How a year of pandemic has damaged our bodies and what we can do

Deterioration in our bodies due to isolation

This sentence is for all of us who have been confined and even more so, teleworking, some with the comfort of an ergonomic chair, computer screen at eye level, footrest, while others with less comfort, but yes, spending hours and hours of physical stillness, intense work and surely, stress.

Almost all countries announced quarantines and lockdowns starting in March 2020.  It's almost a year and our body has been the one to suffer the most. As the months have passed, we have had more and more headaches, neck tension, shoulder discomfort, dry skin and, automatically, excess weight.

The Coronavirus itself has triggered a devastating effect on the health of millions of people across the world.  But even for those who have managed to avoid the virus so far, the effects of coping with a prolonged situation like this have been painful and even tragic.   

Perhaps it is still too early to know to what extent we have physically deteriorated during 2020.  According to some doctors and other health professionals, there are a number of aggravating tendencies that have emerged from upper back pain, constant headaches, neck tension that over time begins to spread to the lower back and legs. More than half of these complaints are the result of hours of immobility at work stations where a modest hump begins to manifest itself, while the head leans forward when the computer screen is very low and in a chair that was designed to support the human body during a meal or a visit, but not for a whole work day.

Physical and emotional deterioration according to population groups

For people of working age

Circumstances for the working-age population group have changed:  There are people who now work from home, or those who have lost their jobs and must spend many hours in front of a computer looking for work. In addition, this group was caught by quarantines and confinements without good ergonomic equipment for a home office with an adjustable height chair or a desk where the computer screen is at eye level and they can rest their elbows.  Others have even had to set up a mini office that they share with their children who must take their school courses virtually.

Other population groups

For older people, who are part of the at-risk population, isolation and immobility have serious consequences.  For everyone, but especially for our seniors, not taking walks, getting fresh air and sunlight further weakens their bones and joints that are already vulnerable to sarcopenia (loss of skeletal muscle as a result of aging) and puts them at risk of falls and fractures.  Prolonged stillness and physical weakness in turn make them lose the confidence to go out and move around.

For children and adolescents whose youth makes them physically strong, isolation, on the contrary, is deteriorating their psychosocial development.    2020 deprived them of regular classes, recess, physical education classes, and all the activities that allowed them to socialize with their friends and classmates.  Many children begin to suffer from the same physical pains as adults after spending hours of virtual classes in front of a computer, in isolation and/or in a small home that they must share in many cases with their parents and siblings. Physical therapist Nancy Durban of the Cincinnati Children's Hospital, USA, says that "the combination of anxiety with temporary desks where the child must take his or her classes imposes tension on several muscles in the body, reducing their mobility, increasing the tension that eventually alters normal sleep cycles." 

A report by Swiss Radio Television (TSR) in November 2020 indicated that 10-15% of Swiss teenagers are suffering from depression.  Paediatrician Anne-Emanuelle Ambresin, head physician of the interdisciplinary section of adolescent health at the Centre Hospitalier Universitaire du Canton de Vaud, points out that “in essence, during adolescence, one projects oneself into the future to develop and find oneself.  “Both Covid and the transition to virtual courses are two circumstances that have hindered the training and future prospects of adolescents.”

To remedy this, consultation spaces have been opened so that this population group has the opportunity to express themselves and also, to allow schools to remain open for children up to 14 years of age and for older children, a combination of virtual courses with physical attendance at classes. ( Source )

Isolation has had an impact even on people who were already working from home before the pandemic, with a schedule of physical, social and visual activities that compensated for the time spent immobile, isolated and fixated on their eyes at home.  In fact, visual problems have spread and increased.  Dryness, blurred vision and eye strain are some of the symptoms that ophthalmologists are treating these days. 

In addition to the conditions mentioned above, the pandemic seems to be causing a number of skin and scalp problems.  An increase in eczema has been detected  on the skin of sensitive people due to frequent hand washing and use of hydroalcoholic gel. 

Hair loss is a common symptom of acute stress, according to the New York Times, many patients recovering from Covid-19 are experiencing hair loss, not from the virus itself, but from the physiological stress of fighting it. Many people who never contracted the virus are also losing their hair, due to emotional stress from job loss, financial strain, the death of family members, or other devastating events stemming from the pandemic. ( source )

The health disorders to which we are exposed  during  imposed isolations

For many people, the physical consequences of a year or more of isolation and distancing will be temporary and perhaps reversible.  For others, the accumulation of disruptions to their daily routine could prove fatal. 

According to an article in the Frontiers in Sports and Active Living journal on physical activity during the Coronavirus (COVID-19) pandemic, 

“What was defined in 2012 as the global pandemic of physical inactivity is believed to have resulted in the deaths of 5.3 million people a year.  High sitting time and low levels of physical activity (PA) are associated with increased risks of depression, type 2 diabetes, cancer, coronary heart disease, and mortality. 

Human physiology responds rapidly to reduced AF.  For example, 2 weeks of reduced PA leads to decreased cardiorespiratory fitness and multi-organ insulin sensitivity.  Just one week of induced sedentary behavior has detrimental effects on mood and depression.  Furthermore, a 1-week decrease in walking steps by 91% reduced levels of myofibrillar protein synthesis (the driving force that triggers adaptive responses to exercise) and increased muscle atrophy in adult males. Furthermore, immobilization and sedentary behavior such as watching television are strong risk factors for venous thromboembolism.  In contrast, regular AF and little sedentary time are associated with a reduced risk of morbidity and all-cause mortality.

