‘Those with underlying health conditions are at most risk’

Preventative healthcare programs, which generally aim to prevent the onset of chronic diseases, and underlying health conditions are intertwined issues and that connection between these two come to the fore in cases like COVID-19, according to Dr. John M. Tudela, chief medical officer for the Commonwealth Healthcare Corp.

In a statement Saipan Tribune obtained last week, Tudela pointed out that the interplay between the two is highlighted by the fact that individuals with underlying health conditions are at most risk of succumbing to COVID-19-related complications.

Generally speaking, Tudela said, preventative healthcare programs “aim to reduce our risk of developing early onset chronic diseases, which leads to physical incapacitation, poor quality of life, and untimely death.”

One example of preventative healthcare in the CNMI that Tudela pointed out is CHCC’s ongoing efforts to prevent obesity, and said that preventative healthcare programs “are always designed to encourage regular exercise, weight management, and a healthy diet at an early age as well as regular visits with a healthcare provider to guide each of us through the important milestones as we age and obtain the recommended screenings.”

However, if obesity goes unaddressed, individuals will develop chronic diseases, notably diabetes, said Tudela. For individuals with diabetes, they are much more vulnerable to “all kinds of infections, including viruses like COVID-19,” he added.

Tudela

“The complications as a result of these chronic diseases reduces the ability of an individual to mount an adequate immune response to counteract such infections as well as have enough physical reserve to maintain a balance within the body’s physiology during an acute illness,” said Tudela.

As to why a small number of vaccinated individuals with underlying health conditions still get infected with COVID-19 (called “breakthrough cases”) and die from severe COVID-19 disease, Tudela said that he and other fellow health officials “don’t have yet a clear understanding” yet of why these deaths occur, but said that early research has shown that “immune response in [these] vulnerable populations may be waning after six to eight months since their vaccination series were administered.”

Tudela said that in these “breakthrough cases,” the individuals tend to have complications of severe organ failure triggered by the virus.

“For example, a patient with chronic heart failure and on hemodialysis infected with [COVID-19] may progress to worsening fluid overload and cause accelerating respiratory failure leading to cardiac arrest,” he said.

Citing research from the Centers of Disease Control and Prevention, Tudela pointed out that unvaccinated individuals are still “12 times more likely to be hospitalized with severe disease [compared] to a fully vaccinated person.”

The research that Tudela mentioned can be found in the summary portion here: https://covid.cdc.gov/covid-data-tracker/#covidnet-hospitalizations-vaccination .

Tudela said that preventative health measures should start “early while we are young to avoid having early onset chronic disease and becoming vulnerable to infections and organ failure” in the long-term.

In the midst of the COVID-19 pandemic, Tudela urges those eligible to receive a COVID-19 vaccine to get their shots, and to get their doses as soon as possible. For those who are vaccinated but are still vulnerable due to underlying health conditions, Tudela advises these individuals to get their booster dose.

Tudela said all of the approved COVID-19 vaccines are available in the CNMI and are free, and that making use of the preventative tools available will lessen the chance of COVID-19 evolving into more easily transmissible, deadlier variants.