Since the start of the COVID-19 pandemic, public health officials, medical professionals, researchers, and messaging from the media have encouraged people of all ages to regularly wash hands, practice social distancing, wear a mask when advised, and to get outdoors and engage in physical activity.
Outside physical activity during a pandemic?
On the surface, this guidance seems counterintuitive to county- and state-wide stay at home orders. In Pennsylvania, a three-phrase matrix is used to determine when counties and/or regions can ease restrictions on work and social interactions. Across the red (high restrictions), yellow (moderate restrictions), and green (low restrictions) phases, outdoor recreation and physical activities are encouraged as long as they done with social distancing in mind (e.g., at least 6 feet away from the next person). People have been encouraged to walk, jog, run, cycle, and enjoy family hikes and water-related activities such as swimming and kayaking (as long as parks and waterways remain open).
The reason behind this is because physical activity is one of the most important behaviors that people of all ages can do to improve and/or maintain good mental and physical health. The executive summary of the Physical Activity Guidelines for Americans states “Physical activity fosters normal growth and development and can make people feel better, function better, sleep better, and reduce the risk of a large number of chronic diseases.” To experience these benefits, adults should do at least 150 minutes (2 hours and 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity aerobic physical activity or 75 minutes (1 hour and 15 minutes) to 150 minutes (2 hours and 30 minutes) a week of vigorous-intensity aerobic physical activity. Adults should also do muscle strengthening activities on two or more days of the week. Preschool-aged children (ages 3-5 years) should be physically active throughout the day, and children and adolescents (age 6-17 years) should do 60 minutes or more of moderate-to-vigorous physical activity (aerobic, muscle and bone strengthening) per day. Importantly, physical activity is also encouraged for adults with chronic conditions or disabilities as well as pregnant and postpartum women.
However, there is growing confusion over where people should and should not engage in exercise as well as whether wearing a mask is required.
A key concern with exercising indoors is the fast and easy spread of COVID-19. Indoor gyms, yoga studios, and recreation facilities have experienced restricted access and closures across the country because the virus can easily spread through air via respiratory droplets and on surfaces that are frequently used such as weights and machines. For example, a recent study conducted in South Korea identified 112 COVID-19 cases associated with fitness classes in 12 different sports facilities. The authors of the study suggested that key characteristics that may elevate transmission of the virus among group members include large class size, small spaces, and high intensity of the workouts which can cause more dense diffusion of isolated droplets. In short, people breathe more rapidly and deeper during an intense workout and so they expel higher numbers of droplets. These droplets are said to remain airborne for up to three hours which makes the potential for spread in gyms and fitness facilities a primary concern.
As states have begun to ease restrictions, some indoor gyms/studios/recreational facilities have opened while other facilities have been told to close as quickly as they opened. For example, on June 30, 2020 Mountainside Fitness in Arizona announced a plan to sue Governor Duecy over the recent closure order. The CEO, Tom Hatten, criticized this decision because of the lack of evidence that the virus is spreading in health clubs across the state, and because this executive order did not include other indoor spaces such as restaurants and casinos that may also spread the virus.
In Pennsylvania, Governor Wolf and Secretary of Health, Dr. Rachel Levine expanded the mask-wearing order, effective July 1, 2020, such that “masks must be worn whenever anyone leaves home.”
So what does this mean for physical activity generally? Are people required to wear a mask when they are exercising? The order states that “face coverings are required if you are outdoors and unable to consistently maintain a distance of six feet from individuals who are not a member of your household.” The main factor is the distance … if one can engage in outdoor activities and keep a steady six feet from others, there may not be a need to wear a face covering. However, if a park, playground, sidewalk, or trail is busy, it is a good idea to have a face covering in the event that the crowds change or social distancing is no longer an option.
How does wearing a mask work in youth sports? This is a challenging question for parents, coaches, and players, and there is some ambiguity with the guidelines. The Centers for Disease Control and Prevention (CDC) suggests that face coverings may be difficult for players to wear while engaged in a sport, but strongly supports their use by coaches, parents, officials, and spectators. To reduce the risk of exposure to COVID-19, youth sports organizations should keep in mind the CDC’s guiding principles for level of risk whereby the lowest risk activities are skill-building drills or conditioning where social distancing is in place and the highest risk activities involve full competition between teams from the same or different geographical locations. If an organization cannot keep safety measures in place during competition (e.g., maintaining social distancing by keeping youth six feet apart at all times) and wearing a mask is not an option, the organization may need to roll-back on procedures to reduce risks of exposure.
Despite these challenges, staying physically active during this pandemic is obligatory for everyone’s overall health and well-being. First,physical activity can help to boost the immune system. Research evidence shows that regular moderate-to-vigorous exercise can help the body to fight off viruses, including COVID-19, by mobilizing billions of immune cells in the body to “take on” infections that are trying to gain a foothold.
Second, exercise can help to prevent weight gain. Because self-quarantine means more time at home (including working and online school for children and young adults), people are sitting more and moving less. A recent study published in Obesity Research & Clinical Practice showed that 91% of the sample stated they spent more time at home than before the pandemic, and 22% have gained 5-10 pounds over the past several months. The majority of the participants also reported eating and snacking more often and eating in response to stress and boredom. Because regular exercise is an important factor in maintaining healthy weight, it may help people combat weight gain associated with these self-quarantine eating behaviors. But this means making a commitment to get up and go … and it may be surprising to some that this means more exercise than expected as upwards of 275 minutes/week of exercise may be needed to regulate weight.
Third, physical activity can improve mood. It can help people deal with the fear, anxiety, stress, depression, boredom, and isolation that is associated with living during a global pandemic and the uncertainty of its ending. There is also evidence that exercise can build emotional resilience, or one’s ability to adapt to stressful situations and crises (such as a global pandemic!)
Thus remaining active during this pandemic is essential for physical and mental health. However, the greatest risk of COVID-19 isexposure, so it is critical to find creative ways to stay active each day. For example:
- Move indoor fitness or yoga classes to the outdoors … enjoy the warm weather during an early morning exercise class at a local park or parking lot of a studio (while practicing social distancing and limiting class size of course).
- Take the opportunity to explore the outdoors. Consider visiting a new park or trail. In Pennsylvania, state parks include over 283,000 acres – more than enough space to be active and social distance!
- Get help from a dog … more time at home means more time with a furry friend. Take mini-breaks from work or household activities and walk the dog around the neighborhood or play in the yard.
- Create an obstacle course. If young children are at home, consider setting up toys and maybe the lawn sprinkler … kids will enjoy running through the obstacle course (and maybe even race the parents for some friendly competition!)
- Consider virtual workouts – numerous organizations offer online memberships and share workout videos and livestream classes for many different activities from weightlifting to Zumba to yoga.
- Enjoy a dip in the pool or lake. Take advantage of the warmer weather and consider a water workout – from swimming laps to treading water to water skiing!
- There’s an app for that … there are numerous activity apps available on the market to personalize a workout. The FitOn app is one of the more popular apps that offers a wide variety of workouts for people of all skill levels. The app is free and does not require additional equipment.
With the long days at home and high stress of the COVID-19 pandemic, finding the motivation and family support to stay active will offer many rewards. So get up and go … but don’t forget to bring a face cover or mask along with you!