Physically-active persons can fight off Covid-19 more easily


The US CDC has guidelines on how to be physically active while maintaining adequate physical distancing. — Filepic

Physical activity has been defined by the World Health Organization (WHO) as “any bodily movement produced by skeletal muscles that requires energy expenditure”.

It adds that: “Physical activity refers to all movements including during leisure time, for transport to get to and from places, or as part of a person’s work.”

Both moderate and vigorous physical activity improve health with positive impact on the body and the mind.

It improves muscular, cardiorespiratory (heart and lung) and bone health, as well as increases life expectancy.

The benefits of physical activity include reduction in the risks of numerous health conditions, including high blood pressure (hypertension), coronary artery disease, stroke, diabetes, various cancers (including colon and breast cancer) and depression.

It also reduces the risk of falls and fractures, especially hip and vertebral fractures, and helps to maintain a healthy body weight.

Decreasing disease severity

The impact of regular physical activity on Covid-19 studied by a team at the Kaiser Permanente Southern California health system was reported in the British Journal of Sports Medicine in April (2021).All forms of movement, including for household chores, are considered to be part of a person’s daily physical activity. — MUHAMAD SHAHRIL ROSLI/The StarAll forms of movement, including for household chores, are considered to be part of a person’s daily physical activity. — MUHAMAD SHAHRIL ROSLI/The Star

The study involved 48,440 adult patients diagnosed with Covid-19 from Jan 1 to Oct 21, 2020.

Their self-reported physical activities were categorised into consistently inactive (0-10minutes per week), some activity (11-149 minutes per week), and consistently meeting guidelines (150+ minutes per week).

These physical activity categories were studied in relation to the risk of hospitalisation, admission to the intensive care unit (ICU) and death after Covid-19 was diagnosed.

The study, which controlled for demographics and known risk factors, assessed whether inactivity was associated with Covid-19 outcomes.

It found that patients with Covid-19 who were consistently inactive had a greater risk of hospitalisation (OR 2.26), admission to the ICU (OR 1.73) and death due to Covid-19 (OR 2.49), than patients who were consistently meeting physical activity guidelines.

Patients who were consistently inactive also had a greater risk of hospitalisation (OR 1.20), admission to the ICU (OR 1.10) and death due to Covid-19 (OR 1.32), than patients who were doing some physical activity.

The odds ratio (OR) is a statistical measure of the association between an exposure and an outcome.

In short, the study reported the favourable impact that physical activity has on Covid-19, a communicable disease.

It found that people who were consistently active prior to contracting Covid-19 had a lower risk of hospitalisation or death.

The least active people in the study were hospitalised 20% more often and were 30% more likely to die from Covid-19, compared to those who were somewhat active.

Unintended consequence

Covid-19 patients who are generally physically active have a better chance of avoiding hospitalisation and ICU admission than those who aren't. — BernamaCovid-19 patients who are generally physically active have a better chance of avoiding hospitalisation and ICU admission than those who aren't. — Bernama

Crude interventions like lockdowns have been used to manage the pandemic.

The Malaysian population have been subjected to the movement control order, which requires staying at and working from home with avoidance of contact with others outside one’s household.

There is restriction of access to gymnasiums, sports centres, parks and other venues where people can be active.

There has been minimal or absent health education about the benefits of physical activity and the need to maintain or increase physical activity during the MCO.

The degree of physical activity before the pandemic started has been generally insufficient, as evident from the fact that Malaysia has the highest incidence of obesity among Asean nations.

The unintended consequences of the MCO include an even further reduction of physical activity.

Physical activity usually does not incur much in financial expenditure unless one indulges in expensive sports.

What it does require is an expenditure of time and effort, and needless to state, persistence.

Ideas are available

Various organisations have provided guidelines on physical activity.

The WHO has recommendations for physical activity for all ages, including children, adults, senior citizens, the pregnant and lactating, and people with physical conditions and disabilities.

The US Centres for Disease Control and Prevention (CDC) has similar guidelines, which take into account the need for physical distancing, with ideas for exercises, stretches, dances, etc.

The Health Ministry also has such guidelines, but they are not tailored to the Covid-19 situation, which can be challenging.

The general recommendation in most guidelines is that adults seeking to derive the most health benefits from physical activity should have at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous aerobic physical activity each week.

Moderate-intensity activity means that you are breathing hard, but can still carry on a conversation.

Vigorous-intensity activity means that you are exercising so hard that you can barely get a few words out.

Although 150 minutes each week sounds like a lot of time, it is not.

It can be spread out throughout the week by dividing it into smaller periods of time.

For example, it can be divided into, say, 30 minutes a day for five days a week.

You have to devise a balance that works for yourself.

Notwithstanding the recommendations by various organisations, some physical activity is better than none.

Positive impact

There are many fitness classes available online to help those who wish to workout in their own home. — AFPThere are many fitness classes available online to help those who wish to workout in their own home. — AFP

Malaysia continues to climb the global Covid-19 league with newer milestones in the past month (June 2021).

On June 12 (2021), its position in the global ranking of cumulative cases reached 38, up from 39th position on May 31 (2021) and 85th position on Nov 18, 2020.

We surpassed India in the daily number of newly confirmed cases per million population on May 23 (2021) and the daily number of deaths per million population on June 2 (2021).

The data reflects the indisputable fact that there is widespread community spread of Covid-19.

In practical terms, it means that everyone is at risk of getting infected, even if there is strict compliance to physical-distancing, mask-wearing, frequent handwashing, and avoidance of crowds, confined spaces and close contacts.

Everyone can help themselves by starting or increasing physical activity to improve their general health to enable the body to be better prepared to deal with Covid-19, should one be unfortunate enough to get infected.

The additional benefit is that physical activity impacts positively on many other health conditions as well.

A discussion with the family doctor is helpful if you are unsure about starting.

If your physical activity level can be increased, even if just a little bit, you will soon start to experience its health benefits.

Dr Milton Lum is a past president of the Federation of Private Medical Practitioners Associations and the Malaysian Medical Association. For more information, email starhealth@thestar.com.my. The views expressed do not represent that of organisations that the writer is associated with. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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