Dr. Irl Hirsch discusses COVID-19: Part 2

Brook is committed to bringing you up-to-date and accurate info about COVID-19. Brook Health Director Heather King interviewed Dr. Irl Hirsch (virtually of course!) to answer some common questions and concerns. In the second part of this interview series, Dr. Hirsch discusses maintaining healthy habits at home and how weight may play a role in COVID-19 risk factors. 

Irl Hirsch, MD, Endocrinologist and Professor at University of Washington, and Head of Brook’s Medical Advisory Board

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Hi Dr. Hirsch, thanks for having another virtual meeting with me. So much is changing so quickly with COVID-19…

We are learning new things all the time. Even though there has not been an opportunity for much published research, the medical community is sharing information with one another all the time, and we are understanding this disease more and more based on this anecdotal information.

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From what I hear from our users, a lot of people are feeling less motivated to care for their chronic conditions, such as diabetes, on a daily basis. I had one user describe it as feeling like she was in a sort of ‘time warp’ bubble, in which the daily self-care she used to do doesn’t feel as important or as easy to do anymore.

Self-care definitely seems to be falling off for many people right now, and it is easier to disregard. One of the biggest issues is that people have more access to food throughout the day. Most of us are sheltering in place at home, in close proximity to our refrigerators. There’s a lot of snacking going on, and larger meals because we have more time to prepare them and eat them, and not much else to do. 

This means it’s more important than ever to make sure that the food you eat is mostly healthy food. If it’s there, you’ll eat it, so make good choices.It’s easy to fill your grocery cart, real or virtual, with a lot of comfort food, because that gives us a measure of comfort and emotional soothing right now. But comfort food is almost always too high in fat, sugar, and salt. Whether you have diabetes, obesity, and hypertension, or no chronic disease at all, none of us need to stockpile this kind of food in our homes.

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Great point about access – if you don’t bring that stuff into your house in the first place, then you won’t eat it. Are there any other key issues you see popping up for people during this time regarding self-care?

Well, we are definitely moving a lot less. Even the steps it takes to get from point A to point B during the day are gone for most of us, now that point A is the couch and point B is the dining room table. We don’t have as much ambient movement in our day. So, we need to be more deliberate about getting it in. 

Now that the days are getting longer, I’m doing more short, frequent walks around my neighborhood. And I have a treadmill at home that I walk on at a low speed when I’m reading or talking with friends online. Keep your body in motion. It goes a long way to helping with weight and blood sugar control, and keeping your mood up. 

And, most importantly for this point in time, we know that people recover better from illness when they are in better shape.

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Speaking of weight, is any information coming out about how weight and BMI affects outcomes for those who have COVID-19?

When we look at the ICUs right now, we’re seeing that, the higher the BMI (Body Mass Index) of patients, the longer they are staying sick and the worse they’re doing. When you’re obese, your ability to move air in and out of your lungs is not as good. This really influences lung health, and is especially important if you have pneumonia or compromised lung function, like with COVID-19. This is a respiratory disease, so it stands to reason that people whose lungs are not working as well will not fare well with this illness.

For this reason, my colleagues and I believe that obesity is a big risk factor with COVID-19. As I mentioned before, we don’t have the data right now to say this is definitely the case, but I feel strongly that this is what conclusion we will come to once we see more research.

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This sounds like a really important message for people who have excess weight. What advice would you give to them right now?

You don’t need to get your BMI all the way down to a ‘normal’ level to decrease your risk level with COVID-19. It can be helpful to get your BMI down any amount. It’s a continuum, just like blood sugar control – the closer you get your A1c to < 7%, the better your overall health. We know that, if you are obese or overweight, lowering your weight even a small amount can improve your health, and with that, your lung function. This will mean you have a better chance at a milder illness and easier recovery if you get sick with COVID-19.

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There’s a lot of data showing that a weight loss of 5 – 7% provides many health benefits for people. That’s a loss of 10 – 14 lbs for someone who weighs 200 lbs. I’d like to encourage  our Brook users who are interested in working towards this goal to reach out to the Experts. They can support you in creating a weight loss plan and daily accountability, and can tell you more about the useful tracking tools on the app.

Any support we can give each other right now is a good thing. We all need to work together on this, in our own homes and with our patients and communities.

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Thank you, again, for taking the time to talk with me again and share your current knowledge and recommendations with us here at Brook.

My pleasure. Take good care of yourselves.

Responses were edited for length and clarity.

We understand that there’s a lot of information and, unfortunately, misinformation going around right now. Google and Facebook can be a scary place. Brook’s medical board and team of health experts are working to sift through the information to bring you what’s pertinent, important, and true.

Reach out to our Health Coaches any day of the week for questions or support.

If you feel like you are experiencing symptoms of COVID-19, stay home, be sure to call your healthcare provider and follow protocols established by the CDC or World Health Organization.

Interview done by Heather King, MS, RDN​, CDE

on April 5th, 2020. Heather is a Certified Diabetes Educator, has been a Registered Dietitian for over 12 years and is Brook's Health Director.