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CDC Director Rochelle Walensky recently referred to it as 'encouraging news' that most COVID-19 deaths occurred among those with multiple comorbidities. While I may not agree with the 'encouraging' part, it's crucial to understand what comorbidities truly mean.
What is the definition of comorbidity?
Morbidity refers to the presence of illness or medical conditions, serving as the opposite of mortality, which relates to death.
So why don't we just say that? These are terms commonly used by statisticians and public health experts when working with large data sets. (Fun fact: the CDC’s public health journal is titled MMWR, short for Morbidity and Mortality Weekly Report.)
Comorbidity refers to having multiple health conditions at the same time. If someone who died from COVID-19 had 'four comorbidities,' it means they were dealing with four other health issues in addition to COVID.
Which comorbidities increase the risk of dying from COVID?
So, what qualifies as a comorbidity? It depends on who you ask. When Walensky made her widely discussed statement, she was referencing this report (from the MMWR). Let’s take a closer look at how that paper categorizes comorbidities.
To start, they weren’t considering every possible comorbidity. They had a list of eight conditions that were recognized as risk factors:
Age 65 or older, immunosuppression, and six additional underlying health conditions are key risk factors for severe outcomes. Every individual who faced severe outcomes had at least one risk factor, and 78% of those who passed away had at least four.
The term “risk factors” is preferred over “comorbidities,” as being 65 years old is not a medical condition. The following risk factors are outlined in the paper:
Age 65 and above
Immunosuppressed
Chronic lung disease
Chronic liver disease
Chronic kidney disease
Chronic neurological conditions
Diabetes
Chronic heart disease
For further details about health conditions that increase the risk of death or severe illness from COVID, the CDC provides a more comprehensive list here. For instance, Alzheimer's and dementia are categorized under neurological disorders.
These risk factors are relatively common and often occur in combination. For example, 17% of adults over 65 have heart conditions, and 27% have diabetes. Many of us likely know neighbors or family members who have at least four of the risk factors listed.
This is why it's discouraging to hear Walensky mention that, “the overwhelming number of deaths, over 75 percent, occurred in people who had at least four comorbidities.” While it would be worse if COVID were affecting healthy individuals as much as those with underlying conditions, if you're feeling relieved by this information, you may be overlooking the fact that many Americans live with these conditions, including some of your own family members.
