I notice that WHO recommends nothing regarding tobacco use and COVID-19. I also notice a deafening silence regarding reports in JAMA regarding tobacco use in the papers published there.
The Lancet has published the solely paper where smoking appears, it looks like it has killed the first victims and it perhaps explains why old males are more likely to die.
Another "appearance" of smoking is seen in this non-peer-review manuscript: https://www.medrxiv.org/content/10.1101/2020.02.06.20020974v1.full.pdf+html. In the manuscript, it looks like smoking is "innocent", but the authors adjusted by a clear intermediary variable towards the "composite endpoint", called "pneumonia severity" that nullifies the smoking effects, which was not recognized by the authors. In my view, it looks like an involuntary mistake from the author, given that the manuscript was not peer-reviewed.
Again, I wish to know why does it happen?-
WHO does not make non-evidence-based recommendations. At this point we do not know what the risk factors are for acquiring COVID-19 or for disease outcomes for COVID-19.
I totally agree with Joyce Morris in that the WHO usually search for the highest evidence possible on associations, risk and risk factors before they publish an evidence-based guidelines and or recommendations. COVID-19 is a new emerging infection which needs more information to describe and put in an aetiological context( Package of risk factors)
I strongly disagree with both of you!
Tobacco products kills a half of their users if used as intended by the manufacturer: They represent a very well-known risk factor for respiratory infections (due to several mechanisms); according to the latest GATS in 2018, a half of men in China have smoked in the last 30 days; at minimum WHO have issue a precautionary recommendation regarding tobacco use during the outbreak, particularly if the most the cases are confined to China and neighbor countries.
I for sure would have agreed you for travelling , food or medication consumption linking them with COVID. But tobacco use is different!
Dear Hedley
COVID-19 is caused by a virus. Other factors are risk factors which increase the risk of occurrence and/ or the risk of severity and fatality. Therefore we have to distinguish between these two effects of risk factors. The question is that: Does smoking increase the incidence rate or case-fatality rate of COVID-19. The authorities in any country and the WHO are working now to contain the epidemic in terms of containing the incidence rate and thus reduce further spread of the infection. Meanwhile efforts are made to reduce case-fatality rate by intensive care. Handling smoking might be of limited effect on the short term. But if it really appears to be a strong risk factor for triggering incident cases and deadly cases then it worth working on it . Unfortunately, 70 years ago researchers showed the bad effect of smoking but people are still smoking and at a high scale.
Smoking in China is very prevailing but what about South Korea, Itally, Iran etc.
Definite;ly researchers in China will do a lot of detailed studies on various issues including risk factors operating in the context of CoVID-19
With best regards
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