Most states have already loosened the COVID-19 restrictions and dropped mask mandates entirely. Oregon, the state in which I reside, will be one of the last. One week from the time of this writing, masks will no longer be required. (Though welcomed and, in my opinion, much too late, the logic of the timing seems ill-advised—the start of finals week at universities on the quarter system and one week before the state-wide spring break. This is a time of heightened risk of infectious spread. Nevertheless….) For many (most?), the perception is that COVID-19 is over. I would argue that COVID-19 ended with the Omicron variant, but “COVID”—the coronavirus—is far from over. Viruses of any kind have not ceased to exist. So, what are we to do?
I am not a medical doctor. (My grandfather would say that I am not a real doctor because I can’t prescribe medicine.) I cannot and do not provide medical advice. I am not anti-vaccine. I am of a libertarian mindset on that issue, though I strongly encourage anyone who is among the most vulnerable (which is many more than who think they are—i.e., many think they are not but likely are) to consider the potential benefits. My training (my doctorate) is in exercise physiology with a bit of an emphasis on exercise immunology (thank you Dr. Michael Flynn).
It is unfortunate, but most of the medical community (many perhaps against their will and better judgement) followed the CDC and pushed the pharmacological and isolation defenses against COVID-19 throughout the pandemic. What was sorely lacking was any emphasis on what was known but rarely communicated (and one could argue was even discouraged) were the strategies that might make us less hospitable hosts to the virus—to any virus. So, what can we do?
Exercise. I have written before about Neiman’s ‘J’ (the image used above). Moderate exercise benefits the immune system and reduces the risk of nearly all disease. Sadly, it was reported recently that fewer than 23% of Americans meet the minimum ACSM/AHA Guidelines for Physical Activity—150 minutes of moderate intensity physical activity per week. These are minimum guidelines for health. The percentage of Americans that are doing physical activity to improve performance and health (i.e., exercising) is therefore lower. Becoming moderately active will dramatically affect one’s risk when the next wave of viral pandemic come (and in my opinion that will come much sooner than the last waves because we are increasingly inactive).
Lose body fat. I am constantly at risk of being accused of “fat shaming,” but that is not my intent. Everyone is beautiful just the way they are, but they are not all healthy the way they are. Obesity is a major health issue. I would argue that it is the major health issue in the United States. We are fast approaching a population in which 40% are obese! Obesity is a central factor in metabolic syndrome (the combination of insulin resistance, hypertriglyceridemia, and hypertension). It is central to diabetes, atherosclerosis, heart disease, restrictive lung diseases, many cancers, and a range of other medical conditions—those conditions that increased the risk of severe COVID-19. Obesity is a modifiable risk factor. Regardless of any discussion about genetics and factors contributing to obesity, it is treatable, and it is preventable (I accept that “over-fat” may be a curse of one’s genetics, but it need not lead to obesity and preventable disease). I am not talking six-pack abs here. That is another issue of body dysmorphia that has implications for our health. I am simply promoting a modest loss of body fat—a goal of a healthy body composition. Any loss of body fat that moves one toward a healthier body composition is going to have health benefits.
Diet. By “diet,” I do not mean cutting calories and following short-term strategies for weight loss. No, by “diet,” I mean what we habitually eat. We need a dramatic shift away from processed and fast foods. The American diet is crap (to say it most politely). We need to make changes. For some that is as easy as making better personal choices. For many, that means that politicians and community leaders need to step up and increase access to healthy food option. When we donate to food pantries, we must consider the quality of what we donate and what we are providing to people in need. We need to bring relief in food deserts. We need to break our addictions to sugar and chemicals and just say “no” to the big food companies that are pedaling their drugs. We need to demand more of our children’s’ schools. We need to say “no” to ourselves and to our children and not load our shopping carts with non-nutritive foods. We need to eat less junk and more health-giving nutritive foods. If our government can spend billions providing COVID-19 test kits that take two weeks to arrive (likely after any of us needed them), we can likewise spend billions to provide nutritive meals in schools and to those with greater needs. We failed to educate people on the role of diet in preventing the spread of COVID-19 because doing so would be contrary to will of big pharma and the big food. There is no political will because we let people who have no interest in keeping us healthy control our politics.
Get outside! Sunshine. Vitamin D. Fresh air. These have benefits for our immune system. Get outside. Be active in the outdoors, but take your inactivity outdoors, as well. Doing so, of course, presents challenges for some. We need to address this as communities, as well. Certainly, we did little good in isolating ourselves indoors and masking outdoors. Spring is around the corner. The weather is already getting better in most places. Get outside!
Demand change. We emphasize “universal health care”—for which I am not opposed. What we need to prioritize is “universal health”! It is relatively easy and quite profitable (and thus quite expensive) to treat disease rather than prevent it. We need a dramatic societal shift in medicine. We need a dramatic shift in public health policies. We need to stop treating disease as biological and start treating is as biopsychosocial. We need to change how we train health care workers—particularly medical doctors (personally, I prefer physicians with an exercise science background and who have had more than one course in nutrition). We need to vote for politicians who care—who show in what they do (and don’t do) rather than what they say. We need to speak up. We need to demand more of our education systems. Fight the cutting of Physical Education in our schools and demand that Physical Education include meaningful physical activity that promotes lifelong habits. We can easily affect the big food companies by not buying the sh** they are selling. We can drive out the fast-food restaurants by not supporting them. Demand that employers provide access to better health and not just better health care. Demand change of yourself, as well. Take the responsibility that is yours to take.
Two weeks to “flatten the curve” turned into two years. In those two years, the health of Americans has worsened. Public health decisions may have saved lives (I am not sure that there is solid scientific evidence for this), but it was focused on the short-term. We may be no better prepared for the next wave. We can and should be. What we do today begins our preparation for tomorrow.
Be your best today; be better tomorrow.
Carpe momento!
