Regular exercise can prevent death from COVID-19 by 42%

Beyond the immediate threat to life posed by COVID-19, the pandemic and its ensuing lockdowns have given rise to a slew of knock-on crises. Among them is a seismic drop in physical activity.

Billions have been confined to their homes, asked by their governments to protect themselves and those around them by halting their leisure and activity time.

In fact, during South Africa’s most stringent March 2020 lockdown, Vitality’s exercise tracking platform logged a 49% decline in physical activity. This has direct consequences for millions of people and the healthcare systems they rely on.

The sharp drop in exercise matters because of the remarkably positive effect that physical activity has on health. Regular exercise benefits the immune system by reducing inflammation, mobilizing white blood cells to fight off infection, enhancing the body’s ability to recognize harmful pathogens that cause diseases and, importantly, by alleviating psychological stress.

As a behaviour-change program, Vitality has always tried to address the four key lifestyle habits that lead to the chronic conditions responsible for up to 60% of deaths globally: lack of physical activity, poor nutrition, smoking and alcohol abuse.

The pandemic has shown that regular exercise, healthy eating and preventative screening not only all have meaningful positive outcomes for the management of non-communicable diseases like heart disease and diabetes, but can also address risks related to infectious diseases, too.

Throughout the pandemic, Vitality has been one of several voices highlighting the protective effect of physical activity against severe COVID-19 outcomes, but all the evidence for that claim had been based on self-reported data — up until now.

In early February, a study published in the British Journal of Sports Medicine (BJSM) became the first to make the case for exercise’s protective benefits based on directly measured physical activity data. Those findings prove what we long suspected, and even go a step further.

The “Small Steps, Strong Shield” study — produced by Vitality in collaboration with the Universities of Witwatersrand and Western Ontario — proved that any form of regular physical activity, even less than two-and-a-half hours per week, can protect against severe COVID-19 outcomes.

While the level of exercise required to improve COVID-19 resilience falls far below the World Health Organization’s recommended weekly minimum, that is not to say you should forego that run on the one day you don’t feel like it. This is because the best outcomes in terms of preventing hospitalization, intensive care unit (ICU) admission, ventilation and death are seen in people who do meet the WHO recommended guideline of more than 150 minutes of exercise a week.

The groundbreaking study reviewed the experience of 65,000 Vitality members in South Africa who contracted COVID-19 and matched it against their physical activity history — which was captured by smart devices, clocked gym attendance and participation in mass sporting events — in the two years prior to the hard lockdown.

The study 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 42% lower risk of death.

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 21% lower risk of death compared with the low-activity group.

The study also revealed that being older, male and having a diagnosis of hypertension or type 2 diabetes all make poor COVID-19 outcomes more likely — but it added that, for these people, exercising for more than 150 minutes per week could have an even more significant positive effect than in healthy individuals.

Lockdown restrictions have understandably aimed to limit the toll that large COVID-19 caseloads take on healthcare systems, but one of the unintended consequences of limiting movement has been a significant decrease in exercise levels.

If left unaddressed, that drop in physical activity could become entrenched for many around the world. To prevent this very real problem, governments and society more generally must enhance efforts to promote regular exercise.

This push for more physical activity will act in cohesion with vaccination campaigns and other preventive measures to protect people across society, especially the most vulnerable.

There are ways for people to safely engage in physical activity while securing the health and wellbeing of those around them. In any future pandemics, and as we ride out the current one, reasonable concessions to consider include access to safe outdoor spaces and well-ventilated indoor spaces to use for exercise.

To beat COVID-19 and other communicable diseases we need policies that promote physical activity as the powerful preventative measure it has proven to be and we need the right behaviour change programs to keep people moving.