Charts of COVID-19 Fatality Rate by Age and Sex

[Tom Kirkman + 8,860]

Finally, some statistical analysis and charts of facts regarding death rates, listed by age and sex.

This information generally aligns with what I have commented previously in another thread.

 

Age, Sex, Existing Conditions of COVID-19 Cases and Deaths

Last updated: February 22, 20:40 GMT

Age of Coronavirus Deaths

Based on all 72,314 cases of COVID-19 confirmed, suspected, and asymptomatic cases in China as of February 11, a paper by the Chinese CCDC released on February 17 and published in the Chinese Journal of Epidemiology has found that the risk of death increases the older you are, as follows:

COVID-19 Fatality Rate by AGE:

AGE	DEATH RATE
80+ years old	14.8%
70-79 years old	8.0%
60-69 years old	3.6%
50-59 years old	1.3%
40-49 years old	0.4%
30-39 years old	0.2%
20-29 years old	0.2%
10-19 years old	0.2%
0-9 years old	no fatalities

In general, relatively few cases are seen among children.

Sex ratio

COVID-19 Fatality Rate by SEX:

SEX	DEATH RATE
Male	2.8%
Female	1.7%

Pre-existing medical conditions (comorbidities)

Patients who reported no pre-existing ("comorbid") medical conditions had a case fatality rate of 0.9%. Pre-existing illnesses that put patients at higher risk of dying from a COVID-19 infection are:

COVID-19 Fatality Rate by COMORBIDITY:

PRE-EXISTING CONDITION	DEATH RATE
Cardiovascular disease	10.5%
Diabetes	7.3%
Chronic respiratory disease	6.3%
Hypertension	6.0%
Cancer	5.6%
no pre-existing conditions	0.9%

 

 

[Zhong Lu + 845]

Ok. So it's basically a slightly deadlier version of the flu.  Thx.  

[Douglas Buckland + 6,308]

So if you are 80 years old, own a set of balls and smoke....you’re essentially toast if you contract this thing.

[0R0 + 6,251]

I think those are "if treated" values from outside Wuhan. 

In Wuhan metro the deaths were much larger in number and unreported. Perhaps one day the government would allow access to the crematoria stats so that a real mortality level can be established for the "free wheeling" disease vs. the published stats for treated disease.

We do have an apparent further drop of mortality in outcomes. to 9% after the most recent data. 

[Tom Kirkman + 8,860]

6 hours ago, Douglas Buckland said:

So if you are 80 years old, own a set of balls and smoke....you’re essentially toast if you contract this thing.

Pretty much.

Keep this in mind when reading about the virus.

If you are below 50 years old, relatively healthy, and don't smoke, it seems likely that you should recover, and not die. 

Statistically, being female reduces the risk of fatality as well.

Very old (over 80) male smokers may wish to get their affairs in order, regardless of the virus.

[Gerry Maddoux + 3,627]

^

Not to be a pessimist, but in looking at these data, one must be aware of the fact that RNA viruses--particularly single-strand RNA viruses like this one--have an exceptional propensity to mutate. It is not uncommon to go into person X as a particular viral genome and come out of X as a quite different genome, entering person Y, and so on. 

If this virus mutates to a milder form--which they seldom do--then things will get better and these data will improve or stay the same. On the other hand, if this virus mutates to a more vicious form--which is likely--then these data will get worse. 

The high mutation rate is why it is relatively difficult to produce an effective vaccine against single-stranded RNA viruses: by the time you've identified the primary antigenic sites and formulated a vaccine, they have changed. The thing is a moving target. 

Still, the data above are current for what has been, and probably for what is happening now. No lesser personage than Tony Fauci said that we "are on the brink of a pandemic." Laboratories are working around the clock to produce a vaccine for this virus. That takes some time, because conventional wisdom mandates an animal trial first. 

Greffex apparently developed formats of the virus's most antigenic sites in the laboratory in Texas and have a vaccine, under an NIH grant that was awarded back in September. If so, they will put the massive resources of the NIH behind this very quickly. 

[NickW + 2,714]

Dose up on them zinc supplements - its about the only supplement with any supporting science to show it having some effect against Corona / Adeno Viruses 

 

[NickW + 2,714]

23 hours ago, Gerry Maddoux said:

^

Not to be a pessimist, but in looking at these data, one must be aware of the fact that RNA viruses--particularly single-strand RNA viruses like this one--have an exceptional propensity to mutate. It is not uncommon to go into person X as a particular viral genome and come out of X as a quite different genome, entering person Y, and so on. 

