COVID-19 has brought numerous challenges globally. It has impacted people’s health, the economy; affected how people communicate and gather; mourn and celebrate and of course, travel. It has also highlighted the importance of physical activity and exercise, for one's overall health and wellbeing and social cohesion of communities.
Some of the diseases that place individuals with COVID-19 at much higher risk of being hospitalised or dying – are the same lifestyle-related diseases that are associated with being physically inactive. The risk from dying from COVID-19 is 1.5 to 3.5 times higher for people with diseases such as Type 2 diabetes, high blood pressure or cancer. And what is even more concerning is that there is evidence from almost 400,000 people in the UK, showing that those who were physically inactive were nearly 40% more likely to be hospitalised with COVID-19. Regular, moderate physical activity has been associated with decreased death from infectious diseases, a stronger immune response, reduced inflammation and a lower incidence of viral respiratory infections. It also reduces depression and anxiety, both of which have escalated during the COVID-19 pandemic. Physical activity improves the quality of life and delays the cognitive decline associated with ageing.
Every year, physical inactivity accounts for more than 5.3 million deaths worldwide. These deaths are primarily due to heart disease, diabetes and some cancers. But in Sub-Saharan Africa, there are major concerns, with nearly half of adults experiencing high blood pressure, 20% who are obese, and 5% with Type 2 diabetes. And, 18% of men and 25% of women are not getting sufficient physical activity, which in simple terms translates to about 150 minutes of moderate physical activity or 75 minutes of vigorous exercise per week.
The response of governments to restrict population mobility to minimise the transmission of COVID-19 created a "window of opportunity". Restrictions created "push back" from civil society, fitness centres, gyms, and community organisations, clamouring to be allowed responsible access for physical activity and to create "activity-supportive" environments. The government recognised that physical activity was essential for one's health and wellbeing and that access to physical activity was seldom equitable.
The need to message and provide guidance to governments and civil society, to implement national plans, policies and programmes to promote physical activity in the African region, both during COVID-19 and beyond, became critical. As a result, a group of more than 40 academics, researchers and implementation partners from 9 countries in the African region prepared a series of policy briefs. The consortium, spearheaded by Professor Vicki Lambert (University of Cape Town Research Centre for Health through Physical Activity, Lifestyle and Sport (HPALS)) and Associate Professor Rowena Naidoo (College of Health Sciences, University of KwaZulu-Natal) and where Profs Paola Wood (Division of Biokinetics and Sport Science in the Department of Physiology, University of Pretoria) and Christa Janse van Rensburg (Section Sports Medicine, University of Pretoria) were part of the core writing team, created two policy briefs. The first targeted the general public, and the second, children in three environments - at home, at school and in communities. Endorsed by the African Physical Activity Network (AFPAN) and supported by the Western Cape Government Department of Health, the goal of the policy briefs is to guide decision-makers, planners and programme leaders, both during the COVID-19 pandemic and beyond. In so doing the first policy briefs:
* Address five major challenges needed to minimise the risk of community transmission while exercising during the pandemic which includes; social distancing (2m); wearing masks (non-medical, cloth masks); exercising in small groups (outdoors, with social distancing); exercising indoors (only with proper ventilation) and avoiding the use of shared equipment or sanitising in between users. These same concerns apply to children, and in particular, children in school settings. Accompanying useful infographics can be placed in prominent locations to remind participants to exercise safely.
* Adopt a policy framework created by the World Cancer Research Fund which is aligned to the World Health Organization Global Action Plan for Physical Activity (GAPPA).
* Introduce a 4 Step policy recommendation for physical activity for the general public in the African region. The four steps include:
1. The development of a National Plan for physical activity for health and development, which would allow for input from multiple sectors and stakeholders, resulting in co-benefits and shared responsibility.
2. Training a cadre of health professionals, educators, sports coaches & community members to promote physical activity for health.
An exemplar of this is already in action with "Exercise is Medicine South Africa" which resides within the South African Sports Medicine Association and offers courses for physical trainers. Another example is with the Western Cape on Wellness (WoW!) lifestyle programme institutionalised by the Western Cape Provincial Government. Says Dr Frederick Marais, the Deputy Director of Health for Increasing Wellness– "WoW! has trained more than 600 health champions who lead community groups, promoting physical activity and public exercise programmes in underserved areas. The improvement to both the members' health and quality of life has been outstanding".
3. Ensuring safe and enjoyable opportunities for physical activity, through urban planning, provision of parks or public spaces and low-cost programmes close to where people live. This is critical in communities that lack safe and accessible facilities where they can be physically active.
4. Adopting a "whole of government" systems approach towards physical activity embedded in multiple sectors, devising flexible, agile and cost-effective solutions. Critical to this – is recognising physical activity as a vital component both in preventive health care and a means to build social cohesion in communities.
Associate Professor Paola Wood and echoed by Professor Janse van Rensburg "physical activity is essential for mental and physical wellbeing during the current COVID-19 pandemic and beyond. It is of vital importance in reducing the risk of developing non-communicable diseases such as Type II Diabetes, heart disease and high blood pressure. This is important in the African region, where more than half of all adults and children are insufficiently active." she said.
This is an exciting era where, for the first time, health-care providers and policymakers are acknowledging the importance of physical activity for health and development in the African region. Regular physical activity saves lives, improves quality of life, physical and mental wellbeing, and boosts the immune system.
To download the policies, please click below:
Policy Brief: Physical activity for children during COVID-19
Policy Brief - Physical activity for Health in Africa