deaths or 17%. And 215 of those deaths, about 9%, were accompanied by obesity or morbid obesity. Others had conditions including cancer, cardiovascular disease, or kidney disease. The numbers in the table above equal more than 100% because many victims had more than one preexisting condition.

The Cook County data aligns with  on comorbidity volume. Though the City’s data does not provide the same level of comorbidity detail, it does report that 1,090 of Chicago’s 1,160 COVID-19 victims had underlying conditions. That’s 94%.

As of May 8, the average age of all COVID-19 deaths in Illinois was 74, while the median age of the state’s population is old.  Almost 50% of all Illinois deaths have  long-term care facilities ().

What’s remarkable about the Cook County comorbidity data is just how few young adults have died from COVID-19 in the absence of a preexisting condition. Nobody under 20 has died without one. Only three deaths in the 20-29 age bracket were without a documented comorbidity. And in the 30-39 and 40-49 age brackets, just 26 deaths had no defined underlying causes. Such statistics suggest the odds are slight of anyone young and healthy dying from this disease.

When those numbers are compared against each age bracket’s population percentage, those at risk (and who have very low risk) become more even more clearly defined.

Illinois residents over the age of 70 account for 8.5% of the state’s population and 63.8% of the deaths. Those under 40-years old account for 54.5% of the population and just 2.2% of the deaths. Put another way, a person over 80 is 706,740% more at risk of dying from COVID-19 than a person under 20.

Understanding who is most at risk (and who is not) is paramount to combating the virus. What Cook County and other comorbidity data across the country indicates is that the risk of death for young and healthy people is considerably lower than people may have originally thought or continue to believe. There are pockets of people (elderly, those with high risk comorbidities) and specific environments (nursing homes, hospitals, jails, congested workplaces like meat processing plants, etc.) warranting stringent infectious disease precautions and concentrated efforts to control the virus’s damage. The young and healthy should take precautions too (proper hand hygiene, immunity-boosting supplements), but there is lower risk to them going about their normal lives.

Stay safe, stay strong!

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I previously mentioned the potential of vitamin D to boost immune system defenses against COVID-19. Two recent studies have between severe vitamin D deficiency and complications and/or mortality rates of COVID-19 patients.

The first – published in – found that COVID-19 infections and deaths were greater in countries where people had low vitamin D levels, such as Italy and Spain, compared to northern European countries where average vitamin D levels were higher. British researchers attributed the vitamin D differences to some southern Europeans having darker pigmentation, which reduces vitamin D synthesis, and northern Europeans consuming more cod liver oil and vitamin D supplements.

The appeared in the online journal . Though not yet peer-reviewed, the study’s conclusion was the same: Low vitamin D levels were linked to a hyperactive immune system.

By analyzing publicly available patient data from around the globe, lead researcher and biomedical engineer and his team at Northwestern University discovered a significant correlation between vitamin D levels and cytokine storm — a hyperinflammatory condition caused by an overactive immune system — as well as a correlation between vitamin D deficiency and mortality.

can severely damage lungs and lead to acute respiratory distress syndrome and death in patients,â€� said Ali Daneshkhah, a postdoctoral research associate in Beckman’s lab and the paper’s first author. “This is what seems to kill a majority of COVID-19 patients, not the destruction of the lungs by the virus itself. It is the complications from the misdirected fire from the immune system.â€�

As vitamin D enhances people’s innate immune systems as well as prevents them from becoming dangerously overactive, Backman and his team’s findings indicate that having healthy levels of vitamin D could protect patients against severe complications, including death, from COVID-19.

“Our analysis shows that it might be as high as cutting the mortality rate in half,� Backman said. “It will not prevent a patient from contracting the virus, but it may reduce complications and prevent death in those who are infected.�

Clinical trials to see if vitamin D can help infected patients are now underway. Meanwhile, I continue to be a proponent of taking vitamin D, vitamin C, and zinc supplements to protect your health should you contract COVID-19. Being healthy in general is the best thing you can do to protect your immune system.

