Most Pierce COVID deaths have underlying conditions. But what does that really mean?

Underlying health conditions is a term that’s become part of routine conversation in 2020, used by public health experts and armchair epidemiologists alike.

It’s also a security blanket that people who are generally healthy tend to cling to during the long, dark night of COVID-19. As in: “Nobody in my family has any serious chronic medical issues, so we should be able to ride out this pandemic just fine.”

Indeed, Tacoma Pierce County Health Department statistics show an overwhelming share of coronavirus fatalities with underlying health conditions — nearly 97 percent as of last Wednesday, when that statistic was last updated.

Then came the tragic news about Eli Sevener, a 2019 Puyallup High School graduate. It should’ve yanked the security blanket from all of us.

Pierce County’s first COVID-related death of someone under age 20 simultaneously exploded two common myths: that a young person in the prime of life — a former student athlete, no less — can’t die from the disease, and that a person with a good medical history — Sevener has “no reported underlying health conditions,” according to TPCHD — can’t succumb to it.

Right now the public could use a remedial education on underlying health conditions, or what doctors sometimes call comorbidities. They’re more prevalent than many folks believe and can go undetected.

TPCHD officials should do more public messaging on this issue in the context of the current outbreak. Nowhere on the department’s COVID-19 dashboard do they define what an underlying medical condition is, nor give examples of comorbidities that are closely associated with COVID.

This should come naturally to them; waging war on underlying conditions comprises most of the work they do when there’s not a pandemic going on — things like smoking cessation, healthy eating habits, preventing chronic disease and unnecessary hospitalizations.

So why aren’t they talking more about it now? That question surfaced at last week’s Board of Health meeting.

Many people likely don’t have a firm grasp of what an underlying health conditions is, said board member Derek Young of Gig Harbor.

“It conjures someone who was close to death without COVID, that they were severely unhealthy, when in fact underlying health conditions can be things as simple as obesity or diabetes or asthma,” said Young, who also sits on the Pierce County Council. “If you run the numbers, about half of Americans have one of the conditions.

“I wonder if it may be playing into this perception by a lot of young people that they’re essentially immune to the disease.”

We wonder the same thing. How many South Sound residents are overly optimistic in their personal risk assessments due to misinformation or lack of information?

Health Department Director Dr. Anthony Chen said TPCHD would look into sharing more about underlying conditions. He also remarked that the months-long shutdown is fueling behaviors that contribute to those conditions. “If you look on social media, people are joking about how many pounds they’re gaining just sitting around at home,” Chen said at Wednesday’s meeting.

TPCHD provides several helpful metrics on its COVID-19 dashboard; unfortunately, there’s nothing about how hospitalizations or deaths are connected to specific medical conditions.

We understand the department normally takes months to investigate, collate and present death findings. Doing it in “real time” during a pandemic certainly poses new challenges.

But other health departments across the US are adapting. This month officials in San Joaquin County, California, started sharing COVID comorbidity data, in response to community feedback. It shows the percentage of deaths of people who also had asthma, chronic heart or lung disease, diabetes or none/other underlying conditions. At 44.5 percent, diabetes had the strongest association to COVID deaths.

Providing more robust information isn’t about satisfying the public’s morbid curiosity. It’s about giving people a more complete picture so they can make smart lifestyle choices to protect themselves and their loved ones.

And it’s about exposing holes in our pandemic security blankets.

This story was originally published August 10, 2020 at 3:15 PM.