Coronavirus Chronicles — Obesity, Cause, Effect, and Distance

In June, Liji Thomas, M.D., pondered the question, “Obesity and COVID-19: Cause or effect?” She wrote,

Earlier studies have shown that diabetes figures could well rise in India, and childhood obesity in Italy, which will result in many more future deaths directly attributable to COVID-19, as well as indirectly caused by BMI-dependent cardiometabolic conditions.

Physical isolation and social distancing are of course very important in preventing infection by the virus. In the past few weeks, researchers have gained a lot of knowledge. It now appears that the virus can spread much more efficiently than was previously suspected. People should probably be isolating even more, and staying even farther apart.

The survival sweepstakes

Lockdown conditions mean that people do not travel far from home. No matter low their daily step count may have been before, when rules are made against movement, they take even fewer steps. They burn fewer calories and accumulate more weight. Under these conditions, one school of thought holds that figuring out a way to somehow get regular exercise is vital, on an equal footing with quarantine and physical distancing.

Chronic, underlying, pre-existing disease makes coronavirus worse. Of that there is no doubt. Can conscientious and purposeful exercise make it better? When a person who is in great shape catches COVID-19, does it stay for a shorter course than it otherwise would have? Will it be less damaging? Could it give up that nasty trick of lingering undetected, only to make a resurgence?

Dr. Thomas discusses a current observational study that asks how exercise-related factors shape the politics of lockdown:

[I]t indicates that the “burden of chronic diseases, even with a 3-month lockdown, may lead to a greater burden of excess deaths, highlighting avoidance of BMI gain and physical activity as public health priorities during the pandemic.

[R]ather than obesity, the target of health interventions should be the chronic diseases often associated with it, which are the determinants of the excess deaths.

Those are some very deep words. Maybe paying attention to them could help end the perceived stigma of obesity. A shift to deploring the poor condition of a heart, rather than the presence of an overcoat of fat all around it, might make a difference in how people act, in taking care of themselves and others.

What was that, about staying farther apart?

Using what has been called “a very clever measurement technique,” researchers studied the behavior of the floating virus. A paper that has not yet been peer-reviewed describes it:

A research team at the University of Florida succeeded in isolating live virus from aerosols collected at a distance of seven to 16 feet from patients hospitalized with Covid-19 — farther than the six feet recommended in social distancing guidelines.

The team used two samplers, one about seven feet from the patients and the other about 16 feet from them. The scientists were able to collect virus at both distances and then to show that the virus they had plucked from the air could infect cells in a lab dish.

If it turns out that viable virus can be cultured out of the air — this is big news. But the bigger news is, we might be kidding ourselves about this social distance thing. Some scientists go so far as to say that indoors, the supposed six-foot rule is invalid, and only leads us to feel safe when we are not.

Dr. Thomas’ article contains some amazing illustrations that visualize how, why, and how far the droplets travel.

Your responses and feedback are welcome!

Source: “Obesity and COVID-19: Cause or effect?,”, 06/25/20
Source: “‘A Smoking Gun’: Infectious Coronavirus Retrieved From Hospital Air,”, 08/11/20
Image by Tom Driggers/CC BY 2.0

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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