If this virus mutates to a milder form--which they seldom do--then things will get better and these data will improve or stay the same. On the other hand, if this virus mutates to a more vicious form--which is likely--then these data will get worse. 

The high mutation rate is why it is relatively difficult to produce an effective vaccine against single-stranded RNA viruses: by the time you've identified the primary antigenic sites and formulated a vaccine, they have changed. The thing is a moving target. 

Still, the data above are current for what has been, and probably for what is happening now. No lesser personage than Tony Fauci said that we "are on the brink of a pandemic." Laboratories are working around the clock to produce a vaccine for this virus. That takes some time, because conventional wisdom mandates an animal trial first. 

Greffex apparently developed formats of the virus's most antigenic sites in the laboratory in Texas and have a vaccine, under an NIH grant that was awarded back in September. If so, they will put the massive resources of the NIH behind this very quickly. 

Viruses generally evolve into less virulent forms over time because high virulence means killing off your host so highly virulent strains tend to be self defeating. 

There is evidence to show HIV has taken this path since the 1980's. 

[NickW + 2,714]

23 hours ago, Tom Kirkman said:

Pretty much.

Keep this in mind when reading about the virus.

If you are below 50 years old, relatively healthy, and don't smoke, it seems likely that you should recover, and not die. 

Statistically, being female reduces the risk of fatality as well.

Very old (over 80) male smokers may wish to get their affairs in order, regardless of the virus.

Living in many of those Chinese cities, with very high particulate levels is the equivalent of being a light - moderate smoker in the west so the baseline is much higher. 

[Gerry Maddoux + 3,627]

1 hour ago, NickW said:

Viruses generally evolve into less virulent forms over time because high virulence means killing off your host so highly virulent strains tend to be self defeating. 

There is evidence to show HIV has taken this path since the 1980's. 

Not to be the eternal pessimist but the HIV virus is a double-stranded RNA zoonotic virus--it has to conform to the stoichiometry of the host DNA replication mechanism. Most of these zoonotic viruses that are jumping genus and species lines these days are single-stranded RNA viruses and they can mutate to be either less virulent or, alternatively, more virulent. 

Over the last thirty to forty years, zoonotic viruses have emerged as the most dangerous viruses to our global community. Scientists are getting onto this. Back when the Nipah virus hit, it took a while to determine that the virus had jumped from fruit bats to pigs that were suddenly being grown on deforested land, and since humans are pretty close to pigs it jumped into human host DNA very quickly and mutated to produce a mortality of up to 75%. 

Each one of these is doubtless going to be different. Some--like this one--will hit a particular organ system hardest, and when that Achilles Heel is already damaged (in this case alveolar cells in the lungs in smokers and workers in high pollution areas), the mortality will be skewed to that subset. This is precisely why the WWI veterans got hit so hard during the 1918 flu pandemic (malnourished, most smoked, many had phosgene lung damage). Today, it is China and Iran--both heavy smoking male populations.

Anyway, given enough zoonotic outbreaks, one will eventually be enormously fatal. Fortunately, the communicable diseases community is all over this, networking, coming up with ways to identify new outbreaks and contain them promptly. The early Nipah containment by the Malaysians could easily serve as a format for this. And since most of these seem to be coronaviruses, with some similarity between glycoprotein spike antigens, a coronavirus vaccine is on the horizon. 

[Otis11 + 551]

1 hour ago, NickW said:

Viruses generally evolve into less virulent forms over time because high virulence means killing off your host so highly virulent strains tend to be self defeating. 

There is evidence to show HIV has taken this path since the 1980's. 

Does that case still hold when a virus has a 14-34 day incubation time and rapid spread? Selecting for lower virulence happens when you kill the host so fast it negatively impacts the rate of spread, but if most of the spreading is done before the host gets significantly sick, well, I don't see how there'd be a mechanism to drive to lower virulence...?

[NickW + 2,714]

52 minutes ago, Otis11 said:

Does that case still hold when a virus has a 14-34 day incubation time and rapid spread? Selecting for lower virulence happens when you kill the host so fast it negatively impacts the rate of spread, but if most of the spreading is done before the host gets significantly sick, well, I don't see how there'd be a mechanism to drive to lower virulence...?

Often Viruses don't spread during the incubation period or at least the early part- you need to be shedding Virus so the incubation period is often of limited irrelevance in regard to spreading the disease. 

