PHYSICAL DISTANCING ≠ PHYSICAL INACTIVITY

Meyer, S., Landry, M., Gustat, J., Lemon, S., & Webster, C.
April 2021
 
Physical inactivity and sedentary behaviors increase the risk of acquiring chronic inflammatory
illnesses. Nearly half of COVID-19 patients admitted to hospitals in the United States are obese,
with a quarter suffering from diabetes and nearly a third from cardiovascular disease. Chronic
systemic inflammation is typically produced by physical inactivity, and it is suspected that
underlying systemic inflammation leads to COVID-19 infection progression. Due to the rapid
positive benefits of physical exercise on immunological function and inflammation, those who
are predisposed to COVID-19, such as those with pre-existing chronic conditions, would benefit
the most from frequent, moderately strenuous physical activity.
 
Physical inactivity is a global health problem that has been identified as the fourth leading cause
of death worldwide, similar to the COVID-19 pandemic in recent years. According to the
Physical Activity Guidelines for Americans, it is recommended that all Americans move more
and sit less during the day in order to achieve at least 150 minutes of moderate-intensity activity
per week for adults, with additional benefits obtained through increased participation in PA. The
recommendation for school-aged children (ages 6–17) is to engage in at least 60 minutes of
mostly moderate or vigorous physical activity every day, while children ages 3–5 should engage
in three hours of light, moderate, or vigorous physical activity per day. Additional muscle-
strengthening activities are recommended at least twice a week for both children and adults,
with bone-strengthening activities being especially beneficial for children and adolescents.
These recommendations were intended to represent the basic minimum.
 
The pandemic and efforts to contain it have caused government officials to warn residents to
stay at home and leave only for absolutely necessary activities, while maintaining a safe
physical distance from others. Continuing efforts have resulted in the temporary closure of
workout facilities and gyms, the suspension of sporting activities and leagues, and the
recommendation that individuals avoid public recreational places. Early school closures and
delayed reopenings have also reduced the possibilities for children and adolescents to engage
in sufficient physical activity. To encourage and provide PA opportunities from organizations, the
utilization of social media platforms such as Zoom and Facebook has been advocated.
According to newly available data, the prevalence of PA has decreased significantly as a result
of attempts to contain the spread of COVID-19. This is troubling, given that previous research
has demonstrated that even brief bouts of chronic physical inactivity can have detrimental
implications. The authors of this paper are concerned that the new normal of "social distancing"
and "sheltering in place" directives will result in an increase in sedentary behavior and a
decrease in physical activity, with negative short-and long-term consequences for chronic
disease risk, emotional health and mortality risk.
 
In recent years, there has been mounting evidence that this coronavirus disproportionately
affects various racial and ethnic minorities, as well as those from lower socioeconomic
backgrounds. Due to the fact that these populations also have a higher prevalence of pre-
existing chronic conditions, greater emphasis must be placed on promoting physical activity
(PA) among vulnerable individuals that are most at risk of getting COVID-19. Inequalities in the
built environment, such as a lack of PA facilities, sidewalks, connected streets, multiuse paths,
and perceived safe outdoor spaces, are associated with lower rates of PA in communities of
color and lower-income populations who live in neighborhoods with greater built-environment
inequalities Physical separation restrictions and limited access to public places may
disproportionately affect such groups, resulting in even fewer opportunities for PA during the
pandemic period.
 
It is more critical than ever in a pandemic-affected setting to make honest recommendations
about the importance of PA and to give chances and support for PA. PA promotion is a
collaborative effort including all sectors. This is a call to action for the entire nation to prioritize
and actively participate in PA promotion initiatives. Clinicians play a critical role in encouraging
PA in their patients, even more so during the COVID-19 pandemic age, when a variety of
factors are contributing to even lower PA levels. Individuals with cardiovascular risk factors
should get PA behavioral therapy. We know that education alone does not always result in
behavior change, but a clinician's advice has a far higher possibility of being followed through.
Health systems must adapt organizational practices and health policies to support PA by
utilizing PA as a vital sign, utilizing exercise recommendations, covering lifestyle treatments
through insurance, and collaborating with community-based PA partners to create safe chances
for PA. Workplaces must promote safe physical activity breaks and a healthy work-life balance.
Clinicians should advocate for employee wellness programs that include chances for PA and
empower patients to advocate for themselves by offering evidence-based tactics that they may
share with their employers and coworkers. Wherever possible, wellness programming should be
extended to employees who telecommute or work from home. At-home PA should not be
forgotten, including the utilization of household items such as chairs for squats, push-ups
against a wall, or step-ups on stairs. Individuals at increased risk, such as older folks and those
with compromised immune systems, can benefit from using modest objects such as resistance
bands and online workout videos in their homes. Access to community recreation facilities must
be addressed. Outdoor activities such as walking, biking, and playing should be encouraged
and made completely accessible. These activities are much more critical now than they have
ever been, given the heightened risk of indoor gatherings. Such activities have never been
contraindicated, and clinicians can collaborate with patients to choose the most suitable course
of action. Our educational systems should be prioritized. Clinicians can serve as a resource for
schools, which should be health-and safety-conscious environments for children and
adolescents. These institutions must prioritize the promotion of students' physical activity
through multifaceted approaches, such as a comprehensive school physical education program
that includes recess, classroom PA breaks, PA integrated with academics, and PA opportunities
before and after school, as well as the support of all teachers, school administrators, families,
Public health and allied health professionals should use their voices to advocate for PA on
social media channels. The news media and social media platforms both want champions who
will focus on promoting healthy physical activity. Additionally, medical professionals who serve
small towns and rural communities have an obligation to act as an advocate for health, which
includes advocating for active transportation and collaborating with local public health units to
help communicate health messages that are most beneficial to the population.
 
Physical distancing, in conjunction with mask wearing, has evolved as the sine qua non social
practice for protecting oneself and others from COVID-19 during this period of global health
catastrophe. However, while physical distancing occurs and all attention is focused on the novel
coronavirus, pandemic continues to rage. Physical inactivity, which is the fourth largest cause of
death worldwide, may be aggravated by physical distancing tactics such as sheltering at home
and closing or restricting access to recreation and exercise facilities. This article aims to remind
public health and medical professionals of the critical role physical activity plays in overall
health, to highlight the value of physical activity as a potential COVID-19 mitigation tool, and to
advocate for active lifestyle promotion. It is critical that the national call for physical distance is
not construed as an invitation to inaction. The present pandemic has brought to light a slew of
additional concerns, which are worsened by social and physical distancing standards. Now,
more than ever, our nation must heed the call for healthy habits, particularly PA, and do so in a
systematic manner, rather than relying solely on individual behaviors.

Reference:
Meyer, S. M., Landry, M. J., Gustat, J., Lemon, S. C., & Webster, C. A. (2021). Physical
distancing ≠ physical inactivity. Translational Behavioral Medicine, 11(4), 941–944.
https://doi.org/10.1093/tbm/ibaa134