Minimising the potential effect of the coronavirus

April 3, 2020

There’s no doubt about it, the coronavirus has been, and continues to be devastating. At the time of writing this there has been over 860,000 confirmed cases and over 42,000 deaths linked to this particular strain, Covid-19, since the outbreak began 10 weeks ago. We also know that the number of confirmed cases may be significantly higher than those numbers due to the lack of testing, and the number of cases and deaths is increasing at an alarming rate. We have been asked by many of our patients in recent weeks if there are ways that you can reduce the coronavirus risk to yourself should you catch it.

Due to the highly contagious nature and relatively high mortality rate of the virus, the government has quite rightly put in place strict rules in order to reduce our possible exposure and therefore reduce the likelihood that we catch the condition. However, as previously stated, the virus is highly contagious and so there is no way of completely removing the risk of catching it. So is there a way we can prepare ourselves to 1. Minimise the effects it has on us, 2. Reduce the coronavirus risk and the need for healthcare to relieve pressures on the NHS, and 3. Optimise chance of recovery?

In short – yes there is!

Experts at the Centre for Perioperative Care (CPOC) have listed a number of measures that people can take to prepare for the virus that will reduce the coronavirus risk of becoming severely ill, reducing the likelihood they will be admitted to intensive care, and reducing the risk of developing other health problems that could put further, unnecessary strain on the NHS. These measures include:

Having a healthy diet.

Taking in the right nutrients can help maintain a healthy immune system, help your body recover from illness, and give you the energy you need to exercise. Furthermore, if you are overweight, reducing your weight can help reduce stress on the lungs. See here for advice on healthy eating from the NHS.

Having alcohol-free days.

Consuming alcohol can make your liver less able to make building locks your body needs for healing, so it is recommended that you have no more than 14units per week. See here for advice on alcohol support from the NHS.

Stopping smoking.

Experts in China found that smokers were 3 times more likely to have a worse outcome from Covid-19, while Professor Christ Whitty, UK Chief Medical Advisor, has previously warned that smoking is an ‘additional vulnerability’ to lung function which is the primary area of impact by the Coronavirus. See here for advice on smoking cessation from the NHS.

Looking after your mental health.

This is a trying time for mental health, with worries and anxieties about the virus itself, what it means for our loved ones, uncertainties with regards to work and finances, and the negative effects on our mood of social isolation and lack of ability to engage in our normal activities. Relaxation, mindfulness and breathing exercises, as well as getting a good night sleep can help you look after your mental health. See here for advice on looking after your mental wellbeing during the coronavirus outbreak from the NHS.

Exercising.

“If exercise were a pill, it would be one of the most cost-effective drugs ever invented”. This sentiment, initially expressed by health promotion consultant Dr Nick Cavell, appears more relevant now than ever and getting more exercise could reduce the coronavirus risk. There are 3 research findings that illustrate this…

• those who complete regular exercise have a 30% lower risk of early death,

• moderate intensity exercise can reduce the risk of death associated with influenza in animal studies.

• those who are less fit are 5 times more likely to have a worse outcome from Covid-19.

The experts from the CPOC have advised that exercise is even more important in the vulnerable, high-risk community (unless you are unwell with the virus).

How should we exercise?

The CPOC advise that the optimal exercise to protect ourselves against the detrimental effects of Covid-19 should ideally include a brisk walk, cycle or jog, but that strengthening and balance exercises should also be undertaken. This aligns well with the general activity guidelines developed by the Department of Health and the NHS – 150minutes per week, ie 30minutes/day 5 days/week of moderate intensity exercise to include strength and balance training. It is, however, advisable for all to stick to moderate intensity exercise at this time as research suggests that unaccustomed strenuous exercise may reduce the function of your immune system.

The reason for the beneficial effects of exercise in the fight against Covid-19 is simple. Covid-19 is a respiratory infection that starts at the throat and moves down to the lungs, impacting lung function which is ultimately the reason for many people to require hospital treatment and the cause of death in those who are severely affected. By completing moderate intensity exercise on a regular basis, we can improve our lung function which in turn will improve the ability of our lungs to cope with the effects of the virus, without need for mechanical ventilation in intensive care units. For many people, their usual sole source of activity, be it work, doing the weekly big-shop, or walking/cycling to and from work has been stopped, potentially for a long period. Therefore, it is now more important than ever to find a way to integrate exercise into your day, both in the fight against Covid-19 as well as to combat the many detrimental effects of sedentary behaviour on our health, be it musculoskeletal, cardiovascular or psychological.

If you are healthy there is no reason for you not to start moderate exercise immediately, while if you are older, have comorbidities or musculoskeletal problems you may just require a little guidance from your GP or physiotherapist. Our specialist older peoples physiotherapists have created a free printable exercise program based on the Department of Health, NHS and CPOC guidelines, and while we are currently unable to complete face to face appointments, our physiotherapists are on hand to complete telephone and video consultations and provide advice on what exercise you can do.