Edited February 25, 2020 by NickW

[Gerry Maddoux + 3,627]

With regard to infectivity during what appears to be a very long incubation period, my friends who are in the loop seem to think that while this coronavirus 19 has tropism for all alveolar cells, and quite possibly for pharyngeal cells and even gastrointestinal cells too, it merely replicates listlessly in healthy hosts, not causing much symptomatology--thus the apparent "long incubation period" that has been talked about. 

If they are right, and they usually are, then such a person (like Typhoid Mary) is actually in the active phase and is shedding virus all the while. In other words, unlike Influenza, which pretty much causes any victim significant physical symptoms, this virus isn't much of a nuisance to young, healthy, nonsmoking people with good lungs and immunity. They're unaware that they're infected. But they are shedding virus. 

Edited February 25, 2020 by Gerry Maddoux

[Tom Kirkman + 8,860]

29 minutes ago, Gerry Maddoux said:

With regard to infectivity during what appears to be a very long incubation period, my friends who are in the loop seem to think that while this coronavirus 19 has tropism for all alveolar cells, and quite possibly for pharyngeal cells and even gastrointestinal cells too, it merely replicates listlessly in healthy hosts, not causing much symptomatology--thus the apparent "long incubation period" that has been talked about. 

If they are right, and they usually are, then such as person (like Typhoid Mary) is actually in the active phase and is shedding virus all the while. In other words, unlike Influenza, which pretty much causes any victim significant physical symptoms, this virus isn't much of a nuisance to young, healthy, nonsmoking people with good lungs and immunity. They're unaware that they're infected. But they are shedding virus. 

Sounds about right.  Unlike many other viruses which typically have mortality for both the very young and the very old, this particular virus seems pretty specific in mortality in targeting old, male, smokers in densely populated urban areas with high levels of air pollution, and who were already seriously unhealthy.

So far, I haven't heard of any fatalities of anyone under 10 years of age. 

So far, this Coronavirus seems more of a Darwin Award nudge for those who are already greatly predisposed for an early demise.

Unhealthy, old (over 80 years old) male, smokers, who live in highly air polluted areas should consider putting their affairs in order soon.  Regardless of whether or not they get infected with the Coronavirus, as they are already looking at a self-caused early demise.

Just spit balling here, it seems this Coronavirus itself does not cause fatality, it seems to attack already greatly-compromised respiratory systems (from old age + heavy smoking + air pollution) and goes downhill from there.

Young, non-smokers who are otherwise generally healthy seem to be statistically safe from dying from this Coronavirus.  It's the difference between getting sick and recovering, and getting sick and dying.

Obviously, I could be wrong.

[Otis11 + 551]

1 hour ago, Tom Kirkman said:

Sounds about right.  Unlike many other viruses which typically have mortality for both the very young and the very old, this particular virus seems pretty specific in mortality in targeting old, male, smokers in densely populated urban areas with high levels of air pollution, and who were already seriously unhealthy.

So far, I haven't heard of any fatalities of anyone under 10 years of age. 

So far, this Coronavirus seems more of a Darwin Award nudge for those who are already greatly predisposed for an early demise.

Unhealthy, old (over 80 years old) male, smokers, who live in highly air polluted areas should consider putting their affairs in order soon.  Regardless of whether or not they get infected with the Coronavirus, as they are already looking at a self-caused early demise.

Just spit balling here, it seems this Coronavirus itself does not cause fatality, it seems to attack already greatly-compromised respiratory systems (from old age + heavy smoking + air pollution) and goes downhill from there.

Young, non-smokers who are otherwise generally healthy seem to be statistically safe from dying from this Coronavirus.  It's the difference between getting sick and recovering, and getting sick and dying.

Obviously, I could be wrong.

So the million dollar question is how polluted is polluted? If I look at the average 60-65 year old, non smoking male in a US major city (Aka, likely overweight and out of shape, with a 'minor' heart condition like hypertension - sounds fairly typical, no?) What are we looking at?

I know our air is nothing like some Chinese cities, but it's still not good... (some cities are equivalent to a light smoker, by some reports)

I realize everything is a guess at this stage, but thoughts...?

[Otis11 + 551]

2 hours ago, NickW said:

Often Viruses don't spread during the incubation period or at least the early part- you need to be shedding Virus so the incubation period is often of limited irrelevance in regard to spreading the disease. 

And I believe this particular virus has already shown to shed during the asymptomatic phase... so while I normally agree with you, here that fact doesn't seem to apply.

