Thoughts on how to drastically reduce the Covid-19 death toll

Thoughts on how to drastically reduce the Covid-19 death toll

Active lifestyle and Covid-19: does the cure start before the disease?

The answer is most probably yes, as this blog will show. Let's start off with some facts about Covid-19.

1. Comorbidities and Covid-19

"A comorbidity is the presence of one or more additional conditions co-occurring with a primary condition."

The World Health Organization (WHO) has reported in February on the impact of comorbidity on the death rate (=deaths/case) of Covid-19. The report was based on 44,600 confirmed cases. For 20,812 cases, underlying conditions were documented. Of those cases, 511 (1.1%) cases lead to a fatality with following comorbidities:

Comorbidities and Covid-19 fatalities (Source: WHO)

The data shows that:

  • One third of the fatalities suffered from hypertension,
  • an other third suffered from cardiovascular disease and diabetes,
  • and the last third suffered from other or no comorbidities

These numbers were reported over all ages. An in-depth analysis of the relation between age, Covid-19 fatality and comorbidities should be performed with worldwide data as well as they become available.

Recently, the relationship between being overweight and Covid-19 in the ICU has been highlighted in a recent Dutch study as well. Up to 80% of Covid-19 patients in the ICU are overweight. Data in Belgium seems to confirm this hypothesis as well, with 7 out of 10 Covid-19 patients in the ICU being overweight. This while the prevalence of overweight in the general population is 40-50%. Which is a dramatic number by itself.

2. Chronic disease in general

"Chronic diseases represent a major share (77 %) of the total burden of disease in Europe and are responsible for 86 % of all yearly deaths".

Research is clearly needed that investigates the effects of chronic disease on Covid-19 fatalities and the avoidable deaths related to the co-occurrence of both.

Around 700 billion€/year is spent in the EU on chronic diseases, which represents up to 70-80 % of a country’s total health expenditure. The rise in chronic diseases are putting an increasing strain on health and social systems in the EU and on the health and well-being of EU citizens. [source]

3. How to reduce the risk of chronic disease

There are 4 widely accepted measures that drastically reduce the risk of getting a non-communicable disease such as diabetes and cardiovascular disease:

  • No smoking
  • No (or limited) alcohol consumption
  • Healthy eating habit
  • Active lifestyle

Scientific research reports that investing in healthy lifestyles that avoid overweight and include physical activity lead to a significant reduction of up to 70% or even up to 90% (diabetes II) of disease incidences for certain lifestyle diseases or non-communicable diseases. [source]


There seems to be strong evidence for a relationship between the lack of healthy lifestyle and a large number of Covid-19 fatalities. This has also been the case for the regular flu. Pressure on our health care system and on human well-being is still at high levels due to unbalanced lifestyle habits. More effort should be invested in researching and battling this issue.

With health care budgets increasingly under pressure, focus is put on curing patients. Rightfully so. However, if we want to reduce the incidence of chronic diseases, we need to start to invest more in prevention now.

In countries such as The Netherlands and Australia, sports and health ministries are combined into one department. This fully makes sense, yet sports is more often viewed as part of youth and entertainment than a part of health. In countries such as the UK and Belgium, sports is housed differently, in departments related to Culture, Youth and/or Media.

As we showed above, physical activity is a key health factor and can prevent many avoidable deaths. It can also relieve pressure on the healthcare budget, creating opportunities to invest even more in curing patients. It's a matter of choice.

The societal value of sports is often understated. Good health and well-being is the number three goal of the EU’s 17 sustainable development goals (SDGs) and sports should play a very prominent role within it.

Let's start understanding that living a healthy and active lifestyle is key to a sustainable health care system and many more positive effects on individuals and society. Curing patients is extremely important, but keeping them healthy and out of hospitals is equally so.


  1. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) [Pdf] - World Health Organization, Feb. 28, 2020,
  2. Kuipers Cavaco Y, Quoidbach V. Public health in the EU: State-of-play and key policy challenges. European Union; 2014,
  3. Willett, Walter C., et al. "Prevention of chronic disease by means of diet and lifestyle changes." Disease Control Priorities in Developing Countries. 2nd edition. The International Bank for Reconstruction and Development/The World Bank, 2006.

Disclaimer: this article does not contain medical advice, nor is it any kind of advice that supersedes the guidelines and regulations set forth by your government. It merely illustrates scientific facts related to preventable death and an underexposed hypothesis on this topic and its relation to the recent Covid-19 virus outbreak. This piece also does not, in any way, provide an opinion or view on measures making sure the health care systems do not collapse due to a high level of hospitalizations due to Covid-19. Follow the guidelines of your government.

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