Why underlying health conditions make Windsor uniquely vulnerable to COVID
Doctors worry about local rates of obesity, cardiovascular disease and lung cancer ahead of second wave
Ahead of an "inevitable" second wave of COVID-19, officials at the local health unit say they're even more worried now about the high rates of underlying medical conditions in Windsor-Essex than they were during the initial surge of the virus in March.
Rates of obesity, cardiovascular disease and lung cancer in the region are all higher than the provincial average, according to the latest data from the Windsor-Essex County Health Unit. The focus during the initial wave of COVID-19 leaned toward long-term care homes, essential cross-border commuters and migrant workers. Now, medical officer of health Dr. Wajid Ahmed tells CBC News he's more worried about those with comorbidities — people with two or more medical conditions — heading into winter.
"It's just a matter of time and if we lose our guard, we are putting all those people [with comorbidities] in our region at risk and can potential overwhelm the entire healthcare system, and have more severe outcomes," said Ahmed.
He also said COVID fatigue factors into why he's more worried about people with comorbidities this time around.
"Going back to the natural tendency of people, if the symptoms are mild people will not go and get tested knowing they may feel they may not have it," he said, adding that's how it could spread to people with underlying conditions.
Early on in the pandemic, Ahmed said it became clear that people with underlying medical conditions, and the elderly population "are more likely to develop more severe outcomes." Nearly 18 per cent of the local population is 65 and up, which is expected to steadily grow.
A local report released by the health unit last year illustrates the health shortcomings in Windsor-Essex compared to the rest of Ontario. It shows 64.5 per cent of local residents 12 and older are considered overweight or obese, compared to 59 per cent across Ontario, according to the latest data available, which is a snapshot between 2015 and 2017,
The rate of all types of cancer in Windsor-Essex — 564 per 100,000 residents — is higher than the provincial average of 531 per 100,000 people, according to 2014 data, the most recent available.
COVID-19 'affects the heart significantly'
Another point of concern for locals is the high rates of heart disease and high blood pressure, again topping provincial figures. The long-standing issue is even more alarming amid the COVID-19 pandemic for cardiologist Dr. Wadea Tarhuni, who runs the Windsor Cardiac Centre.
"We know that the COVID virus itself affects the heart significantly," he said.
Watch Dr. Wadea Tarhuni explain how COVID-19 hits patients with heart issues even harder:
Some of Tarhuni's heart patients have contracted COVID-19, and he said luckily most have experienced mild symptoms.
But if it becomes severe, Windsor Regional Hospital takes over their care. People with underlying medical conditions "contributed to a lot of the cases that we had in hospital," said Chief of Staff Dr. Wassim Saad. Specifically, he's noticed obesity and high blood pressure have been problematic.
And he said there isn't anything the hospital can do to prepare for people with comorbidities who contract COVID-19.
"All we can do at the hospital right now is be ready, be prepared for anybody that comes in who's sick, look after them as best we can like we did in wave one," said Saad. "Manage our bed capacity, manage our ICU patients and look after everyone to the best of our ability."
Watch why Dr. Wassim Saad doesn't expect a 'big surge' for second wave of COVID:
The health unit said it uses data related to Windsor's comorbidities, as well as the region's demographics, before making "evidence-based" recommendations.
For example, the health unit points to how it handled the outbreak among migrant workers. Providing supports to farm operators and placing them in isolation housing is one way they dealt with that specific demographic, Ahmed said.
Or, Ahmed referenced the health unit removing residents from a particular retirement home experiencing an outbreak because of their "unique needs." Dementia and mental health issues made it clear there was an "inability for staffing to manage it there." So, they were moved elsewhere to better support their COVID recovery, he added.
However, the health unit isn't aware of comorbidity rates among those who test positive for COVID-19 in Windsor-Essex because "it is not captured in the lab data," according to a spokesperson. And they couldn't immediately say how many of the more than 75 people who died in Windsor-Essex with COVID had underlying health issues.
Comorbidity rates will take 'years and decades to correct'
The problems around high comorbidity rates in Windsor didn't happen overnight, "but now it's come to the forefront as a result of COVID-19," Saad said.
"To fix a lot of these underlying conditions and some of these factors that affect the social determinants of health is something that takes years and decades to correct," he said.
Some even view the pandemic as a time to take stock of our higher-than-normal health issues, and begin to improve things such as obesity and heart disease, said Tarhuni. Reducing our calories, being more active and putting out that cigarette can all help bring down the region's high comorbidity rate, he added.
"There's a lot of bad things that come from [this] disease, but I think there's a lot of good things as well," said Tarhuni.
"It's very difficult to change behaviour, especially if it's bad behaviour. I think it's a good opportunity for us to be more healthy."
Better education and improving access to healthcare are two things experts say can help improve the high local rate of underlying medical conditions over time. Finding a primary care provider in Windsor-Essex has been difficult in the past, and "in some parts we still are technically are under serviced," said Saad.
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