Ask the Pharmacist – consider the greater good

Q) Listen, I don’t want to get this bloody virus but let’s face it, I’m young and healthy. I feel that if I do catch it I will be fine. I avoided gatherings all summer and do not want to miss out on seeing friends and family this holiday season. Am I wrong to feel this way?

A) It is completely understandable to feel this way. Many of us are undergoing pandemic fatigue and the ongoing dreary weather is not helping matters at all. It would be nice to forget about social distancing and reunite and celebrate over the next few weeks with loved ones and old acquaintances. However, as tempting as this is, it would be a mistake, even for those of us still in our twenties.

There are a number of considerations that this sort of attitude does not pay heed to along with an assumption that many young and healthy adults have that may well be very wrong. It is, quite frankly, a selfish and somewhat ignorant attitude given how much worse the second wave has turned out to be and the fact that help in the form of what appear to be very effective vaccines are mere months away from hopefully finally putting an end to all of this.

To begin with, many of us assume that we are healthy just because we haven’t been diagnosed with a medical condition. How many of us under the age of 50 regularly see our family doctors on even an annual basis? The vast majority of underlying medical conditions that can put you at greater risk of suffering from complications of the coronavirus are relatively symptom free during their first years of onset. Even people who have had sky high blood pressure or elevated blood sugars for years do not necessarily feel any different than before their condition took hold.

A study done in Quebec back in 2009 serves to reinforce this. A total of 1,829 participants mailed in blood samples to researchers as well as answered a survey regarding their health. The participants were a random sample of males and females with a median age of 49.7 years old which is far from being considered a senior. When the samples were tested for blood sugars and the results were compared to the completed surveys regarding the prevalence of diabetes, it was found that a full 40% of the samples that were diagnostic of diabetes occurred in individuals that did not know they were diabetic.

In 2017, there were roughly 2.3 million Canadians who reported being diagnosed with diabetes. If we were to extrapolate this study to the Canadian population at large, that means there is just short of a million Canadians who are in fact diabetic, they just don’t know it yet. The same applies to high blood pressure, cardiovascular disease and even respiratory disorders.

A Canadian study in 2017 set up mobile clinics in malls, work places and community centers in a large city to check the blood pressures of volunteers who happened by. When researchers checked their results against the individual medical histories, they found that 50% of those whose pressures were too high had never been diagnosed with hypertension (the medical term for high blood pressure) and that 2% of them were at very high risk for cardiovascular complications. Once again, when we extrapolate the number of known hypertensive people in Canada, about 4.6 million as of 2010 between the ages of 20 and 79, this means that there are easily another 2.3 million of us walking around assuming we are healthy and able to withstand the worst that the virus can throw at us while being unwittingly at risk.

Also, it’s important to remember that obesity in and of itself is a risk factor for a worse outcome from COVID-19. Given the continued “fattening” of our society, this leaves plenty of young people once again at a greater risk of having the coronavirus be more consequential than just a bad few weeks.

It’s also time for us to realize that this coronavirus is capable of killing or maiming anyone, young or old, healthy or not. Yes, the risk of serious consequences increases with age and poorer health, but there have been far too many 20 year olds without any risk factors (previously known or not, as we discussed above) who have had their lives permanently altered by this infection.

One study that nicely showcases this comes from U.S. hospital databases back in April, May and June. During this period, of the 63,000 patients whose symptoms were severe enough to be admitted to hospital, 5% or 3,222 were young adults. While a third of these were obese individuals and others had known risk factors (18% were diabetic and 16% had high blood pressure) the majority of these 20 somethings had no risk factors whatsoever (note. I realize 33+18+16 add up to m ore than 50%, but in many cases, one individual had more than 1 risk factor, i.e. they were both obese and a diabetic). Many of these people recovered of course, but 2.7% died in hospital and a large number continue to suffer from poor energy, lousy breathing and a general feeling of being unwell to this day (for further information on this, look back to our article on what is termed “long-haulers”).

The last thing to consider before heading out and spreading your germs around this holiday season is that it is upon all of us to consider the greater good.

I keep hearing about how sacrosanct our “right” to live our life as we see fit should be, come hell or high water. When did so many of our mindsets shift this way? The public good should always come before the rights of an individual. Just as you do not have the right to drive intoxicated or 100 km on a neighbourhood street, nor should you have the right to possibly infect your fellow citizens, many of whom are older and/ or perhaps battling some chronic condition just because you hate wearing a mask or feel like socializing.

I sometimes wonder if we could ever pass laws such as our current ones enforcing alcohol limits or the wearing of seatbelts given today’s highly energized climate. Remember that 30% of those with documented COVID-19 exhibit no symptoms whatsoever. That means that when 9 people are diagnosed in a single day, there may well be another 3 cases that are undiagnosed who are feeling completely fine and intermingling with the public. Some of this is unavoidable. We need to work and to periodically buy groceries and other necessities. We do not need to attend a house party or hang at the local mall (well, not so local, around here).

This is the season for thinking about others. The end of this ordeal is in sight. Hang tough, don’t put your long-term health in peril, or anyone else’s for that matter, and enjoy a safe, socially distanced holiday season. For more information about this or any other health related questions, contact your pharmacist.