COVID and COPD from another perspective

 I mentioned in the previous post that COVID and small-particulate matter (and thus COPD) might have some sort of causal relationship.    That led to some additional questions--duh!!!

The first question I posed for myself was just how big is this COPD problem around the globe.  I've herein several times made the point that it is a bigger disease death issue than almost any other specific disease, but it has mostly been anecdotal rather than quantitative.

With my partner, Scott Futryk, at AstroVirtual Inc, we've been using several AI tools for data extraction and compilation--way faster and easier than doing it 'the old way'.  Once we had satisfied ourselves that we are finding 'accurate data' (which by the way has not been all that easy), we set about to ask some COPD questions.

Well, here are some interesting findings.  First, the map of the world COPD prevalence, in terms of deaths per 100,000 population by country (USA on the next chart):

So India, China, the Philippines, and a few African nations are the most at risk.  Have you been to either Beijing or Bengaluru (nee Bangalore)?   Air so thick it is hard to see buildings four blocks away.  Far worse than Los Angeles when I was growing up there in the 1950s.

As for the US, it has been an evolution, migrating from the Rocky Mountains to the central Southern states over the past twenty years (partially smoking trends, partially fossil-fuel power plants???). 

But to ask about COPD is to be a bit narrow, so we asked for the full definition by WHO (World Health Organization); it came out something like this.   If you ask about incidence, more people by far 'have asthma than COPD, but it is 'just' disabling and uncomfortable rather than a killer.  Moreover, there are effective drugs and treatments for asthma by comparison with COPD.

Other forms of respiratory distress, of coure, exist.  Lung Cancer, a deadly killer; penumonia is a common killer for hospitalized patients for other reasons.  So here is a more complete WHO list:

So COPD is almost as big a killer in total worldwide deaths as all the respiratory cancers and pneumonia combined--surprise!  But the age distribution is quite different for these various issues:

And so are the gender death-rates, especially notable worldwide for the much higher male death-rate for these canceers (smoking mostly?):

A final question might be "How fast are these growing, or hopefully shrinking, over two decades?

Note that these are absolute deaths, and the world's population has been growing over this two-decade period, so the actual growth rates are much lower than these numbers would suggest.  The world's 2020 population estimate was 6.1 billion folk, while 2020 numbers are about 7.85 billion, a growth ~ 29%

Using this divisor changes the numbers substantially:

Respiratory infectious deaths were down 33%, not just 14%

Respiratory disease deaths (COPD mostly) were DOWN 6% rather than up 21%

And respiratory cancers were only up 14% instead of nearly 50%.

So, there's a bit of a deep dive into more about COPD and other respiratory diseases and deaths than you probably wanted to know.  

But, how does all of this stack up against the ills of COVID during, say, the first or 2nd year it hit?

Confirmed Deaths WW for 2020 were 1,815,000, which is only about half of the accredited COPD deaths for the same period.   After-the-fact assessments, though, based on comparison with "Excess Deaths" on a global basis placed the number of COVID deaths around 3.0 million, not that far from the Worldwide COPD death totals.

For 2021, the numbers were substantially higher, vaccine deployment notwithstanding.  The estimate for two full years (2020 and 2021) by the United Nations Dept of Ecominc and Social Affairs 

https://www.un.org/en/desa/149-million-excess-deaths-associated-covid-19-pandemic-2020-and-2021    said that 14.9 Million deaths in total were COVID-dependent.  If true, this would indicate that for the primary two years of COVID rampage in the world, it was responsible for twice as many deaths as COPD each year.

Now, it might seem amazing to compare the amount of money spent on COVID vaccine research and treatment methods and equipemnt with that of the COPD investments, and find that the disparity was like 40:1.   COPD has for some reason remained outside the mainstream of the medical worldview for where research and treatment efforts should be spent (have I made that point in this blog for 15 years?).

