Coronavirus: Has Covid-19 exposed UK's underlying ill health
Covid-19 has taken a disproportionate toll on those with underlying health conditions. Some experts say the crisis has shone a light on the poor state of our health as a nation.
But in many communities it has also highlighted the link between ill health and poverty. So what lessons has coronavirus taught us - and will ministers and health leaders act upon them?
'Meeting my demons'
Those with type 2 diabetes, often associated with being overweight or obese, have been particularly vulnerable to falling seriously ill with Covid-19.
About a fifth of all those who have died after contracting coronavirus had diabetes. Roxana Falfara knows that she falls into that dangerous category. Ever since she was a child, Roxana has had a difficult relationship with food.
She understands that her eating is tied up with her mental health, but says that doesn't make it any easier to manage. "Every time you sit at a table you meet your demons. So you meet the addiction every time you have to eat." As an adult, Roxana became very overweight and developed type 2 diabetes.
Now she's trying to eat more healthily and lose weight ahead of a second bout of surgery. But, with her heightened vulnerability to Covid-19, the past few months have been tough for her. "I had this anxiety of going out, especially with knowing I have type 2 diabetes," she says. "I'm at a high level of danger so I tried to avoid going out as much as I could."
In her home town of Sheffield, about 60% of the adult population is overweight or obese. And like Roxana, that group was among those at greatest risk of falling seriously ill during the pandemic bThe story of Sheffield The coronavirus has exposed the deep inequalities in our health.
What happened in Sheffield at the height of the coronavirus pandemic reflects what happened in many towns and cities across the UK. The more affluent areas of Sheffield escaped pretty much unscathed.
But in the poorer parts of the city, they saw some of the highest mortality rates in the entire country. For the director of public health in Sheffield, Greg Fell, that raises some really difficult questions about the underlying state of our public health.
He describes it as a complex, multi-layered picture. "It's the environments in which we live. It's the poverty, it's the poor housing, it's the lack of educational opportunities, it's the job opportunities," he says.
"Economic policy, housing policy, all of those things make a difference to health, far more so than the treatment the NHS can provide." Inequalities 'amplified' So what has this coronavirus pandemic told us about the underlying state of our health - and more broadly, our society?
Earlier this year an influential report warned that life expectancy - particularly among the poor - had stalled. Now the author of that report, Sir Michael Marmot, says coronavirus has reinforced the connection between poverty and ill health. "Health and health equity, the fair distribution of health, tell us a great deal about how well society is doing," he says.
"And the fact that health stopped improving, life expectancy has stalled, and inequality in life expectancy is increasing - that told us that over the last decade, society had stopped improving and inequalities in society had been increasing.
"So when the pandemic came, it just exaggerated, it exposed and amplified those inequalities." For many public health experts, the coronavirus crisis is the inevitable consequence of decades-long failure to address our unhealthy habits Prof John Wass has spent much of his professional life studying a pandemic that has been growing steadily for decades - obesity.
"The fact that we have one of the highest death rates in the world is something which really does need to be understood," he says. "We are not a healthy nation with regard to, for example, the statistics for obesity, the statistics for diabetes, and so on.
"This is not a simple thing. It's not just selling fewer McDonalds on the high street. "We need a situation where health is linked to education, it's linked to healthy eating and agriculture, it's linked to business. "So we need a joined-up approach between all the government departments. "It's complicated - but this is a complicated thing that needs a solution."
Coronavirus: An opportunity?
Governments set the direction of policy, but the job of creating real change on the ground falls to people like Sheffield's director of public health.
And despite the challenges posed by coronavirus, Greg Fell is still optimistic that the situation we find ourselves in might present an opportunity.
"We know that we have neglected the health of the public for many, many years," he says. "Now is a perfect time to start to put some of that right.
"We know that health is unequally distributed. We know that people who are from black and minority ethnic backgrounds live shorter lives and in poorer health than those of us who are white British. "We know that those who are disabled live shorter lives in poorer health. We know those who live in the poorest parts of our towns have shorter lives and poorer health.
"So now's a perfect time to put that right, there's never been a better time to put that right." As communities across the UK reflect on their experience of coronavirus, the challenge for political leaders is how to apply the lessons of the pandemic. It's hard to draw any conclusion other than a real transformation of our nation's health will need fundamental changes in society.
