- Lockdowns during the Covid-19 pandemic kept many people from exercising.
- It has been proven that regular exercise benefits the immune system.
- Lack of exercise during the pandemic may, therefore, have led to many more people getting sick.
Hindsight is indeed insight. In 2020, nearly four billion people in more than 90 countries were asked by their governments to stay at home to contain the spread of Covid-19.
While we are all hoping lockdowns are on the verge of being phased out, there are some critical lessons to apply based on the experience of the last two years. A key lesson is that, to protect people’s health, physical activity should not be restricted during lockdowns.
While lockdown regulations in most countries were relaxed to allow exercise as the pandemic evolved, there is no question that lockdowns led to a sharp drop in physical activity levels by limiting movement and access to outdoor facilities and gyms. We saw a 49% decline in the number of physical activity points logged on the Vitality platform during the strictest Level 5 lockdown in South Africa in March 2020.
This matters because of the remarkable positive effect that physical activity has on all illnesses, in all instances. Regular exercise benefits the immune system by reducing inflammation, mobilising white blood cells to fight off infection, enhancing the body’s ability to recognise harmful pathogens (which cause disease) and, importantly, improving psychological stress.
Management of non-communicable diseases
We have always tried to address the four lifestyle habits (lack of physical activity, poor nutrition, smoking and alcohol abuse) that lead to the four chronic conditions which are responsible for 60% of global deaths.
But the pandemic has shown that Vitality has a meaningful preventative effect beyond the management of non-communicable diseases (e.g. heart disease and diabetes) in addressing risks related to infectious diseases too.
The Covid-19 mortality rate has been devastating with over 5.7 million global deaths recorded to date.
Throughout the pandemic, ours has been one of several voices pointing out the protective effect of physical activity against severe Covid-19 outcomes, but until now, all the evidence has been based on self-reported data.
This week, in a study published by the British Journal of Sports Medicine (BJSM), produced by Vitality in collaboration with Wits Sport and Health (WiSH), a research group at the University of Witwatersrand and the University of Western Ontario, was the first to make this case based on directly measured physical activity data. The findings prove what we suspected and go a step further.
Study shows how exercise saves lives
The “Small Steps, Strong Shield” study shows that any form of regular physical activity, even moderate levels of 60–149 minutes of exercise per week (which falls below the World Health Organization recommended weekly guidelines for health), protect against severe Covid-19 outcomes.
Moderate to high levels of regular activity are shown to have a distinct benefit in preventing hospitalisation, ICU admission, ventilation and death.
Just to be clear, I’m not advocating for anyone to exercise while they are ill. The study reviewed the experience of 65 000 Vitality members in South Africa who contracted Covid-19, matched against their physical activity history (captured by smart devices, clocked gym attendance and participation in mass sporting events) in the two years prior to the hard lockdown.
The researchers found that, compared to those with low levels of activity, high engagement in physical activity was associated with a 34% lower risk of hospital admission, 41% lower risk of ICU admission, 45% lower risk of requiring ventilation and a 42% lower risk of death.
Drop in exercise levels
Even those patients engaged in moderate activity had a 13% lower risk of hospital admission, 20% lower risk of ICU admission, 27% lower risk of ventilation and a 21% lower risk of death compared to the low-activity group.
The study also revealed that while being older, male, having a diagnosis of hypertension or Type 2 diabetes increases the likelihood of poor Covid-19 outcomes, exercising at high levels (150 minutes or more per week) may have an even more significant effect than in healthy individuals.
Lockdown restrictions have understandably aimed to limit the pressure that large increases in Covid-19 cases have on healthcare systems, but one of the unintended consequences of limiting movement has been the significant decrease in exercise levels.
Our concern is that the drop in physical activity levels may become entrenched for many around the world. It is beyond question that we need to enhance our efforts to promote regular exercise as an adjunct to vaccination and other preventive measures, especially for those at high risk, and educate about the benefits of physical activity in the context of communicable diseases.
There are ways for people to safely engage in physical activity while securing the health and wellbeing of those around them. If we ever encounter future pandemic waves, reasonable concessions to consider include access to safe outdoor exercise spaces and well-ventilated and uncrowded indoor exercise spaces.
We need policies that promote physical activity as the powerful preventative measure it has proven to be – and the right behaviour change programmes to get and keep people moving.
Dinesh Govender, CEO of Vitality South Africa
