As of 18th February 2021, the number of Coronavirus cases worldwide topped 110 million, with more than 2.43 million deaths.
COVID-19 is a complex virus that affects many parts of the body (such as the heart, lungs, liver and kidneys).
We also know that the impact on individuals can vary, with some suffering mild symptoms, and others spending months in intensive care units.
Recovering from these complications is a long, slow process and for 1 in 20 sufferers it takes more than 8 weeks, this is known as 'long covid'.
COVID-19 is a novel disease and as such, there is little evidence available regarding recovery and the implications and potential consequences of having it.
The effects of COVID-19
Before we begin to focus on increasing your activity levels after COVID-19, it's important to understand the effects of having the disease, and how it affects your breathing.
Acute COVID-19 has a varied and complicated set of factors that can lead to breathlessness;
Lung stiffness
Fluid build-up and/or secretions that lead to excess workload when you are trying to breathe.
Reduced inactivity leading to muscle weakness, muscle wastage and general deconditioning.
Low blood levels or high levels of blood carbon dioxide can lead to excessive demand for oxygen and an increase in breathing rate.
Heightened anxiety through having COVID-19
When the breathlessness lasts longer (long COVID), the causes could be attributed to;
Deconditioning from inactivity
Lower oxygen levels during activity
Possible lung fibrosis (scarring and thickening of lung tissue)
Increased anxiety levels
So as well as the physical consequences of COVID-19, you also need to consider the possible psychological impact.
The vicious cycle of breathlessness is a recognised state and is where you reduce your activity levels due to a fear of becoming breathless and not enjoying it.
Imagine the anxiety of constantly worrying about being out of breath when you move.
The more anxious you get, the less you move and the more deconditioned you become.
A vicious cycle of physical deterioration that can lead to social isolation and mental wellbeing issues.
As I said before, this breathless cycle is not new and can often be seen in patients diagnosed with Chronic Obstructive Pulmonary Disease (COPD).
Patients becoming increasingly inactive and more fearful of the breathless state, which impacts their day to day lives, like working, socialising and exercising.
It's worth remembering that long-COVID is about physical rehabilitation and mental health, so a holistic approach that focusses on thinking well, moving well and eating well is needed.
When to begin exercising after COVID-19
Before commencing an exercise programme after COVID-19, you need to ensure that;
You have recovered from the acute stages of COVID-19
You are motivated to begin exercising
You are physiologically stable (your general health is not a concern)
Your GP or consultant agrees that you are ready to begin exercising
A common, ever-changing symptom of a disease like COVID-19 is fatigue, which can be triggered at any stage of the infected or recovery period of COVID-19, and shares similar features with chronic fatigue syndrome.
The severity of fatigue varies and can be dependent on the individual's health status, length of time in the hospital, medication, treatment and fitness levels (before and current).
A one-size-fits-all plan would be the wrong way to approach recovery because of the way symptoms vary from one patient to the next.
A return to exercise needs to be individualised after much consideration of your own symptoms and lifestyle before COVID-19
It's vital to prioritise rest and recovery throughout the onset of COVID-19 and right the way through to the home recovery period.
As you begin to feel up to it, gentle movement and a return to steady daily activities will gradually improve your fatigue threshold.
But, it's important not to overdo it on the days where you are feeling good as this may set you back.
As yet, there are no specific guidelines released concerning a return to more strenuous activities.
Initial bouts of 5-10 minutes of very moderate physical activity, 3-5 times per week, maybe enough to see health improvements over time.
Initially, your intensity levels should be at a level where you can hold a conversation and not be fearful of extreme breathlessness.
Rather than jumping headfirst back into a gym routine, it may be a good idea to focus on daily movements, like sit-to-stand, going upstairs and walking at pace.
And, pay attention to often neglected areas like mobility, flexibility, balance, coordination and motor skills.
As your fatigue threshold improves, your breathlessness reduces and your anxiety levels decrease, consider gradually increasing your activity intensity, but as always do it after consulting with your GP.
What support can I get for long Covid?
Long Covid clinics are being rolled out across England to help those struggling with ongoing symptoms. Speak to your GP or healthcare professional to find out if you are being referred. Sadly, no similar services have yet been announced in Scotland, Wales or Northern Ireland.
Your Covid Recovery has been set up by the NHS to provide information and support to those who've had Covid and are still suffering from symptoms.
If you’re worried about your symptoms, or if they are getting worse, contact your GP. You may be able to be referred for physiotherapy, or for psychological support such as cognitive behavioural therapy (CBT).
Always call 999 if you have any emergency symptoms, such as sudden chest pain, shortness of breath or if you think you may be having a heart attack or stroke. Find out more information on when to get medical help.
To sum up
The impact and recovery from COVID-19 vary from person to person.
Unfortunately, there is currently not enough evidence to predict how long it takes to recover from long-COVID.
As such, the lasting physical and mental effects of the illness can get worse over time, even though the actual acute symptoms of COVID-19 improve.
What this means is that a return to exercise begins after the go-ahead from your GP and at a carefully planned pace, so as not to make your symptoms worse.
Ben Yates is a personal trainer based at Places Gym Hinckley and Hinckley Leisure Centre in Leicestershire.
To book your free personal training consultation click here