And yes, as nearly as I have been able to find out, the research team at Geo Washington Univ in St. Louis is the only research center with multi-year study of 1 micron and smaller particulates and their impact on COPD victims.   If you know of other institutions with such a focus, I'd greatly appreciate learning about them.  Kinda like the asinine view of both CDC and WHO for 2 years that COVID was spread by contact rather than aerosols.   Crowd blindspots happen so frequently . . . . 

COPD and COVID

 This blog has periodically inveighed against small particulate air pollution, as our many longpterm readers know well.   Two things have not been reported on in any particular fashion, however, that upon study require some comment.

First, the common 'concern' for health departments and air pollution monitoring stations, along with abatement technologies, is 2.5 micron particulate matter vs. the more commonly monitored and controlled 10 micron 'rocks.   Almost no agency monitors for smaller material, even though the physiology of humans tends to say it takes something smaller than 1 micron to impact the lungs.  Large materiasl are filtered usually by gravity (the bigger 'rocks' don't even get to the nasal passages or the pharanz; small particulates in the 2 to 4 micron size usually lodge in the trachea.  Below 2 microns can enter the lung passages, but only material less than 1 micron reach into the deep lung.  Such particles are often 'trapped' there; particles less than about 0.2 microns remain mobile and are usually exhaled.

Unfortunately, both monitoring and control techniques get more difficult for smaller sizes.  Thus, the measuring tools seldom report on concentrations of 1 micron particle density, and even if noted, there are few control technologies available for amelioration.   

Now, consider one of the long-observed but strikingly under-reported phenomena--inert small (1 micron) particulates in a toxic gaseous environment may have a toxic molecule adhere to the particle, and travel with it into the deep lung, where the particle lodges and the toxic molecule remains to do damage.   This is tailor-made for NO2, NO3, or SO2-rich atmospheres to send such molecules deep into the lung.  Consider that if the molecule is not bound to the particulate matter, it may easily enter the lung and 'wash' back out (thse molecules are less than one one-thousandth the size of the particle), but if it is captive to the particle, it remains in situ, ready to wreak a small, localized 'ulcer',

One US resaerch group, at Washington University in St. Louis, has lstudied the presence and impact of 1 micron particulate matter for the past 25 years, and their findings are significant, particularly for the West and Rocky Mountain regions.   This map lacks the detailed definition that I prefer to illustrate, but it certainly highlights the California, Oregon, Idaho, New Mexico and Texas hotspots.

Map shows highest concentration of tiny, toxic air particles

https://www.newsweek.com/air-pollution-pm1-submicron-usa-map-2085962

If we go deeper, for example in California, the picture for the 58 counties is quite distinct, especially for the Central Valley with air trapped by the Sierra Nevada mountain range--with air considerably dirtier than Los Angeles county or the Bay area.

2.5 micron particulate levels in Californian counties

https://www.kidsdata.org/topic/524/air-particulate/map#loct=3&fmt=2751&tf=164&center=-13325098.893387,4509031.392449&zoom=1

For a world where COPD is today almost always the third or fourth leading killer in nations all over the world, you'd think that this would be deeply studied and understood.   Instead, the AMA continues, as does the American Lung Association, to brand COPD as a 'smoker's disease' and avoid as much as possible doing serious research for either monitoring or control methodologies.  Okay, you've heard this theme from me now for a decade, and my initial discovery of it dates back to 1970 to the chagrin then of the new Clean Act for America.  So much for 'truth' by our leaders.

BUT, here's the kicker.  And I am amazed at myself for not realizing this earlier.  COVID is also a virulant killer, via lung congestion.  And early on, a few doctors surmises that COVID impact was higher on folk already burdened by COPD, but the studies were anecdotal and episodic.  Now, we could if desired, map the correlation co-efficients using big data extractions and geospatial mapping.   Consider for example the Deaths/100K plot for COVID for California for three 2020 biweekly periods, and compare this map by county to the one above for 1 micron concentration of particulates.

