COMMENT: Preexisting Conditions of the Coronavirus Pandemic

The Preexisting Conditions of the Coronavirus Pandemic An enormous new data set peers into the health of the world’s population before 2020—and how the coronavirus turned that into a global disaster. Adam Rogers Wired

A massive new accounting of the health of humans on Earth, collating and inferring stats on hundreds of diseases and injuries across 204 nations, has mostly good news. People are healthier, and they stay that way for longer. The bad news: That’s not true if those people are poor, are people of color, live in the United States, and there’s a pandemic.

Then they’re screwed.

The ongoing work of thousands of international researchers, the Global Burden of Disease project is based at the University of Washington—it’s a big part of the work of the Institute for Health Metrics and Evaluation, which you might remember from its hyper-pessimistic but highly motivating models of the coronavirus pandemic earlier in the year. With GBD, that modeling experience fills in the gaps from countries that don’t gather all the same data, but overall the work slurps in all kinds of epidemiological and health outcome numbers from governments and health care organizations, and tabulates who gets what illness by age and sex. That’s 286 causes of death, 369 diseases and injuries, and 87 risk factors in 204 countries and territories, with numbers going back to 1990. The latest bolus of data, published in the medical journal The Lancet, brings that up through 2019. (The Bill and Melinda Gates Foundation is the major source of funding.)

In a way, the Global Disease Burden report is a blast from the past, a look at the health of a planet now gone—the best of Before Times and the worst of Before Times. Chronic diseases were undermining the gains of modern medicine and public health. But 10 months into a pandemic, the GBD report is a map to the vulnerabilities that Covid-19 would exploit. It's also a laser-pointer showing the way to a brighter timeline.

Overall, the things that kill the most people aren’t communicable diseases like Covid-19. The number-one killer worldwide is high blood pressure; number two is disease related to tobacco use. In fact, everything on the top-10 list is the same population-scale stuff that takes systemic change to fix. That’s air pollution; nutritional gaps that lead to diabetes, obesity, and heart disease; and alcohol abuse. Childhood and maternal mortality still sneaks into the top 10 worldwide, too. ...