COVID Booster

Physical inactivity a risk factor for severe COVID and death

A paper published in BMJ Sports has established a link between physical inactivity and severe COVID-19 infection.

The study examined the records of 48,440 patients in a Southern Californian healthcare system in the US. Each patient had tested positive to COVID-19 between January and October 2020. Each patient had also reported their physical activity levels to a doctor at least three times in the preceding two years.

Around 7% of people in the study were consistently meeting physical activity guidelines of over 150 minutes per week of moderate to strenuous exercise. Consistently inactive people, who were doing less than 10 minutes of exercise per week, made up 15% of the cohort, with the remaining 78% doing between 11 and 149 minutes of exercise per week.

Physical inactivity is also linked to a number of other risk factors for COVID-19, including race, age, and underlying medical conditions. The researchers controlled for this in their statistical analysis.

Even when other risk factors were accounted for, physical inactivity was still a predictor of severe COVID-19. Patients who were consistently physically inactive were more than twice as likely to be hospitalised than patients who did more than 150 minutes of physical activity per week. They were also 2.5 times more likely to die from COVID-19.

The authors emphasise that the study is observational, meaning they can’t establish a causal relationship. It also relies on patients’ own assessments of their physical activity.

No evidence of an increase in suicide during early stages of the pandemic

A team of Australian, New Zealand and UK researchers has found that there was no increase in suicide during the early stages of the COVID-19 pandemic in high and upper-middle income countries.

The study examined suicide data from government sources in 16 high income and five upper-middle income countries, comparing the rates from 1 April to 31 July 2020 to data from previous years.

They found there was no evidence of an increase in suicides in any of the countries in the study. In 12 regions, including New South Wales and New Zealand, suicide rates were significantly lower than expected.

The authors stress that this trend may not continue.

“We need to continue to monitor the data and be alert to any increases in suicide, particularly as the pandemic’s full economic consequences emerge,” says Jane Pirkis, director of the Centre for Mental Health at the University of Melbourne and lead author of the paper.

“We know that many people have had their lives changed dramatically by the pandemic, and the journey for some of them is ongoing. We need to recognise that suicide is not the only indicator of the negative mental health effects of the pandemic – levels of community distress are high, and we need to ensure that people are supported.”

The study is published in The Lancet Psychiatry.

Managers should talk less and listen more in locked down workplaces

A study published in the Journal of Communication Management has emphasised the importance of ‘ethical listening’ for managers during the pandemic.

The study interviewed 30 US communications professionals in a range of fields, asking them about communications challenges they had encountered during COVID-19.

They found that ethical listening – defined as “listening with an open mind and being able to hear the good, the bad and the ugly,” according to one participant – was critical to effective work, but more difficult to achieve as regions locked down and communications went online.

“We heard that the pandemic posed challenges in internal communication due to the alienation many employees experienced, and it prompted us to re-evaluate the moral responsibility communications holds for keeping employees feeling connected to their teams,” says co-author Shannon Bowen, professor at the University of South Carolina, US.

“We recommend that senior leadership and communication professionals seek ways to continue to improve moral sensitivity well after the global pandemic has receded, which can lead to more ethical decision-making,” says lead author Marlene Neill, associate professor at Baylor University in the US.

Experts urge Tokyo to reconsider the Olympics

An editorial published in The BMJ has argued that the world is not ready for the Olympic Games, scheduled to begin in Tokyo on 23 July 2021.

The authors say that mass gathering events “are still neither safe nor secure”, and there are still uncertainties around the trajectory of the pandemic.

The International Olympic Committee has a strategy to vaccinate competing athletes, but the editorial suggests that “it could also encourage vaccine diplomacy, undermine global solidarity (including the Covax global access scheme), and promote vaccine nationalism”.

The authors, based at the London School of Economics and Political Science, UK, point out that Japan has not contained community transmission of COVID-19, meaning large in-person events like spectator sports carry a risk of superspreading.

“Japan must develop and implement a clear strategy to eliminate community transmission within its borders, as Australia did before the Australian Open tennis tournament,” argue the authors.

According to the Johns Hopkins University tracker, Japan has recorded half a million total COVID-19 cases and is currently recording an increasing number of daily COVID-19 cases. Around 0.5% of its population is currently fully vaccinated.

“Even healthcare workers and other high-risk populations will not have access to vaccines before Tokyo 2020, to say nothing of the general population,” warn the authors.

Second infection is less likely than first infection, but still a risk

A study of several thousand healthy members of the US Marine Corps, most of whom were 18-20 years old, has found that reinfection with COVID-19 is a distinct possibility, although it’s less likely than being infected the first time.

The study tracked Marine recruits who were regularly tested for COVID-19 between May and November 2020. Of the 2,346 total subjects, 189 were seropositive (meaning they had SARS-CoV-2 antibodies, implying they’d been infected with SARS-CoV-2 before) and 2,247 were seronegative at the start of the study. Approximately 10%, or 19, of the seropositive participants were reinfected with SARS-CoV-2 during the study, while 48%, or 1,079, of the seronegative participants contracted COVID-19.

The authors point out that the young, healthy, mostly male population and the specific conditions they lived in make the exact numbers from this study unlikely to be applicable to the general public. However, it does show that previous infection with COVID-19 provides only partial protection against reinfection.

“As vaccine roll outs continue to gain momentum it is important to remember that, despite a prior COVID-19 infection, young people can catch the virus again and may still transmit it to others,” says Stuart Sealfon, a professor at the Icahn School of Medicine, US, and senior author on the paper published in The Lancet Respiratory Medicine.

“Immunity is not guaranteed by past infection, and vaccinations that provide additional protection are still needed for those who have had COVID-19.”