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Practice Policy Update regarding COVID-19

Published on: 25-Mar-2020

*UPDATED 3/24/2020*

Evolving public health guidance will result in changing recommendations on safe physical activity from the team at Exercise is Medicine. We are committed to providing the most up-to-date guidance possible to maintain healthy physical activity.

The current coronavirus (COVID-19) pandemic presents some challenges to maintaining a physically active lifestyle. COVID-19 is spread by droplet transmission – someone sneezing or coughing into the air or onto a surface, and then the virus enters a new host through the mouth, nose or eyes. The most up-to-date information about COVID-19 should be accessed from the Centers for Disease Control and Prevention (CDC) website: https://www.cdc.gov/coronavirus/2019-ncov/about/index.html

Given what we understand about transmission of the virus, the CDC recommends avoiding gatherings of 10 people or more and maintaining a social distance of 6 feet or more. (Updated recommendations from the White House are to limit gatherings to 10 people or less.) That, along with recommendations related to personal hygiene (hand washing, not touching your face) may create concern about exercising in gyms, where hundreds of people are in and out on a daily basis. Those at greatest risk for severe complications of COVID-19 are the elderly (defined as age 65 and older), and others with chronic diseases or compromised immune function. Those individuals should avoid gyms altogether, and exercise at home or in their neighborhood. In many areas of the country and around the world, community members of all ages, have been asked to shelter-in-place, thereby avoiding gyms altogether.

For all of us, young and old, regular physical activity remains an important strategy for staying healthy! Compared to being sedentary, moderate-intensity physical activity is associated with better immune function. Likewise, regular physical activity is associated with lower levels of anxiety and perceived stress (which many of us are feeling in the wake of the COVID-19 pandemic).

The Physical Activity Guidelines for Americans recommend 150-300 minutes per week of moderate-intensity aerobic physical activity and 2 sessions per week of muscle strength training. Fit in 2, 5, 10 or 20 minutes, however and wherever you can. Every active minute counts!

This information has been adapted into an Rx for Health handout that can be given to the public, patients and clients. Below are some strategies to maintain physical activity and fitness:

Aerobic Activities

Indoor Activities

  • Put some music on and walk briskly around the house or up and down the stairs for 10-15 minutes 2 or 3 times per day.
  • Dance to your favorite music.
  • Jump rope (if your joints can handle it).
  • Do an exercise video.
  • Use home cardio machines if you have them.

Outdoor Activities (if your local government allows)

  • Walk or jog around your neighborhood (avoid crowded spaces and maintain the recommended 6 foot physical distance between individuals).
  • Be active in a local park. Spending time in nature may enhance immune function. Be sure to wash your hands when you get home.
  • Go for a bicycle ride.
  • Do gardening and lawn work (Spring is around the corner!).
  • Play active games with your family.

Muscle Strength Training

  • Download a strength workout app to your smart phone, such as the 7-Minute Workout (no equipment necessary).
  • Do a strength training video.
  • Perform yoga – deep breathing and mindfulness can also reduce anxiety.
  • Find ways to do simple muscle strengthening exercises around your house such as:
    • Squats or sit-to-stands from a sturdy chair
    • Push-ups against a wall, the kitchen counter or the floor
    • Lunges or single leg step-ups on stairs

Don’t sit all day! For example:

  • If watching TV, get up during every commercial (or periodically) and do a lap around your home or an active chore. For example, throw some clothes in the laundry, do the dishes or take out the garbage. Feel productive after just one show!

Here are current answers to frequently asked questions about physical activity and exercise with respect to COVID-19:

  • I’m under quarantine but not infected.  Should I limit my physical activity?
    • There are no recommendations at this time to limit physical activity if you do not have any symptoms. Symptoms that should prompt evaluation by a health care provider include cough, fever, and shortness of breath.
  • Will exercise help prevent me from getting the virus? 
    • Moderate-intensity physical activity is associated with a healthier immune system. However high-intensity high-volume training may suppress immune function especially if you are unaccustomed to it. Balance your workout program.
  • Are there precautions I should take?
    • The most important strategy to prevent infection is to avoid coming into contact with others who are infected with COVID-19.
  • What if my kids are home with me?
    • Being active with kids is the most fun of all! Find activities that you can do together – an active gaming video, basketball in the driveway, go for a walk in the neighborhood.
  • What if I start to experience symptoms?
  • I’m under quarantine and infected.  Should I limit my physical activity?
    • People who are known to be infected, but asymptomatic, can continue moderate-intensity physical activity but need to use symptoms as a guide. They should take care to maintain quarantine to prevent virus transmission to others.  If they develop fever, cough or shortness of breath, they should discontinue physical activities and reach out to a health care provider.

By Liz Joy, M.D., M.P.H., FACSM, FAMSSM for Exercise is Medicine

Thanks also to Jeffrey Woods, Ph.D., FACSM, and Brandt Pence, Ph.D., ACSM member experts in exercise physiology and exercise immunology who graciously reviewed this blog.

The post Staying Active During COVID-19 appeared first on Sports Medicine Weekly.