These are difficult times for everyone. The pandemic’s spread is naturally impacting people mentally and physically. As of 26 April, the recovery rate in India was 82.6%. If you are healthy and safe, you are lucky. If you are recovering, you are luckier still.
But let’s not take our health for granted. Also guard against fake news, such as whatsapp forwards that say that the virus cannot harm fit and active people. If you are used to leading an active lifestyle, it is but natural to want to go out for a run as soon as you feel a bit better, or if you are asymptomatic. But should you do so? Here’s what the experts say.
I am asymptomatic, can I workout?
Covid-19 varies widely in the way it affects people. Some patients display either none or mild symptoms, while for others the disease is fatal. As to whether or not one can exercise while infected, the general guideline is one should avoid exercise if there are any signs of systemic infection (fever, body aches, swollen lymph nodes). “If symptoms are mild and limited to the upper respiratory tract (cough, runny nose), then light to moderate exercise might be beneficial. More intense exercise should be avoided during covid infection, even if symptoms are mild, as higher-intensity exercise can temporarily reduce immune function, which would not help one combat the virus,” explains Alexander J. Koch, professor and program coordinator for Exercise Science at Lenoir-Rhyne University, North Carolina, US. He describes moderate exercise as 30-60% of VO2max (the amount of oxygen uptake while performing intense exercise), which equates to walking at a light to brisk pace. A 60% VO2max should be an exercise intensity which is sustainable for an hour’s duration.
Also Read: Getting fit after recovering from covid-19
I have now tested negative, can I workout?
What about once you have recovered? It is natural to think that now that the RT-PCR test has returned a negative test result, and you feel fine, you can start exercising again. But Dr Ramji Mehrotra, cardiac surgeon at New Delhi’s BLK Hospital, believes that before beginning vigorous exercise, any recovering or recovered covid patient should consult a doctor.
“There are some tests which are to be done. Because covid is known to increase blood clotting (hypercoagulability of blood) and many patients also have myocarditis (inflammation of the middle layer of the heart wall), fat arteries, heart attacks etc even after recovery. Many patients would continue to have compromised respiratory and lung function,” explains Dr Mehrotra.
Dr Kavya Bhatia, head of department, Masina Hospital Reliva Physiotherapy Center, agrees. “Recovered covid patients have a compromised lung function. So the first thing they should do is to improve their breathing through respiratory and thoracic expansion exercises and only then move to aerobic exercises, such as a brisk walk and then cycling,” she says.
What are the health red flags I should be aware of?
How do you check if the level of exercise you are planning on performing is viable for your recovering body? Most people now have a pulse oxymeter at home. You can use that to also check if your exercise is impacting you more than it should.
Dr Bhatia explains that normal breathing exercises should not have an impact on your pulse rate more than +/- five beats. But if you go for a brisk walk, your pulse rate can fluctuate by 10-15 beats. Anything more than that means you should slow down and not push your body yet. Exercise intensity can be increased following 7 symptom-free days. A general rule of thumb would be to gradually increase peak exercise intensity by approximately 5% every week until you’re back to your normal training level.
Similarly, a generally healthy person should have oxygen saturation of 95-96% (or more). “If we are doing vigorous exercise, our heart rate increases, our heart pumps faster to get more air into the lungs. So in an ideal situation there should be a balance between this demand and supply. It may fall a little bit—2% here or there. But deep breathing should also bring that reading up. In no situation should it fall below 92-93%,” warns Dr Mehrotra.
Also Read: How to ensure that your heart is healthy
People who have been working out regularly before contracting covid, should be able to tell if their breathlessness if normal or if it has increased. They can increase the intensity of their exercises more gradually. “But those who have not worked out, and are suddenly trying to become active during the lockdown, then it should be gradual and the person should, if needed, consult a physician. This is especially true if he/she suffers from diabetes, hypertension or obesity,” says Dr Mehrotra.
Most troublesome, according to experts, is the observation that some people with covid-19 infection develop myocarditis. This damage to the heart may persist after the resolution of other symptoms. “So, if, during an active covid infection or after other symptoms have subsided, one experiences these ‘red flag symptoms’: chest pain, unusual breathlessness on light exertion, dizziness, or palpitations, they should refrain from all exercise and seek medical treatment. Athletes and highly motivated recreational exercisers may find this to be hard, but the risks of exercising with myocarditis can be fatal, and should not be taken lightly,” says Koch.