As a professor of public health for the past 22 years, it is clear to me that we are in the very early stages of the current COVID-19 pandemic. Playing the “short game” is fine for now — people are giving this virus the due diligence it certainly deserves. Public health history, however, has taught us that rapid development of effective medication and vaccines is not realistic. Instead, it will ultimately be long-term changes in health behavior that can stem the morbidity and mortality of this new virus.
This “long-game” vision of beating the virus has two parts. Part one is about containing the spread — this is currently receiving ample attention in our community, in Colorado, and in the nation. Part two is about avoiding death for people who do contract the virus. This is a grim topic that is not receiving adequate attention.
Having studied health behavior change for my entire career, I wish to acknowledge that the advice offered in this column suggest actions that are very difficult for most people to adopt. The advice is centered on a single goal — increasing what is known as maximum oxygen capacity. This is a measure of how much oxygen the lungs can take in during increased exercise. In essence, it is a measure of pulmonary fitness — one that determines how well the lungs may perform under the stress of COVID-19.
Fortunately, maximum oxygen capacity is something that anyone can increase through daily exercise. It is an incremental process, and one that requires a long-term investment in proactive self-care. For everyone, but especially those people over 60 years of age, who is not a runner, biker, Nordic skier, etc., now is a good time to begin the slow and gradual process of making this all-so-important investment in fortifying the pulmonary system in the event of being infected by the virus.
This proactive self-care is actually a key aspect of changing the death toll. Ultimately, the study of epidemiology comes down to three factors that each influence how quickly an epidemic (or pandemic) spreads: 1) the agent (the virus itself), 2) the environment (e.g., crowed urban conditions, weather, social habits), and 3) the host (i.e., the person infected). It is currently the case that control efforts are focused on the host, particularly isolating people during the infectious period (this begins about two days before symptoms occur and extends several days after recovery). Changing the “host factor” by increasing maximum oxygen uptake is a precaution that will address the fatality rate of the virus, rather than the rate of transmission.
Adopting the daily health behavior of progressively more challenging aerobic workouts is, of course, not an easy task. It will take concerted efforts for each person to find his/her own “best methods” to find and maintain the routine that works best for them. Adopting exercise behaviors in concert with friends and family members is extremely helpful, especially when it comes to outdoor aerobic activities. Even more important is the act of learning new skills that favor successful adoption of the behaviors (e.g., learning how to stretch and condition leg muscles to avoid injuries when walking quickly, jogging or running). For added motivation, people who are not in optimal shape aerobically will also benefit from daily workout routines in the form of fortifying the body against heart disease, obesity, hypertension, diabetes and even some forms of cancer.
Dr. Richard Crosby is a professor of public health and holds a PhD in health behavior from Indiana University. He is the author of numerous textbooks on the topic of health behavior and has published well over 100 peer-reviewed journal articles addressing theories of health behavior change. He has recently moved to Glenwood Springs.