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H3N2 (or the “Hong Kong flu,” as it was more popularly known) occurred between 1968-1970. It arrived in the United States from Hong Kong in , peaking in mid-December through January 1969. It ultimately killed 100,000 people in the U.S., mostly over the age of 65, and one million worldwide.

At that time, the U.S. lifespan was today. The population was much smaller, 200 million as compared to 328 million. Adjusting for population and demographics, it’s probable the pandemic of five decades ago would result in a quarter million deaths today, making it as lethal as COVID-19.

But while the outbreak is shockingly similar in scale, the way society handled it couldn’t be . Stock markets didn’t plummet. Congress passed no legislation. The Federal Reserve didn’t cut interest rates. Not a single governor acted to enforce social distancing, curve flattening (even though hundreds of thousands of people were hospitalized), or crowd banning. No daycares shuttered despite there being more infant deaths from H3N2 than there have been from COVID-19. No for violating stay-at-home orders. Unemployment didn’t skyrocket. There was no worry of or . Despite a New York Times editorial describing the pandemic as “one of the worst in the nation’s history,” only 23 schools and colleges closed, businesses remained open, and Woodstock was still held (although it took place between the first and second waves of the pandemic). Going about daily life in the face of the disease was a deliberate choice.

So what changed between 1968 and now? Dr. Deborah Birx cited fatality estimates from a Imperial College London for the federal government’s drastic restrictions, a model for its veracity. Some theorize there were partisan elements to the government mandated shelter-in-place orders, with political parties using them to achieve objectives unrelated to public health. Certainly, the Vietnam War received far greater media coverage than the virus in a much less invasive way. Today, with a relentless 24-hour news cycle, stories of COVID-19 can dominate. 

I don’t know the answer. But as a urges, I do think there’s value in revisiting the nation’s response to the Hong Kong flu pandemic. Much like the world repeatedly learned and lost the , it seems like the country needs to rediscover how it treated past disease-born hardships so it can make the most well-informed decisions regarding future pandemic measures. As a healthcare leader, I believe I have a duty to bring that knowledge to light. 

Stay safe, stay strong!

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When I was entering 4th grade, my parents bought their first house, which was my primary home through high school.

Seeing my childhood home on Zillow today, the landscaping is greatly improved, but the front looks much the same. Growing up, I spent a lot of time in the basement. It had the only TV in the house, fake wood panels, cinder block and wood shelves with my parents’ college text books and novels, a laundry room with a 1/2 bath, and whatever stuff my brother and I were playing with at the time.

Two signs hung on the basement walls. For different reasons, I remember them both vividly.

The one over the bathroom toilet said this:

As an adult, the message is clear. But growing up, it meant different things to me at different ages.

The other sign was a proverb.

I read and thought about that proverb often over the years. It is so simple – yet so profound, powerful, and true. That proverb influenced my views on the world and helped me determine how I could make the greatest difference in it.

I noticed over and over, when people did not follow that proverb, long term success proved elusive. Be it economic policy, parenting style, management strategy, relationship attitude, or any other aspect of life, that proverb always provides sage wisdom.

With my children, I believe my job is to help them on their journey to becoming strong and decent people. I let them struggle at times, not because I do not care, but because I do. Learning to become self sufficient is the only way they can become independent. They should want to be with me, not need to be with me. I want them to be more successful and better than I am in every way that matters, including happiness. That drives my parenting style.

I get more joy and satisfaction from knowing 911³Ô¹Ï is providing an outlet for people to “fish” for themselves and their families, than I do from any pride in myself. Providing a great place for people to work, grow, and excel is something I relish.

With charities, I always ask “are they solving the problem permanently (teaching people to fish) or temporarily masking it (giving people a fish)?” Candidly, I struggle to support organizations if they are not working towards a permanent solution to the problem.

