Joe Diffie and many other musicians have died from COVID-19

Dr. Gabe Mirkin

I have no data to show that popular musicians are at greater risk of death from COVID-19 than the general population, but we note the headlines marking the passing of many beloved artists just in the past few days:

• Joe Diffie, a Grand Old Opry country music singer and songwriter who had been voted best all-around male athlete in high school (football, baseball, golf and track) but chose music over sports and his planned career in medicine. He had 35 singles on the Billboard Hot Country Songs. He died in Nashville on March 29, 2020, at age 61, two days after he tested positive for the coronavirus.

Joe Diffie


• Adam Schlesinger, 52, Emmy and Grammy award–winning musician, died of COVID-19 complications at a hospital in Poughkeepsie, New York. He had been hospitalized and placed on a ventilator for a week prior to his death on April 1.
• Ellis Marsalis Jr., 85, a New Orleans legend as a jazz pianist and teacher, died on April 1. Of his six sons, four became noted musicians: Branford, a saxophonist; Delfeayo, trombonist; Jason, drummer; and Wynton, trumpeter and composer.
• Manu Dibango, a Cameroonian musician best known for his 1972 hit “Soul Makossa,” died on March 24 from complications of the coronavirus at age 86.
• Alan Merrill, singer, guitarist and songwriter who wrote “I Love Rock and Roll,” died March 29 at age 69.
• Wallace Roney, 59, a famous Granny award winning jazz-trumpeter, died on April 1 in Paterson, NJ.
• Cristina Monet-Palaci, new wave pop singer known professionally as Cristina, died at age 61 on April 1.
• Bucky Pizzarelli, jazz guitarist and father of two other jazz artists (guitarist John Pizzarelli and bassist Martin Pizzarelli), died of COVID-19 on April 1, at age 94.
• Mike Longo, jazz pianist and composer, died in Manhattan on March 23, 2020, three days after his 83rd birthday, from complications of COVID-19.

Several other musicians have announced that they have tested positive for COVID-19, including:
• John Prine, this year’s Lifetime Achievement Grammy Award winning singer who was inducted into the Songwriters Hall of Fame in 2019, hospitalized on March 26.
• Ray Benson, founder of the country band Asleep at the Wheel
• Christopher Cross, pop-rock singer
• Pink (Alecia Beth Moore), singer
• Idris Elba, British actor and musician
• Placido Domingo, opera singer

Why Are So Many Musicians Affected by COVID-19?
I can think of two reasons why musicians would be at risk for contracting COVID-19, and for having a higher-than-average risk for serious complications:
• Musicians play in crowded places where people are forced to breathe in germs spewed into the air by everyone else in that area. Being exposed to anyone who spreads COVID-19 into the air markedly increases your risk for developing this disease.

• Musicians spend their lives performing in environments full of smoke that damages their lungs, and often have other lifestyle factors that increase their risk for diseases such as heart disease, diabetes, and particularly lung diseases such as chronic obstructive pulmonary disease (COPD). People with these conditions are the ones most likely to die from COVID-19.

What is COPD ?
You need oxygen to stay alive. Oxygen goes into your lungs through your bronchial tubes and passes through air sac membranes called alveoli into your bloodstream. COPD means that your bronchial tubes are thickened and scarred so you have difficulty bringing oxygen into your lungs, and your alveoli are damaged so that oxygen cannot pass readily into, and carbon dioxide cannot pass out from, your bloodstream.

COPD affects 32 million people and is the third-leading cause of death in the United States, after heart disease and cancer. Smoking is the most common cause. You get COPD from breathing in smoke, fumes from fuel for cooking or heating, air pollution, workplace exposure to dust, smoke or fumes, and so forth.
• The most significant risk factor for COPD is long-term cigarette smoking. The more years you smoke and the more packs you smoke, the greater the risk. Pipe smokers, cigar smokers, marijuana smokers and all other smokers are at high risk for COPD.
• All smokers who have a chronic airway disease, such as asthma, will eventually develop permanent lung damage called COPD.
•People exposed to large amounts of second-hand smoke also are at risk. Living or working with smokers increases risk for COPD as well as for heart attacks and certain cancers.

Who Is Most Likely to Die From COVID-19?
COVID-19 is not more deadly than ordinary flu viruses. Many people become infected and recover without even having any symptoms. However, this virus had never appeared in humans before 2019, so 100 percent of humans had no immunity to it and therefore all humans exposed to it are likely to become infected. If you are healthy and have a strong immune system, your lymphocytes and cytokines will kill the virus and you will recover and be immune so you will not be reinfected. At this time, scientists have no idea how long your immunity will protect you from a future infection.

Risk of death is higher in people over age 65 (31 percent of the cases, 45 percent of hospitalizations, 53 percent of ICU admissions, and 80 percent of deaths). You are at increased risk for death if you suffer from:
• Lung disease. COVID-19 enters the lungs and can kill people by filling up the lungs with mucus so they can smother to death. People with any kind of lung disease or damage are unusually susceptible to this buildup of lung mucus. Smoking and exposure to second hand smoke are the most common causes of lung damage.
• Diseases that affect your immune system, such as cancers, anemia, and bone marrow damage interfere with your ability to fight infections.
• High blood pressure. A hormone called angiotensin constricts arteries and too much of that hormone can cause high blood pressure. Angiotensin constricts arteries by acting on special ACE2 receptors located in organs such as heart and lungs. People who have high blood pressure usually have increased numbers of ACE2 receptors in their hearts, lungs and other organs. COVID-19 enter the lungs and heart through these receptors, so the virus can kill some people by entering their lungs and heart in large numbers to cause lung damage and heart failure.  We do not know whether drugs used to treat high blood pressure by blocking the effects of angiotensin (ACE inhibitors and ARBs) increase susceptibility to COVID-19. Therefore, virtually all of the medical societies that have made recommendations say that people taking these drugs should not stop taking them.
• Diabetes. High rises in blood sugar cause sugar to stick to and destroy cells, particularly in immune cells that protect you from infections.
• Heart and blood vessel disease. COVID-19 can kill by sending a person into heart failure. Any heart damage increases risk for this side effect.
• Liver or kidney damage. You liver and kidneys are necessary to protect you from infections.
• Bleeding and clotting defects
• Taking drugs that suppress your immunity
• Nerve damage disorders. Any disease that affects nerves in your body can interfere with your ability to fight infections.
• Other chronic diseases
Most of the musicians who have died are men, and overall with COVID-19 there are more deaths in men than in women, for reasons we do not fully understand. Some of the genes responsible for a person’s immune response are found on the X chromosome, and women have two X chromosomes while men have only one.

My Recommendations on COVID-19
For my regularly-updated reports on this pandemic, see:
The Current Coronavirus Pandemic (updated at least weekly during the pandemic)

Dr. Gabe Mirkin is a Villager. Learn more at www.drmirkin.com

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