[Tom Kirkman + 8,860]

3 hours ago, Otis11 said:

So the million dollar question is how polluted is polluted? If I look at the average 60-65 year old, non smoking male in a US major city (Aka, likely overweight and out of shape, with a 'minor' heart condition like hypertension - sounds fairly typical, no?) What are we looking at?

I know our air is nothing like some Chinese cities, but it's still not good... (some cities are equivalent to a light smoker, by some reports)

I realize everything is a guess at this stage, but thoughts...?

We will probably need to wait until this virus spreads more in the U.S. and other Western countries, which should have more openly available statistics than the outright lies and disinformation nonsense spewing from the CCP.

China Hunting Down Coronavirus Critics, Here's How

But again, this specific coranavirus does not seem to cause death all on its own, it only seems to cause death in older, already very unhealthy people, who were already statistically leaning toward an early demise - compared to healthy people, and younger people.

 

COVID-19 Fatality Rate by AGE:

AGE	DEATH RATE
80+ years old	14.8%
70-79 years old	8.0%
60-69 years old	3.6%
50-59 years old	1.3%
40-49 years old	0.4%
30-39 years old	0.2%
20-29 years old	0.2%
10-19 years old	0.2%
0-9 years old	no fatalities

 

COVID-19 Fatality Rate by SEX:

SEX	DEATH RATE
Male	2.8%
Female	1.7%

 

COVID-19 Fatality Rate by COMORBIDITY:

PRE-EXISTING CONDITION	DEATH RATE
Cardiovascular disease	10.5%
Diabetes	7.3%
Chronic respiratory disease	6.3%
Hypertension	6.0%
Cancer	5.6%
no pre-existing conditions	0.9%

 

Note that so far, the death rate for people who were previously otherwise healthy (no pre-existing conditions) is less than 1%.  Statistically insignificant.

This ^ simple fact should be noted before panic ensues.

If you are otherwise generally healthy, don't smoke, and are relatively young enough to be working full time, if you get sick, then you have at least a 99% chance of recovery.

Again, this seems like a nudge toward Darwin Awards for those that are statistically already predisposed to falling seriously ill and dying.

 

[J.mo + 165]

7 hours ago, Tom Kirkman said:

Sounds about right.  Unlike many other viruses which typically have mortality for both the very young and the very old, this particular virus seems pretty specific in mortality in targeting old, male, smokers in densely populated urban areas with high levels of air pollution, and who were already seriously unhealthy.

So far, I haven't heard of any fatalities of anyone under 10 years of age. 

So far, this Coronavirus seems more of a Darwin Award nudge for those who are already greatly predisposed for an early demise.

Unhealthy, old (over 80 years old) male, smokers, who live in highly air polluted areas should consider putting their affairs in order soon.  Regardless of whether or not they get infected with the Coronavirus, as they are already looking at a self-caused early demise.

Just spit balling here, it seems this Coronavirus itself does not cause fatality, it seems to attack already greatly-compromised respiratory systems (from old age + heavy smoking + air pollution) and goes downhill from there.

Young, non-smokers who are otherwise generally healthy seem to be statistically safe from dying from this Coronavirus.  It's the difference between getting sick and recovering, and getting sick and dying.

Obviously, I could be wrong.

So what about the 34yo doctor who received care? Fairly young, and this is an assumption here so dont nail me to the wall, but as a doctor I'm sure he wasnt in the worst of health. 

Those downplaying it to a very bad flu. I've never seen any flu do what this Coronavirus is doing to the stock market, oil prices, mortgage rates or city/state/countrywide lockdowns. I believe this is more on the side of the original SARS but on a MUCH LARGER level, and the talking heads are trying to reduce panic. 

[Gerry Maddoux + 3,627]

1 hour ago, J.mo said:

So what about the 34yo doctor who received care? Fairly young, and this is an assumption here so dont nail me to the wall, but as a doctor I'm sure he wasnt in the worst of health. 

Those downplaying it to a very bad flu. I've never seen any flu do what this Coronavirus is doing to the stock market, oil prices, mortgage rates or city/state/countrywide lockdowns. I believe this is more on the side of the original SARS but on a MUCH LARGER level, and the talking heads are trying to reduce panic. 

You make a very good point, and there are going to be people who appear healthy and don't smoke or have lung damage who, for some reason--maybe run down with a weakened immune system--develop this virus and die. 

The immune system is immensely subject to emotional and physical exhaustion. The immune system keeps out cancer--yet we see young, healthy appearing people get cancer every day. Same thing here. 