Recently, 911³Ô¹Ï team members held an internal fundraiser to support the Greater Chicago Food Depository, the Milwaukee Hunger Task Force, and Feeding America. As a company, 911³Ô¹Ï matched our employees’ generous contributions. With unemployment soaring, food banks are seeing a dramatic increase in demand. For the first time in their lives, many people do not know where their next meal will come from. They are food banks hours before they even open. People are in dire need and the money we donated will help people in the short term.

But what about the long term? People are in need because they were “banned from fishing.” As a country, we will not be able to “give a fish” our way out of the economic hardships resulting from COVID-19. The longer the national shutdown continues, the number of people in need will grow while the number of people with resources to assist will dwindle. The pattern needs to be reversed. Every day someone is prevented from fishing, the livelihood of that person, their family, and society overall is jeopardized.

The best thing I can do, and the best thing I feel society can do, is provide people with as much evidence-based information as possible about the virus. That way, when restrictions are lifted, people are knowledgeable and comfortable taking the necessary steps to provide for themselves and their families. From what I’ve observed, the panicdemic surrounding COVID-19 has proven to be far more destructive and dangerous than the pandemic itself. Only knowledge can offset fear of the unknown, which is why I have found such a pressing need to write about and discuss the status of the COVID-19 outbreak. I just want you all to know my perspective as I write these blogs.

Stay safe, stay strong!

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Across the country, there has been a growing concern that COVID-19 has been in the United States longer than experts first believed.

Earlier this month, physician and Santa Clara County Executive Dr. Jeff Smith said data collected by the Centers for Disease Control and Prevention (CDC), local health departments and others suggest it was “a lot longer than we first believed� — most likely since “back in December.�

Speaking with the , Smith said, “This wasn’t recognized because we were having a severe flu season. Symptoms are very much like the flu. If you got a mild case of COVID, you didn’t really notice. You didn’t even go to the doctor. The doctor maybe didn’t even do it because they presumed it was the flu.�

In Santa Clara County, which had previously reported its first COVID-19 death on March 9, the said it will likely identify more deaths from COVID-19 as the Medical Examiner-Coroner continues to investigate area deaths.

Because COVID-19 symptoms can be slow to appear in infected individuals, and the time from onset of symptoms to death averages three weeks, the patient that died on Feb. 6 would have become infected in January at the latest.

With a by the University of Southern California and the LA Department of Public Health showing that the Los Angeles County COVID-19 outbreak could be up to 55 times bigger than the number of confirmed cases, evidence is quickly mounting that the virus has been here in the U.S. far earlier than was originally suspected. As Dr. Smith noted, in all likelihood since December 2019.

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This new estimate is 28 to 55 times higher than the 7,994 confirmed cases of COVID-19 reported to the county through early April.

This is exciting research. If correct, the data would mean that the county’s than originally thought, instead of the projected 4.5%.

Although not enough people have developed antibodies yet, this is encouraging news for the development of herd immunity. If further studies confirm that the virus is less deadly than originally feared, the more likely it is that certain activities can be resumed sooner than expected for people in low risk categories.

Stay safe, stay strong!

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With unable or unwilling to travel, many needed to plant, maintain, or harvest their food supply. In Britain, a new campaign hopes to fill these critical vacancies by encouraging citizens unemployed by COVID-19 to apply for paid farming positions across the country. France, the European Union’s biggest agricultural producer, has also made a out of filling the labor shortage. Appealing to leagues of newly sidelined workers — waitresses, hotel workers, hairdressers and others rendered jobless and confined by COVID-19 — Farm Minister Didier Guillaume urged them to “join the of French agriculture.�

North America and the United States are now being similarly impacted. Canada’s agriculture sector is warning of higher prices and if it isn’t designated an essential service and allowed to do business as usual during the COVID-19 crisis. Farm labor shortages, an issue in the United States , will only worsen this year.

