With the US president, Donald Trump, testing optimistic for coronavirus, hypothesis has begun concerning attainable outcomes. The fact is, it’s unattainable to say for sure what’s going to occur to a person as soon as they’ve contracted COVID. Some folks might don’t have any signs in any respect, whereas others might have far worse outcomes. It’s one of many many mysteries of the virus that scientists worldwide are working across the clock to untangle.

In the case of danger, there are some issues we do know, however many who stay unsure. There are additionally some issues we will change and a few that we’re caught with. It’s now frequent data that age is crucial issue driving the danger of worse outcomes from COVID. Being male, dwelling with weight problems, being from a non-white ethnic group and having long-term circumstances – comparable to diabetes and coronary heart illness – additionally improve danger.

The elevated danger with age is putting – folks 80 and older are estimated to be 70 occasions extra more likely to die than these beneath 40. Within the UK, being aged 70 or older lessons folks as clinically weak, or reasonably in danger. Within the USA, eight out of each ten deaths attributed to COVID have been of individuals 65 and older.

Against this, weight problems is estimated to extend danger of dying from COVID by virtually 50%, and sort 2 diabetes is estimated to double the danger.

These are solely the headline elements – totally different medicines might have an effect on danger, as might a bunch of different elements which can differ from individual to individual and embody issues comparable to viral load, which means how a lot of the virus an individual is uncovered to within the first place.

Age, physique weight and being a person are all danger elements for extreme COVID and improve the probability of needing intensive care.

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Linked to many of those danger elements can also be the important thing, however advanced, concern of socioeconomic standing – with folks from much less advantaged teams struggling a disproportionate burden of COVID illness and dying.

A number of the above danger elements are non-modifiable, which implies, basically, we’re caught with them. You may’t change how outdated you might be. The excellent news, nonetheless, is that motion may be taken to deal with a few of the others. Raised physique weight, for instance, is pushed by a fancy system of socioeconomic, industrial, environmental and genetic elements, however governments can roll out insurance policies to assist handle a few of these. There are additionally evidence-based strategies out there to help wholesome weight reduction.

Being rich is wholesome

When overlaying Trump’s danger elements, one is much less spoken of however weighs closely in his favour – his socioeconomic standing. Individuals from less-advantaged teams are at better danger from COVID.

If one teases this out, the well being advantages of upper socioeconomic standing develop into right down to various elements, together with a decrease danger of contracting the illness within the first place (typically linked to socioeconomic elements comparable to occupation or the place you reside). Different elements at play embody the presence and remedy of underlying well being circumstances, the relative danger of publicity to air air pollution and different environmental threats to well being – and, crucially, entry to healthcare.

For folks with essentially the most extreme types of COVID, remedy with the drug dexamethasone can scale back danger of dying by as much as one-third. Socioeconomic standing is among the elements figuring out who will get the perfect remedy for COVID, significantly in international locations the place there isn’t any common healthcare – together with the US.

When the UK’s prime minister, Boris Johnson, contracted COVID this yr, it was described as a wake-up name, significantly with regard to weight problems. The prime minister himself has raised physique weight as a problem, and attributes his extreme an infection to that danger issue.

It stays to be seen how Trump reacts, each bodily and politically, to his personal an infection. There is no such thing as a doubt that, on account of his place, he can be receiving each facet of healthcare he may want for. Against this, hundreds of thousands of People can’t entry primary care, together with entry to important medicines comparable to insulin for kind 1 diabetes (Trump not too long ago asserted insulin is priced as cheaply as water, which sadly is much from true), not to mention intensive care through the acute part of a pandemic.

Whereas the press focuses on the danger elements that will put Trump at better danger of extreme an infection, we should always not neglect these modifiable and strikingly inequitably distributed elements which work in his favour. Focus ought to be not solely on treating the virus, however on mending the damaged system that has allowed it to assert the lives of 207,000 People and counting.

Jamie Hartmann-Boyce receives funding from the Nationwide Institute for Well being Analysis, the British Coronary heart Basis and Most cancers Analysis UK.