To the SA government: Exercising outside is the best Level Four solution

A consistent theme emerges when President Cyril Ramaphosa addresses the nation about the latest updates in the fight against coronavirus – congratulating us, the South African public, for showing discipline and resilience during these difficult times.

And it’s true. South Africans have been remarkably compliant despite some of the toughest lockdown laws in the world. Of course, some have flouted the regulations, but overwhelmingly this country has responded in a responsible, mature and compassionate way.

We are not asking for much. Armed with scientific and medical facts, we are simply presenting a solid argument for the sake of collective mental and physical health, to be able to escape our homes and walk or run for an hour or so each day. Give us a two-week trial period to prove we can manage exercise responsibly during level four lockdown.

We are aware of the disease we are up against. We are fully versed in the physical distancing and hygiene protocols needed to stop the spread of the virus. We have already demonstrated that during the past 33 days.

Now it’s time for the government to show that it trusts its people. This is not a plea to open gyms and sports clubs. It’s an invocation to allow us to move, outside of our homes.

Everyone’s circumstances are different and for people in townships, physical distancing has been near impossible. In the suburbs it’s been easier but presents different challenges. Humans are made to move and be active. Yes, we can run up and down the driveway, if we have one, or around the garden if more fortunate. But science shows that walking and running outside of those confines is essential.

Exercise is essential to health

“It’s not new that exercise is vital to human existence,” renowned sports scientist Ross Tucker says. “Name a disease – cancer, diabetes, cardiovascular, cholesterol, strokes – and I guarantee you there is a study that shows exercise helps prevent them.

“There is no question that the health of South Africans has deteriorated in the past five weeks, particularly in elderly people. Generally, the only exercise the elderly get is the activities of daily living such as walking around the block, to the shops, or walking the dog.

“When those are taken away, they go from training to being completely sedentary. Being sedentary is bad, and the older you are, the worse it is. This is a massive problem. Elderly people will have aged and become years unhealthier, in these four to six weeks.

“The lockdown, which is seen as a big part of the solution to coronavirus, has had huge side effects. It is creating secondary consequences. For instance, the risk of strokes and blood clots goes up when people are inactive. Bone mineral density goes down, muscle mass drops, fat mass increases, which all have negative health consequences. 

“Pretty much everything you can imagine deteriorates when you are inactive. Exercise is the solution to better health.”

The key to allowing the public out to exercise is managing physical distancing and other coronavirus protocols while outside. Every day, thousands visit grocery stores to buy food and manage to adhere to those conditions. Why not with exercise too?

“A healthy dose of exercise is vital for your physical and mental well-being, because it reduces dopamine and increases your serotonin levels and that makes you feel better,” says Runners’ World and Bicycling editor Michael Finch.

“The amount of exercise is a critical part of this discussion, and most experts will tell you that now is not the time to train for a serious race. Now is the time to train for health and maintenance.

“One of the interesting developments around the world, especially in places badly affected by coronavirus such as Milan, New York and Berlin, has been a big push towards using cycling as a new method of transport.

“A lot of those cities are closing down roads to cars and opening them up to pedestrians and bicycles to allow for more space, so people can have more scope for physical distancing by walking down the centre of a once-busy road.

“If we’re looking at best practices in dealing with coronavirus, there are lessons from around the world. In Sydney, London, New York and many other places, being able to go outside and exercise is a key part of the strategy, even though they have been hit much worse than us.

“The key is that people behave themselves and obey the rules.”

 Permission to obey

South Africans need to be trusted that they can respect the rules. Being allowed to exercise outside of the confines of our homes will require self-discipline and consideration. It also gives scope for the public to self-police and call out transgressors. That is certainly something the government could ask us to do if they relax the restrictions slightly.

There is a suspicion that government has taken such a hard line because it doesn’t want to cope with 3,000 people descending on Sea Point promenade or some other public space. That has been a problem in places such as the UK because public spaces became congested.

But we need to be given the benefit of the doubt. There are enough people who will self-police. Of course, there will be those who transgress but they should be punished harshly and issued with hefty spot fine if they break the rules. Not the entire nation.

The long-term health issues of no exercise could have a far greater and more catastrophic impact on our collective well-being than coronavirus.

“Exercise optimises the immune system by causing what is called increased immunosurveillance,” Tucker says. “Basically, your immune cells circulate in your blood, and in the lymph tissues of your system. When we exercise, blood flow goes up, which takes those cells to more places in the body.

“It’s the immune system’s equivalent of putting more security guards on duty at a public event. We are in an immune crisis at the moment. But directly more exercise would be in the public health interest, simply because people who are active, are less likely to get sick.

“You should be doing as much exercise as you can, within reason, because it is in the public health interest and it will protect you and everyone else. If we want to do something to help reduce the risk of this virus spreading, actually being active is one of the important things we should be doing.

“So many normal liberties have been taken away, and that stuff is meaningful, which has led to stress and anxiety. What then is the outlet for people? Being outdoors and exercising is that outlet.

Physical health equals good mental health

“There was a big study in the respected scientific journal The Lancet, which surveyed 1.2 million people,” says Tucker. “The study showed that exercise was far and away the best predictor of mental health and well-being. Anxiety and depression are reduced in people who exercise regularly. It seems to me, this is a time you would want to do more exercise, not less.

“When you’re forced to run up and down your driveway in 15-metre increments for 30 minutes, exercise is no longer enjoyable; it becomes an obligation. In that scenario, whatever mental health benefits you were getting from it have probably been taken away and possibly reversed.

“How are people who don’t do structured training staying healthy? The answer is; they’re not. They are getting less and less healthy every day with related co-morbidity issues. An active community is a healthier community and when you force them to be inactive, society pays for it.”

Historically South African attitudes towards the law have been demonstrated in small things – the high numbers of people who drive without seat belts, or who ignore red lights, or under the influence of alcohol or drugs. Why would South Africans respect the law, when that confidence is undermined by the daily experience of citizens in their interactions with the criminal justice system? As long as many who hold office appear to act with impunity, or use the criminal justice system to dodge serious allegations of the abuse of power or state resources, surely we cannot reasonably expect South Africans to respect the law.

It’s a little like the jaywalking effect. In South Africa, a pedestrian is only supposed to cross a public road at a pedestrian crossing or an intersection, yet citizens routinely cross the road where they feel like it. Jaywalking doesn’t feel like a bad crime, so some of us resort to doing it from time to time.

And yet, the overwhelming majority have abided by the law during the lockdown, but these laws also need to make sense, or more citizens will start taking the jaywalking approach. There is sound medical and scientific advice supporting why the government needs to cut South Africans some slack when it comes to exercise. DM