Food suppliers must also contend with . Outbreaks in certain companies or large plants can have a huge impact. Smithfield Food Inc., the world’s biggest pork producer, is a major US plant indefinitely after a coronavirus outbreak among employees. The company warns that closures across the country are taking American meat supplies “perilously close to the edgeâ€� of shortfalls. This news comes less than six months after China’s pork supply was decimated by African swine fever, . The compounding shortage will drive prices upward.

But even if there is a food shortage in one location and a surplus in another, supply chains need to be in place for the food to actually be of any use. As farmers’ longstanding clients temporarily or permanently close, farmers often cannot find new customers in time to offload their inventory.

Across America, because schools and other standard purchasers are shut down. Even as COVID-19 closes slaughterhouses and meat shortages loom, farmers are struggling to sell their product given that their usual clients (restaurants, restaurant distributors, etc.) are going out of business. proactively to survive financially (pigs cost a lot to feed and breed rapidly).

As the Associated Press reported, thousands of acres of Florida grown fruits and vegetables are being because the crops’ intended buyers – schools, restaurants, and theme parks – are closed. Other US businesses still buying produce already have contracts with other companies, including foreign suppliers.

Many farmers and growers have donated to food banks and homeless shelters, but storage is an issue for perishable items like produce and milk. Per , ‘We gave 400,000 pounds of tomatoes to our local food banks. A million more pounds will have to be donated if we can get the food banks to take it.” 

As evidenced by these countless articles, the journey from farm to table for much of the world’s food supply is complex and robust. Any breakdown or slowdown in the process impacts everything downstream. From fewer workers to harvest fields to fewer to transport food cross-country, one of the long term repercussions of COVID-19 may be a to the American diet.

Things are interconnected in strange ways in our complex economy. I remember a story on how the housing market effects the price of guitars. If wood is in heavy demand for home building, guitar makers have to pay more for the material to make their products. That price increase gets passed along to consumers.

In this COVID-19 economy, soon, more gas might mean less beer.

Growing up, I heard many stories about how gas and oil supplies would soon expire. Today, oil inventory is the highest in recorded history. With fewer people traveling due to stay-at-home orders, oil consumption is down by 30% in the US alone. This pandemic-induced supply glut has sent oil prices so low, to have barrels taken off their hands. At the pump, the with 13 states selling gas for less than $1 per gallon.

But while filling your tank may be cheap, less driving could reduce the nation’s , soda, and seltzer water. Carbon dioxide (CO2), which is what makes those beverages fizzy, is a chief byproduct of ethanol production. Ethanol producers sell large quantities of CO2 to the beverage industry. But ethanol, which is blended into the country’s gasoline supply, has seen production drop dramatically due to the sharp dip in gasoline demand as a result of the pandemic. Less CO2 availability has suppliers charging brewers more for the ingredient. Bob Pease, chief executive officer of the Brewers Association, a trade group representing small and independent US craft brewers, anticipates some brewers to start cutting production in response to the price hikes.

These are just a few of the unforeseen consequences COVID-19 shut downs are having on food supply chains. In the coming weeks and months, more are sure to follow. No decision made now to limit the disease’s spread occurs in a vacuum, it’s just some repercussions won’t manifest themselves until later. This is true across all industries. Retailers order their Christmas inventory early in the year and manufacturers produce it far in advance. Shut downs now will impact what seasonal merchandise appears on store shelves come autumn.

Of course, the breadth of holiday decor selection will matter little if people cannot afford to purchase any. As politicians contemplate when and how to reopen parts of the country, the driving factor is stemming the surge of unemployment. More than 22 million Americans have in the past four weeks and the number is only expected to climb. The challenge will be to tackle COVID-19’s economic fallout without jeopardizing the lifesaving strides made by social distancing. There is no playbook for this situation. But whatever the “new normal” becomes, I am confident in people’s ability to adapt.

Stay safe, stay strong!

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