Dr. Shyam P Lohani

The importance of physical activity and its benefits for health and quality of life have been well documented. It helps to increase muscle and strength, reduces the risk of disease, ensures a better quality of life, and consequently lowers the risk of premature death. However, there is less awareness among the general population on how damaging and expensive reduced physical activity can be. A recent study has advocated that an active lifestyle may be one of the best defences against COVID-19 and revealed inactivity contributes to higher rates of death among infected patients.

Physical inactivity is associated with insulin resistance responsible for the development of type 2 diabetes, reduction in muscle mass, increased body fat and poor sleep quality. They are, in turn, risk factors for the development of non-communicable diseases which are responsible for the majority of deaths throughout the world. Physical inactivity contributes significantly to poor mental health and social isolation is particularly severe to older adults. The health effects of inactivity start building up within days.

Effects
The COVID-19 pandemic has affected the entire world and left no one untouched. During the pandemic, populations across the globe have been advised to stay home and avoid contact with individuals outside their households. Public health practices such as lockdowns and other restrictive measures that constrain movement have resulted in limited access to gyms, parks, and other venues where people can exercise.
The awareness of the benefits of physical activity and advice to maintain physical activity during the pandemic has been essentially absent throughout the world. The World Health Organisation (WHO) has warned that physical activity was grossly insufficient among all age groups and responsible for millions of deaths every year long before the beginning of the COVID-19 pandemic.

The pre-pandemic levels of physical activity were generally insufficient, preventive measures for pandemic have likely had the unintended consequence of reducing it even more. Indeed, it has been seen a significant reduction in physical activity levels since the beginning of the pandemic. This has led to a lack of daily movement and an increasingly sedentary lifestyle, which has made people throughout the world prone to developing NCDs. As the world witnessing the repeated waves of COVID-19, flu season, and winter, people also face a serious risk from reduced physical activity.

Following the declaration of COVID-19 as a global pandemic by the WHO on March 11, 2020, most countries then recommended social distancing, quarantine and self-isolation, closure of borders, ban on international flights and closure of schools and most businesses. Those measures resulted in a substantial negative impact on human society regarding lifestyle, economy and health. The pandemic has impelled the governments to focus on the prevention, diagnosis and management of COVID-19 and develop effective vaccines against COVID-19. However, the long-term effects of the pandemic on physical activity and sedentary behaviour of the people around the globe due to quarantine and isolation and their long-term effects on global health have not been given due attention.

Physical activity is an essential indicator of health status and has been stressed as critically important for lessening the harms of COVID-19 on health and well-being. Moreover, quarantine and social distancing measures are impacting the ways in which people can be active and have caused a significant decrease in physical activity along with an increase in sedentary behaviour in comparison to pre-pandemic levels. Increased sedentary behaviour due to lockdown and spending more time sitting in chairs with computers is destined to be associated with increased risks for weight gain, heart disease, type 2 diabetes, and premature death, to name a few. It has been reported that the effects of lower physical activity start shortly within as early as 3 to 4 weeks.

Obesity and physical activity are interlinked. The risk of obesity is four times higher among physically inactive individuals. Obese individuals are also excessively affected by COVID-19 infection. It has been reported that obesity increases the risk of COVID-19 infection, hospitalisations, ICU admission, and mortality.

Moreover, obesity is linked with major cardio-metabolic disorders, including hypertension, diabetes, and other comorbidities. These comorbidities have been reported to be associated with a worse prognosis and serious adverse events in patients with COVID-19. Thus, it is critical that moderate physical activity and a reduction in sedentary behaviour is important for the prevention and management of obesity and associated comorbidities not only during the pandemic and initial inoculation period but also in the long term.

Awareness
Studies have shown that the sedentary COVID-19 patients were more than twice as likely to be admitted to the hospital as those who were more active. People of advanced age are more vulnerable to serious cases of COVID-19; loneliness due to lockdown can also have more profound effects on the elderly. Even in a quarantine or lockdown situation, physical activity is essential for avoiding a sedentary lifestyle and its negative effects. Physical inactivity was exceeded only by advanced age and among people with organ transplants in terms of a risk factor for severe COVID-19.

In order to prevent COVID-19 and its complications, including death, it is recommended that all eligible populations should get the vaccination and follow public health safety guidelines such as social distancing and mask use, avoiding large crowds, eating a healthy diet, and engaging in regular moderate physical activity.

(Prof. Lohani is the founder and academic director at Nobel College. lohanis@gmail.com)