Well, here we go again The emergence of the second wave of the pandemic and the subsequent Lockdown brings me back to this subject. Of course we are all delighted by the news of an effective vaccine. However it will be many months before it has been rolled out widely enough to be sure that we will not need further Lockdowns.
What have we learned about the virus and the consequences of confining us to our own homes?
Catching the virus
Fortunately most of those who catch the virus are affected only slightly if at all. The figures are very variable depending on the source and the population described. Roughly speaking about 75% of people testing positive for the virus have no symptoms and only a minority, perhaps 5%, become unwell. An even smaller number, nearer 1%, become severely ill with a death rate of less than 0.5% overall. These figures for the population as a whole do not apply to particular age groups. Increasing age seems to be the best predictor of becoming severely ill with Covid infection and carries the highest risk of dying. In this country the other risk factors are belonging to an ethnic minority and having other health problems to start with – so called co-morbidities. Obesity seems to be the most important. A body mass index (BMI – see glossary) of over 45 has been associated with a fourfold increase risk of dying from Covid. Heart disease, kidney disease and lung disease are all important. but less so.
If a study were done to examine the link between physical fitness and the outcome of Covid infection, I strongly suspect that a low level of fitness would come in high on the list of risk factors.
Why is age so important?
Firstly, the older you are the more likely you are to have one of those co-morbidities. Secondly, your immune system becomes less efficient in later life and you are then less able to combat the infection. Both are good reasons to increase your exercise taking. Nearly all the degenerative diseases of later life – the co-morbidities – are aggravated by inadequate physical activity and nearly all are helped by regular exercise. Exercise has also been shown to boost the effectiveness of the immune system.
The Lockdown and body weight
A survey of 2,254 people has addressed the question. 48 percent of respondents said they had put on weight during lockdown,
However the weight gain seems to have been modest. The COVID Symptom Study app has now been downloaded by over 3.5 million people in the UK, with 1.6 million users participating in the questionnaire about behavioural changes during the lockdown. The average increase in body weight across the country has been a mere 0.78 kg (1.6 lbs). For those who reported increased snacking the weight gain was about 3kg. Contributing factors were decreased levels of physical activity (34%), increased alcohol consumption (27%) and a less healthy diet (19%).
What about mental health?
Surveys have found that between half and two thirds of people have noted ill effects of Lockdown on their mental health. The most common issues have been worry about the future (63%), feeling stressed or anxious (56%) and feeling bored (49%).In addition to the fear of infection other contributory factors have been social isolation, job loss, financial difficulties, housing insecurity, working in front-line services and reduced access to mental health services. Over a third of people in full-time work surveyed were concerned about losing their job. Mental health impacts on people who were unemployed were widespread and severe.
The people most of risk of damage to their mental well-being are young people, those with lower household income, people with a diagnosed mental illness, people living with children, and people living in urban areas. Reported self- harm in the teens and twenties has increased. There has also been a considerable rise in domestic abuse.
And physical activity?
The last Lockdown closed gyms and most other exercise venues and resources. This left walking, jogging, cycling and self-imposed home exercise programmes as the best ways of keeping active. The one possible boost for physical activity was the increase if free time for doing it.
The last Lockdown saw a general reduction in exercise taking in the population as a whole. Surprisingly and pleasingly the group that most needed the protection of increasing physical activity, the over 65s, was found to be the one group which did become more active. A study from University College London used a smartphone app to track activity in more that 5,000 people between January and June. Younger people reduced their activity most with less walking, running and cycling. Many previously active subjects stopped exercise altogether. However the over 65s bucked the trend and were more active during their incarceration and increased their activity further when it they were released.
Under 40s responded in the opposite direction. Children in particular increased their sedentary behaviour. And unfortunately a disproportionate numbers of adults with chronic diseases, such as obesity and hypertension, reduced their physical activity during the COVID-19 lockdown.
Get more active, that’s what! Being fitter will not reduce the chance of catching the virus but it does reduce most of the risk factors for developing severe symptoms or dying. It may also speed recovery from the after effects. The most notorious of these is “long covid”. It is too soon to know the best treatment for this most unpleasant of Corona virus consequences but graded physical activity has to be a very promising candidate.