The harmful effects of COVID-19 include lung damage, pneumonia, overwhelming innately produced inflammation, abnormal coagulation characteristics, and both cardiac and renal injuries. In this context, the preventive and palliative effects of PA on complications from viral infections are of great interest. First, regular PA improves cardiovascular functions, coagulation, and fibrinolytic homeostasis, as well as general protection from cellular stress.  Secondly, PA can increase the endurance and strength of the respiratory muscles, making them more efficient.  Third, frequent AF has positive effects on the immune system, can slow down the immunosenescence generally observed with aging, and could improve the immune response to viral antigens, decreasing the incidence of viral infections throughout life.” 1

Accentuated and lasting effects of Physical Activity (PA) 

According to the recommendations of the occupational medicine and toxicology journal BMC ( 2 ), physical activity (PA) practiced frequently benefits people of all ages, sexes, races, health conditions and physical states since it reduces mortality and morbidity rates, increases quality of life and autonomy in old age.  This requires regular physical activity throughout life since the benefits can be temporary and dissipate if the stimulation caused by physical activity is not repeated frequently.

Effects:

• AF stimulates human metabolism.  This happens because it increases the absorption of glucose, thus reducing high blood sugar levels. 

• A single session (30–60 minutes) of moderate- to high-intensity physical activity can increase circulating IL-6 activity (Interleukin 6 is a cytokine that is involved not only in responses to inflammation and infection, but also in the regulation of metabolic, regenerative, and neuronal processes) and neutrophil counts in untrained adults.  Inflammatory processes have been linked to chronic diseases such as cardiovascular disease, type 2 diabetes, cancer, dementia, osteoporosis as a result of organ damage and dysfunction. 

• Mental health, physical well-being, mood, sleep and cognitive ability.  Even low to moderate volume and intensity exercise can boost stamina and mood.  Likewise, PA, regardless of intensity and time of day, would improve sleep quality and cognition, the latter especially in executive function (how one plans and reacts to situations).

Recommendations:

1. When and where permitted and possible, according to local and/or national regulations, people should be encouraged to engage in outdoor activities, preferably in green areas.  As in all other situations, social distancing rules (1.5-2 m) apply outdoors.
2. The use of surgical or homemade masks has sparked controversy.  While the Centers for Disease Control (CDC) in the United States recommends them, the World Health Organization (WHO) maintains that the use of face masks by healthy people in the community has no scientific support and in fact, carries critical doubts and risks.  It should be noted that face masks may impede airflow and therefore cause discomfort, especially when performing more intense exercise. Limited air exchange around the face may result in a warm and humid microclimate. Wearing and removing a mask requires certain safety measures.( 3 )
3. Some of the outdoor activities can be brisk walking, jogging and cycling.  So-called green exercise allows you to improve your overall fitness, while moderate sun exposure can strengthen your immune system.  For people who consider themselves beginners, starting with low volumes (5-10 minutes 2-3 times per week) as well as low intensity (uniform speed) is a good way to start.  Eventually, alternating with short periods (e.g. 3 minutes) of increasing or decreasing speeds can improve the health effects and make the workout more varied and enjoyable.
4. If you cannot leave the house, you can go up and down stairs to exercise your lower limbs.  People with compromised balance should hold on to the railings; in this case, the use of gloves and mandatory hand washing are recommended.
5. Strength exercises can be performed with elastic bands and, if available, with inflatable bands using the KAATSU or blood flow restriction technique.  If not, exercises such as squats, push-ups, knee extensions, and all exercises performed with your own body weight are ideal.  All exercises can be modified to suit less fit or older individuals.  There are excellent tutorials on Youtube that can guide you in achieving this.
6. PA sessions can be short, up to 10 minutes, and activity time can accumulate over the course of the week.  Starting with short sessions and gradually increasing the activity time may be more accessible for people who are very untrained.
7. To reduce adverse effects, no physical activity should be performed during acute infection (other than COVID-19) and in case of absolute contraindications.  In these cases, intense exercises such as high-intensity interval training (HIIT) are NOT recommended, as they could cause temporary states of immunosuppression and increase susceptibility to infection.

The isolation implemented by countries to contain the spread of SARS-CoV-2 is unprecedented and therefore a challenge for all societies.  Furthermore, the repercussions on your physical and mental health may depend on how you handle this test, so do not be discouraged and use this information to take advantage of adverse situations in life.

References:

¹ Jakobsson J, Malm C, Furberg M, Ekelund U and Svensson M (2020) Physical Activity During the Coronavirus (COVID-19) Pandemic: Prevention of a Decline in Metabolic and Immunological Functions. Front. Sports Act. Living 2:57. doi: 10.3389/fspor.2020.00057   

² Füzéki, E., Groneberg, DA & Banzer, W. Physical activity during COVID-19 induced lockdown: recommendations. J Occup Med Toxicol 15, 25 (2020). https://doi.org/10.1186/s12995-020-00278-9

³ World Health Organization. (2020). Advice on the use of masks in the context of COVID-19: interim guidance, 5 June 2020 (No. WHO/2019-nCov/IPC_Masks/2020.3). World Health Organization.