* My column in BusinessWorld last Tuesday, April 14, 2020.
In the ongoing Enhanced Community Quarantine (ECQ) in the Philippines, there are many prohibitions and closures — office or shop work, many businesses, and public transportation have been shut, strolling around and long travel are prohibited, etc. Also among the weird bans is a liquor ban in many cities in Metro Manila and provinces, and cigarette and e-cigarette bans in some small municipalities like General Luna in Quezon province.
The main reason given is that these three products are seen to weaken our body’s immune system against the China virus infection, so these should be restricted or prohibited for the ECQ duration.
And the World Health Organization (WHO) issued a paper, “WHO, Q&A on smoking and COVID-19” (posted March 24) saying that “smokers are likely to be more vulnerable to COVID-19 as the act of smoking means that fingers (and possibly contaminated cigarettes) are in contact with lips which increases the possibility of transmission of virus from hand to mouth.” (https://www.who.int/news-room/q-a-detail/q-a-on-smoking-and-covid-19)
Is the WHO correct here? I want to see numbers to verify if the WHO is correct or spreading disinformation. I searched many materials online and I found two case studies, in China and the US. The China case study, “Smoking, vaping and hospitalization for COVID-19,” (10 pages) was published (April 4) by three academics, Konstantinos Farsalinos, Anastasia Barbouni, and Raymond Niaura. The first two are from the University of West Attica, Athens, Greece and Dr. Niaura is from New York University, USA. The authors made a review of publications on PubMed using the terms “[SARS-CoV-2 OR COVID-19 OR 2019-nCoV] AND [Clinical OR Mortality OR Outcome].” Out of 432 studies in total, the authors identified 13 studies that included data about smoking status of hospitalized COVID-19 patients.
I repost their table below but I did not include three studies which have small sample sizes of below 140 patients. The median interquartile (IQR) or mean standard deviation (SD) age of patients are given. There is an interesting revelation – in China, with high smoking prevalence of 26.6%, only about 7% of the hospitalized COVID-19 patients are current smokers (see Table 1).
The authors concluded, “The generalized advice to quit smoking as a measure to improve health risk remains valid, but no recommendation can currently be made concerning the effects of smoking on the risk of hospitalization for COVID-19. No studies recording e-cigarette use status among hospitalized COVID-19 patients were identified. Thus, no recommendation can be made for e-cigarette users.”
Next the US case. I found a report from the US Centers for Disease Control and Prevention, “Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with coronavirus disease 2019 — United States, February 12–March 28, 2020” (posted April 30). An attached table shows the total cases with case report forms, 74,439, of which (a.) with missing or unknown status for all conditions, 67,277, and (b.) with completed information, 7,162.
And the table shows another interesting revelation — only 3.6% of the US’ COVID-19 cases as of March 28 are former or current smokers. Meaning 96.4% are non-smokers, past or present, and they still got the infection (see Table 2).
In the two cases, the big lesson is that the WHO is spreading disinformation when it announced that “Smokers are likely to be more vulnerable to COVID-19…”
And If we follow the WHO’s logic that hand to mouth actions like smoking or vaping increase the risk of transmission, then finger-lickin-good foods like potato chips, KFC chicken should also be avoided or banned?
The WHO and many national governments’ Health Departments or Ministries seem to have PhD and post-doctorate degrees in regulating, banning certain products to deal with non-infectious diseases, but they seem to have only an AB or high school degrees in dealing with really killer infectious diseases like dengue and many strains of corona viruses. They should learn to reverse their priorities.