These are not 'one-to-one' correlation maps, but they are certainly suggestive.   More striking as we look around America, there is clearly a pattern with ski resorts in high mountain valleys where high car travel and air layer inversions often combine during peak visitor time.   

I'd love to have good correlation maps for i micron pollution layers for America, by season.

Food for thought/

COVID Follow-up to June 2025 post

 I mentioned a mere seven months ago that I was underway on a COVID manuscript, based on the voluminous COVID database that we constructed at InnovaScapes from 2020 through 2022.  

See, for example, many InnovaScapes posts at https://innovascapes.blogspot.com/  

The excitement now for me is that the Innovation Value Institute at Maynooth University has added me to "Stay Left, Shift Left-10X" Digital program for 2026+, seeking to improve Health Care by10 times   https://ivi.ie/v4/wp-content/uploads/2023/07/The-Digital-Transition-for-Healthcare-Curley-Stay-Left-Shift-Left-v1.0f-IVI.pdf

Dr. Martin Curley has penned a book about the program, which can be found at https://www.amazon.com/Stay-Left-Shift-Left-10X-Transformation/dp/1068283904

Astonishingly, the combination of Respiratory diseases and Respiratory infections afflict more people worldwide than any other, even outpacing Cardiovascular diseases.  This from "Our world of data" on page 34, Figure 14.  Then, on page 130, Figure 63, COPD is listed by WHO as ahte third leading killer in the world, well behind all forms of Heart disease, and moderately behind Strokes.   But the fourth leading killer is Lower Respiratory Infections (e.g. pneumonia, often exacerbated by COPD).  Third and fourth causes together more than outpace Strokes.

So any way that you cut the data, COPD remains a BIG PROBLEM for the world.   And, although "we" know some of the particular reasons, the research monies are still minuscule by comparison with any of the other top ten diseases on a per capita basis.  Moreover, they are actively fought against by many economic and political forces, not least of which is US 'leadership' seeking more rather than fewer coal-fired power-plants for a world hungry for electrical power, and actively combating the rise in EVs in favor of fossil-fuel burning vehicles.

Somewhat strangely, two graphs on page 135 fail to support the COPD Top Three contention of Figure 63.  Figure 69 is about leading killers for Low-Income countries, and COPD doesn't make the Top Ten list.   Pneumonia here is the 2nd leading killer, after neonatal issues, ahead of Heart issues, and Strokes.  Figure 70 for High Income countries has COPD fifth, and Lower respiratory issues sixth.   So how do you get to be third, if not in the top four of either list?    

The answer, though not detailed in the book, is that a lot of countries are rated "Middle Income Nations" and that is where the bulk of the world's population is.  For example,  China and India, which taken together are one-third of the world's population are in this 'center' group, as are most of northern African countries and all of South and Central America, with another 12% of the world.   So, these countries, while not singled out in the book, feature very high COPD death-rates.   In fact, WHO lists Indian deaths from COPD as the 2nd leading cause, and in China as the third.   Both South American and northern African areas cite surging rates, while decrying under-reporting and lack of adequate diagnostics.

The research funding is a stunning and shameful story.  NIH (2024) spent $3.8 Billion on Alzheimers resaerch; and $3.6 Million on COPD.   The American Lung Association kicked in a whopping $22 Million for COPD.  This is your capitalist system at work.   The 'good news' with the current administration is they've stopped a lot of NIH expenditures, so this remarkable 1,000 to 1 disparity is being slightly reduced.  And both CDC and ALA and most USA pulmonary doctors insist to this day that cigarette smoking is by far the leading cause of COPD, never mind the sixty years of data suggesting that other factors are in fact as or more significant.  Have you read my earlier rants?    

What has been surprising to me with the COVID studies is that irrationality, like stupidity, knows to bounds.   The mistakes of CDC and WHO, not to mention an unspoken tug-of-war between epidemiologists and Public Health officials, are manifold, and tragic.   And will no doubt be repeated in the next pandemic or epidemic.

Plenty of room to contribute to the conversation . . . .    Stay tuned.