This is scaring the daylights out of people because it's probably going to get loose here in the US and seems awfully infectious. We have nowhere near the facilities to deal with a major outbreak, so we'll be in more or less the same shape as China if it hits in force. We're farther along toward spring now, so there's that. Remember, when this hit China it was early December. Springtime is our friend in dealing with something like this. 

[0R0 + 6,251]

20 hours ago, J.mo said:

So what about the 34yo doctor who received care? Fairly young, and this is an assumption here so dont nail me to the wall, but as a doctor I'm sure he wasnt in the worst of health. 

Those downplaying it to a very bad flu. I've never seen any flu do what this Coronavirus is doing to the stock market, oil prices, mortgage rates or city/state/countrywide lockdowns. I believe this is more on the side of the original SARS but on a MUCH LARGER level, and the talking heads are trying to reduce panic. 

Keyword is "doctor". Meaning overworked and sleepless, meaning that his immune system is not functional. You need your parasympathetic system to have priority in directing the body's distribution of resources in order to have good immune response. Which is why you need rest, as that is when resources are allocated to immune functions. You are particularly immune suppressed when you are (1) cold (your body is working hard to maintain temp), (2) exercising, (3) missing sleep.

[Tom Kirkman + 8,860]

20 hours ago, Gerry Maddoux said:

and there are going to be people who appear healthy and don't smoke or have lung damage who, for some reason--maybe run down with a weakened immune system--develop this virus and die. 

But so far, it appears that fatalities in young, otherwise healthy, non-smokers is statistically insignificant.

Lots and lots of people will get infected and get sick, but most younger, healthy non-smokers should recover.

Again, once this eventually spreads globally to more Western countries, the data and statistics should become dramatically improved in reporting by developed countries, compared to China's disinformation.

[ronwagn + 6,290]

On 2/24/2020 at 1:45 AM, Zhong Lu said:

Ok. So it's basically a slightly deadlier version of the flu.  Thx.  

The infection rate seems higher though, due to it being able to persist on surfaces longer and for carriers to be asymptomatic for up to 20 days. This makes it much more likely to be a pandemic which I would call it already. We will see. 

[ronwagn + 6,290]

6 hours ago, 0R0 said:

Keyword is "doctor". Meaning overworked and sleepless, meaning that his immune system is not functional. You need your parasympathetic system to have priority in directing the body's distribution of resources in order to have good immune response. Which is why you need rest, as that is when resources are allocated to immune functions. You are particularly immune suppressed when you are (1) cold (your body is working hard to maintain temp), (2) exercising, (3) missing sleep.

Yet "studies" supposedly have shown that weather has nothing to do with the common cold. I have never really reviewed them though. I almost died of the measles and double pneumonia at age five after walking home from kindergarten in the rain. My tonsils may have been infected already though. Penicillin probably saved my life. I even had a mustard plaster back then. 

Thanks for the information on immune suppression! I have been waiting to do some work due to several days of bad weather. 

[Tom Kirkman + 8,860]

New England Journal of Medicine: Scientific Study Reports NO CASES of Coronavirus in Children Under Age 15 in Test Study

The New England Journal of Medicine published a report by Dr. Anthony S. Fauci, M.D., H. Clifford Lane, M.D., and Robert R. Redfield, M.D.

The authors are from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD (A.S.F., H.C.L.); and the Centers for Disease Control and Prevention, Atlanta (R.R.R.).

Dr. Fauci is on President Trump’s committee on coronavirus.

The article was published on Friday, February 28, 2020.

In the article the three experts on contagious disease report that there has been no known cases of Covid-19 in children under the age of 15.

Via Dr. Andrew Bostom.

NIAID Dir Fauci’s welcome sobriety on corona/COVID-19, which “may ultimately be more akin to a severe seasonal influenza (which has a case fatality rate of approximately 0.1%)” [published by the ideologically Left, NEJM, no less!]: https://t.co/lUr6dqDC54 pic.twitter.com/HnUDQX2OST

— Andrew Bostom (@andrewbostom) March 1, 2020

 

Via the New England Journal of Medicine.

In their Journal article, Li and colleagues3 provide a detailed clinical and epidemiologic description of the first 425 cases reported in the epicenter of the outbreak: the city of Wuhan in Hubei province, China. Although this information is critical in informing the appropriate response to this outbreak, as the authors point out, the study faces the limitation associated with reporting in real time the evolution of an emerging pathogen in its earliest stages. Nonetheless, a degree of clarity is emerging from this report. The median age of the patients was 59 years, with higher morbidity and mortality among the elderly and among those with coexisting conditions (similar to the situation with influenza); 56% of the patients were male. Of note, there were no cases in children younger than 15 years of age. Either children are less likely to become infected, which would have important epidemiologic implications, or their symptoms were so mild that their infection escaped detection, which has implications for the size of the denominator of total community infections…

…If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.2  ...