The main symptoms of coronavirus (COVID-19) are a high temperature, a new, continuous cough and a loss or change to your sense of smell or taste. The main symptoms of coronavirus (COVID-19) are:
a high temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
a new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)
a loss or change to your sense of smell or taste – this means you've noticed you cannot smell or taste anything, or things smell or taste different to normal
To protect others, do not go to places like a GP surgery, pharmacy or hospital if you have any of these symptoms. Stay at home (self-isolate) and get a test.
Widely shared claims on social media link to a video alleging that a future vaccine against COVID-19 would “genetically modify” humans. This claim is scientifically untrue.
Most claims refer to a version of a now-deleted, widely shared YouTube video of Dr Andrew Kaufman, a “natural healing consultant” ( here ) in an interview with Spiro Skouras, an online-personality and “independent researcher” with a popular YouTube channel.
In the video, Kaufman talks about how a future COVID-19 vaccine would provide a vessel to “inject genes” into humans, first by a procedure known as “electroporation”,
in which an electric current “create[s] little holes in our cells that allow the DNA to go into our own cells” and then through the insertion of “foreign proteins that supposedly generate immunity”. Kaufman concludes that the vaccine, like the results of biotechnology in agriculture, will make humans “genetically modified organisms”.
There are multiple claims in the nearly one hour-long video, which are beyond the scope of this fact check. However, the main claim in these posts on social media that a COVID-19 vaccine will genetically modify humans (described in the headline of the video and by Kaufman) is false. While most headlines don’t mention DNA-based vaccines, Dr Kaufman talks about them in the video.
According to the World Health Organization (WHO), a DNA vaccine “involves the direct introduction into appropriate tissues of a plasmid containing the DNA sequence encoding the antigen(s) against which an immune response is sought, and relies on the in situ production of the target antigen.”
This means that, in contrast to the more widespread “conventional” vaccines ( here ) which use a whole pathogen or fragment, a DNA vaccine involves the injection of a small part of the virus’s genetic code (DNA or RNA) to stimulate immune response in a patient without an infection
This procedure does not create a genetically modified organism, which the Food and Agriculture Organization (FAO) defines as “an organism in which one or more genes (called transgenes) have been introduced into its genetic material from another organism using recombinant DNA technology.”
Mark Lynas, a visiting fellow at Cornell University’s Alliance for Science group, debunked the idea that a DNA vaccine could genetically modify an organism. Lynas told Reuters that no vaccine can genetically modify human DNA.
“That’s just a myth, one often spread intentionally by anti-vaccination activists to deliberately generate confusion and mistrust,” he said. “Genetic modification would involve the deliberate insertion of foreign DNA into the nucleus of a human cell, and vaccines simply don’t do that.
Vaccines work by training the immune system to recognize a pathogen when it attempts to infect the body - this is mostly done by the injection of viral antigens or weakened live viruses that stimulate an immune response through the production of antibodies.”
Lynas added: “The DNA [in DNA vaccines] does not integrate into the cell nucleus so this isn’t genetic modification - if the cells divide they will only include your natural DNA. But this approach is incredibly promising for COVID because it can be scaled up very quickly, and is very versatile - it is easy to synthetically produce DNA sequences that match the required bits of viral genetic code.”
Dr Paul McCray, Professor of Pediatrics, Microbiology, and Internal Medicine at the University of Iowa further explained to Reuters via email how the COVID-19 vaccines being developed would work:
“For COVID-19, the main protein used to boost the immune system is the spike (S) protein from the virus. This can be given as a vaccine in many different forms: as inactivated (dead) virus, as expressed protein, in a DNA or RNA vector that will make cells make this protein, etc.
So the only modification to the host is to stimulate them to make antibodies and T cells that will prevent infection with the virus or kill any infected cells to prevent or reduce disease severity. This is what happens if you get a virus infection naturally, but the vaccine takes the risk of serious disease out of the equation.”
There are many trials currently underway for a COVID-19 vaccine worldwide, with some exploring the possibility of a DNA vaccine, which may be where this false claim stems from
While there are trials for a DNA vaccine for COVID-19 underway, the method does not involve changing people’s existing DNA. A future COVID-19 vaccine would not make humans “genetically modified organisms”, as the video claims
False. A future COVID-19 vaccine will not genetically modify humans. DNA vaccines do not integrate the virus’ DNA into the cell nucleus of its recipient but instead inject part of the virus’ DNA/RNA into tissues to stimulate an immune response in the body.
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