The Best Way to Protect Against COVID-19 with Dr. Robert Sallis

It is an activity associated with cutting your risk of death from COVID by two and a half times, and cutting risk of developing severe COVID by two times. That activity is exercise, and the study that established its power as a modifiable risk factor against the coronavirus was led by Dr. Robert Sallis, past president of the American College of Sports Medicine and director of the Sports Medicine Fellowship program at California’s Kaiser Permanente Medical Center. In this episode he’s in conversation with Medcan chief medical officer Dr. Peter Nord. 

https://www.eatmovethinkpodcast.com/podcast/ep-65-how-to-protect-against-covid

 

LINKS

The study lead by Dr. Robert Sallis in the British Journal of Sports Medicine:

https://bjsm.bmj.com/content/early/2021/04/07/bjsports-2021-104080

New York Times’ Well blog story on the COVID/Fitness study:

https://www.nytimes.com/2021/04/14/well/move/exercise-covid-19-working-out.html

Exercise is Medicine blog post by Bob Sallis and James Sallis that provides good background on some of Sallis’s frustration with the public health response to COVID:

https://www.exerciseismedicine.org/support_page.php/stories/?b=959

Resources tying fitness level and exercise to immune function:

https://www.exerciseismedicine.org/support_page.php/covid-19-and-exercise1/

Medcan director of fitness Stephen Salzmann and fitness manager Anna Topali hosted a webinar about how to incorporate exercise snacks throughout your workday. Check it out. 

To create a personalized exercise training regimen and work with some of the country’s best trainers, check out virtual training by Medcan Fitness.  

 

INSIGHTS 

Get moving: Dr. Sallis’ study divided study participants into three groups — those who didn’t exercise at all, those who exercised a little bit and those who achieved at least 150 minutes of moderate exercise per week. Compared to the group that received the most exercise, the “no exercise” group was two and a half times as likely to die from COVID and twice as likely to be hospitalized, as well as twice as likely to be admitted to intensive care. [07:20]

There’s no time like the present: “There has never been a better time to start an exercise program,” Dr. Sallis says. “Short of getting the vaccine, this is the single most important thing you can do to protect yourself from COVID... protect yourself against the next variant, or the next pandemic down the line. This is a wake up call. You need to pay attention to it and start getting active to protect yourself.” [08:22] 

Words matter: Dr. Sallis is disappointed that physical inactivity hasn’t been included as a major risk factor for severe COVID in key messaging from medical leaders. “All of us have been a bit disappointed that the uptake has been slow. Certainly, you don’t hear it coming from Anthony Fauci’s mouth, or the CDC—the CDC still does not list it on its website, that physical inactivity is a major risk factor,” he says, adding that the World Health Organization, at least, does include physical inactivity as a major risk factor for severe COVID. “We’re always running behind on our messaging.” [11:56]  

“The take home message for everybody around the world is that you just need to walk,” Dr. Sallis says, noting that the ideal pace is hard enough to prevent you from singing, but moderate enough that you can still talk. A brisk 30-minute walk five days a week will do it, but you can also break it up throughout the day: Taking the stairs instead of the elevator, or parking farther away in the parking lot. [13:39]

Rethinking lockdowns: Dr. Sallis disagrees with closing outdoor athletic or recreational facilities like parks, hiking trails, tennis courts and golf courses. Outdoor venues where you can partake in physical activity, while distanced and masked, are safe, he says. In fact, people should be encouraged to take advantage of them. In Dr. Sallis’s mind, if big-box stores  can stay open, then we should be able to figure out accommodations for exercise, too. “These [venues] are essential to life. Physical activity is essential to life,” he says. [18:21]  

Proactive patient care: Dr. Sallis believes the medical profession should treat exercise as a prescription, one that would optimally be attempted before pharmaceutical treatments. For example, if a patient is struggling with depression, the doctor should explore their fitness habits before prescribing an antidepressant. After all, studies have shown that exercise can “dramatically improve” depression. “You have to really sell it like you would [sell] Prozac,” he says. [19:22]  

Shifting mindsets: Closely connected to the idea of “prescribing” exercise is moving the medical field, where possible, away from a focus on pills and procedures. “We are so driven by pharma,” Dr. Sallis says. The message of this pandemic has been: Stay inside until you get a vaccine. Dr. Sallis wishes the messaging would have been different. “It should have been: ‘Until you get a vaccine, you need to try to walk everyday, because that’s the single best defense short of a vaccine,’” he says. Plus, there’s evidence that exercise improves one’s immune response overall. “We have shown that [in people who exercise], the flu vaccine works better. I’ve got to believe that the COVID vaccine is going to be similar.” And that means: Keep up those daily walks even after the pandemic is over. [22:07]