The current coronavirus (COVID-19) pandemic has left us all with a sense of uncertainty and many questions. We’d like to take the chance to answer a few of those questions that we have come across, namely those that may be particularly relevant for people living with cancer: “What affect does this all have for me?”, “Should I still be exercising?”, and “Is there any exercise that I should be avoiding?”
How does the COVID-19 pandemic directly affect someone living with cancer?
Currently, those at highest risk of contracting, and experiencing complications, of COVID-19 are the elderly (70 years or older), and people living with chronic diseases or with a compromised immune function. Those who are living with cancer will in fact fit into the later 2 categories, and those who are indeed over 70 years of age will be classed into all 3 categories. Bear in mind that even if your cancer treatment was some years ago, a small percentage of people may still have immune systems which are not fully recovered.
At this stage, the recommendation if you are living with cancer is to follow any specific advice or standard precautions recommended by your health care practitioners (such as your GP or Oncologist) to minimise your risk of infection during and after treatment. These recommendations include:
- Wash your hands with soap and warm water for 20 seconds, or using an alcohol-based hand sanitiser, frequently throughout the day
- Maintain a 1.5 metre physical distance between yourself and others; unfortunately kissing, hugging, or hand shaking is out
- Avoid crowded areas in general, particularly if you are currently undergoing chemotherapy or bone marrow transplant treatment
- Avoid touching your eyes, nose and mouth as this can transfer the virus from surfaces and increase our risk of exposure to infection
- Avoid interaction with anyone who has contracted the virus, is sick or unwell, or those that may have recently returned from overseas travel to high risk countries
- Clean and disinfect objects around the house that are frequently being touched, ideally while wearing gloves if available
- Ask your treatment team about when you may be at a higher risk of infection during your treatment so that you can plan around this
- Discuss with your treatment team whether they have Telehealth services available to avoid being exposed to any unnecessary risk (this may not always be appropriate and face to face consults may still be required)
- Stay at home as much as possible and avoid non-essential travel and public transport if able.
Should I be exercising during this time?
The short answer is yes, now more than ever is the most important time for us to all be maintaining regular physical activity in our weekly routine.
Evidence suggests that completing exercise, compared to being sedentary, within the recommended exercise guidelines has an overall positive effect on our immune function, at the same time reducing inflammation and thus our overall risk of contracting viruses.
Exercise also has a profound benefit on our mental health (by reducing anxiety and depression) and can provide structure during a period where people may feel like that routine is somewhat lacking. Additionally, during high periods of stress (safe to say that’s all of us at the moment!) our body produces increased levels of cortisol. Interestingly these levels of cortisol are also heightened during periods of isolation and confinement, giving us the current situation of a double whammy. On top of this, increased cortisol levels can have a negative effect on our immune system and prolonged heightened periods can increase our risk of contracting diseases and viruses.
The good news is that exercising can help reduce cortisol levels in our body and assist with maintaining our immunity. Without getting too sciencey: acute bouts of exercise help circulate our immune cells around our body so that they can do their job of helping to fight off any infections. This makes maintaining exercise particularly beneficial for those in the high risk category of contracting COVID-19.
At this early stage there is no evidence to suggest that exercise can directly protect us from COVID-19 however there is evidence that it can protect us from other viral infections such as Epstein-Barr virus (glandular fever) and influenza.
Are there any types of exercise I should be avoiding?
Although moderate-intensity physical activity is associated with a healthier immune system, high-intensity high-volume training (may be referred to as prolonged HIIT) can actually suppress our immune function, particularly if you are unaccustomed to it. We recommend that unless you have been regularly performing this type of exercise recently that you avoid it – there are plenty of other options!
Currently there are no recommendations that you should limit your physical activity if you are under quarantine without being infected. Even if you are infected, but remain asymptomatic, it is encouraged that you continue performing moderate-intensity physical activity. Remember, as per usual, that you should be guided by your symptoms and cease all physical activity if any signs of fever, cough, or shortness of breath appear and consult with your health care team.
Be sure to check out next week’s blog where we will provide advice on how you can get creative while keeping active at home during the COVID-19 pandemic.
Written by Michael Czaplowski, Accredited Exercise Physiologist at Movement Against Cancer