[Tom Kirkman + 8,860]

On 2/25/2020 at 1:20 PM, Tom Kirkman said:

Unlike many other viruses which typically have mortality for both the very young and the very old, this particular virus seems pretty specific in mortality in targeting old, male, smokers in densely populated urban areas with high levels of air pollution, and who were already seriously unhealthy.

Update, from Stanton A. Glantz, PhD, Director, Center for Tobacco Research Control & Education:

Reduce your risk of serious lung disease caused by corona virus by quitting smoking and vaping

When someone’s lungs are exposed to flu or other infections the adverse effects of smoking or vaping are much more serious than among people who do not smoke or vape.

Smoking is associated with increased development of acute respiratory distress syndrome (ARDS) in people with a risk factor like severe infection, non-pulmonary sepsis (blood infection), or blunt trauma.   People who have any cotinine (a metabolite of nicotine) in their bodies – even at the low levels associated with secondhand smoke – have substantially increased risk of acute respiratory failure from ARDS (paper 1, paper 2, paper 3). 

The recent excellent summary of the evidence on the pulmonary effects of e-cigarettes reported multiple ways that e-cigarettes impair lungs’ ability to fight off infections:

Effects on immunity

Reporting of respiratory symptoms by e-cigarette users suggests increased susceptibility to and/or delayed recovery from respiratory infections. A study of 30 healthy non-smokers exposed to e-cigarette aerosol found decreased cough sensitivity.82 If human ciliary dysfunction is also negatively affected, as suggested by animal and cellular studies,83 the combination of reduced coughing and impaired mucociliary clearance may predispose users to increased rates of pneumonia. Exposure to e-cigarettes may also broadly suppress important capacities of the innate immune system. Nasal scrape biopsies from non-smokers, smokers, and vapers showed extensive immunosuppression at the gene level with e-cigarette use.84 Healthy non-smokers were exposed to e-cigarette aerosol, and bronchoalveolar lavage was obtained to study alveolar macrophages.46 The expression of more than 60 genes was altered in e-cigarette users’ alveolar macrophages two hours after just 20 puffs, including genes involved in inflammation. Neutrophil extracellular trap (NET) formation, or NETosis, is a mode of innate defense whereby neutrophils lyse DNA and release it into the extracellular environment to help to immobilize bacteria, a process that can also injure the lung.85 Neutrophils from chronic vapers have been found to have a greater propensity for NET formation than those from cigarette smokers or non-smokers.57 Given that e-cigarettes may also impair neutrophil phagocytosis,86 these data suggest that neutrophil function may be impaired in e-cigarette users. [emphasis added]

Studies in animals reinforce and help explain these human effects:

Two weeks of exposure to e-cigarette aerosol in mice decreased survival and increased pathogen load following inoculation with either Streptococcus pneumoniae or influenza A, two leading causes of pneumonia in humans.97 Furthermore, the aerosol exposure may lead to enhanced upper airway colonization with pathogens and to virulent changes in pathogen phenotype, as shown with Staphylococcus aureus.98 99 Thus, although more studies are needed, the animal data suggesting that vaping leads to an increased susceptibility to infection would seem to correlate with the population level data in young adult humans, whereby vapers have increased rates of symptoms of chronic bronchitis.23 [emphasis added]

 

Consistent with this science, analysis of deaths from corona virus in China shows that men are more likely to die than women, something that may be related to the fact that many more Chinese men smoke than women.  Among Chinese patients diagnosed with COVID-19 associated pneumonia, the odds of disease progression (including to death) were 14 times higher among people with a history of smoking compared to those who did not smoke. This was the strongest risk factor among those examined.

CDC, FDA, the Surgeon General, state health departments and everyone (including comedians, such as John Oliver who spent his whole show on the issue last weekend) working to educate the public on how to lower risk of serious complications from covid-19 should add stopping smoking, vaping, and avoiding secondhand exposure to their list of important preventive measures.

This would also be a good time for cities, states private employers and even individual families to strengthen their smokefree laws and policies – including e-cigarettes -- to protect nonsmokers from the effects of secondhand smoke and aerosol on their lungs and to create an environment that will help smokers quit.