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‘Obesity should have been on the list of comorbidities’ | India News


NEW DELHI: Surprised that obesity could not make it to the list of 20 comorbidities that would determine eligibility for Covid-19 vaccination for people between the ages of 45 and 59, experts say it should have been included as it was one of the most common underlying diseases. conditions found in hospitalized patients. Overall, the categories of underlying conditions for vaccination released by the Union Health Ministry on Saturday have divided the medical community with some calling it comprehensive, while others have found it too restrictive.
Doctors also noted that diabetes and hypertension have been associated with other ailments or linked to complications, or the length of time a person has been taking medications. One of the criteria says “having diabetes for more than 10 years or with complications and hypertension under treatment.” “Diabetics must take medications for more than 10 years and if they also have hypertension, they will qualify,” said physician Dr. Gautam Bhansali.
Bariatric surgeon Dr. Muffazal Lakdawala, who had created the city’s first jumbo center at NSCI Worli, said that removing obesity from the list was a “glaring exception.” “All over the world, it has been considered a risk factor. Also in Mumbai, we found that obese patients had a 60% higher chance of complications and a 30% higher risk of dying from the infection, “he said, adding that those with a BMI over 40 should have been taken into account. . “Just as diabetes and hypertension have been associated with other ailments, they could also have added obesity to the list,” he said. Diabetologist Dr. Rajiv Kovil said that metabolic problems in the 135 million obese people in India are driving the epidemic of diabetes and heart disease. “Obesity should have been included,” he added.
In the US, vaccine eligibility based on BMI has been a topic of discussion, as several states listed it as a criteria for priority vaccination as recommended by the Center for Disease Control to include obese and morbidly obese. Dr. Lakdawala said that statistics show that 80% of diabetics would also be obese. A senior physician at BYL Nair Hospital said that at least 35% of ICU patients had a higher body weight. “Their lungs were compressed and putting them on a ventilator posed an additional challenge,” the doctor added.
The list of 20 comorbidities includes heart failure with hospitalization in the last year, post-cardiac transplantation, coronary disease with a history of bypass, chronic kidney disease, liver and stem cell transplant recipient or on the waiting list, among others. The list also includes people with severe respiratory illnesses, blood cancers, solid cancers diagnosed as of July 1, 2020, or people currently receiving cancer therapy. A doctor would have to certify that a person is eligible for vaccination based on their previous medical reports. Apart from obesity, another point of contention has been the inclusion criteria for diabetics, which states that they should have been in treatment for more than 10 years or have complications. The criteria for patients with AP is “pulmonary arterial hypertension and hypertension / diabetes (for more than 10 years or with complications) and hypertension under treatment.”
According to Dr. Naveen Thacker, former civil society representative on the board of the Global Vaccine Alliance (Gavi), people with diabetes and hypertension should have been included regardless of the duration of the medication. Obesity was found to be a major factor in serious illness, even in younger people. The inclusion of diabetes and hypertension is extremely restrictive. Wondering what data you relied on to exclude obesity or to make these expectations? “He said. A total of 70% of Covid victims in Mumbai had a comorbidity, with diabetes and hypertension being the predominant ones. Dr. Thacker also said that since certification is a must for those in the age category of 45 to 59, a price must be set on how much doctors can charge for it.A senior BMC official admitted they still have “prescription misuse” to think about.
However, infectious disease expert Dr. Tanu Singhal found the list exhaustive. “Maybe calculating BMI could have been a challenge at the community level, but as vaccination becomes more flexible, we may see a change,” he said.

Times of India