COVID-19: The importance of physical activity

The world is experiencing an extraordinary, life-altering challenge due to the COVID-19 pandemic (WHO, 2020). Its epidemiology highlights that age and inequalities in health, wellbeing and economic status make people more vulnerable. The disease can be particularly severe for those that are older, obese with comorbidities and people of ethnic minority backgrounds. The conditions created by the pandemic has raised the importance of physical activity and wellbeing for society.

Whilst more than 71,500 research papers have been published in 2020 (As of November; PubMed database references including the term “COVID19”[1]), less than 1% of them (n= 798) relate to the potential role and/or impact that physical activity might have on the pandemic and more importantly, preventing a second wave (PubMed database references including the terms “COVID-19 and exercise”[2]).

This is somewhat surprising given the abundance of evidence linking an active lifestyle (involving physical activity, regular exercise and/or sport participation) with a reinforced immune system, one with a proper viral defence (Neiman, Wentz, 2019).

Regular physical activity supports both physical and mental health in adults, teens, and children. Physical activity is especially important amid the COVID-19 pandemic given its role in helping to strengthen and improve immune functioning, as well as lowering the risk of viral illness[3] . Physical activity plays a central role in the prevention and management of cardiovascular and metabolic health conditions as well as some cancers (WHO GAPPA, 2018[4]), which can increase the risk of adverse COVID-19 outcomes. Additionally, people are being isolated and confined to their homes for long periods of time, the social benefits associated with physical exercise in a community have been removed, thereby threatening people’s mental health[5].

A recent randomized control trial, involving 3,764 participants, developed by the University of Oslo (Helsingen et al., 2020 [6]), showed that there was no virus transmission or increase of COVID-19 related to the opening of training facilities, where good hygiene and distancing measures were observed. This trial highlights that facility-based activity can be undertaken safely, with limited risk.

In September 2020 the SafeACTiVE study was launched, commissioned by EuropeActive's Research Centre THINK Active, which aims to demonstrate the low risk of COVID-19 infection in fitness clubs. Research and evaluation partners have collected data based on more than 62 million visits to fitness clubs and leisure facilities with only 487 positive cases (both members and staff) reported by operators based in Germany, France, Sweden, Belgium, Netherlands, Spain, Portugal, Norway, Switzerland, Czech Republic, Poland, Denmark, Luxembourg and The United Kingdom. This translates to an average infection rate at 0.78 per 100.000 visits.

The data collected seeks to mitigate public health concerns (of both users and members), confirming that fitness clubs are safe environments with a relatively low risk of COVID-19 infection; while also offering the fitness and physical activity sector a strong argument for keeping their resources open during any future outbreaks of infectious diseases.

[1] https://pubmed.ncbi.nlm.nih.gov/?term=covid+19&size=200

[2]https://pubmed.ncbi.nlm.nih.gov/?term=covid+19+and+exercise&size=200

[3] Nieman, D.C., Wentz, L.M. The compelling link between physical activity and the body’s defense system. J Sport Health Sci, 8 (2019), pp. 201-217.

[4] Global Action Plan on Physical Activity (GAPPA): https://www.who.int/ncds/ prevention/physicalactivity/global-action-plan-2018-2030/en/

[5] Chekroud SR, Gueorguieva R, Zheutlin AB, Paulus M, Krumholz HM, Krystal JH, Chekroud AM. Association between physical exercise and mental health in 1·2 million individuals in the USA between 2011 and 2015: a cross-sectional study. Lancet Psychiatry. 2018 Sep;5(9):739-746.

[6] The TRAiN Study Group. Randomized Re-Opening of Training Facilities during the COVID-19 pandemic. https://www. medrxiv.org/content/10.1101/2020.06.24.20138768v2.full.pdf