The more and more we learn about COVID-19, the disease caused by the novel coronavirus, how it spreads and manifests in the body—the more questions we have.
And with nearly everyone in the country being ordered to stay at home with the exception of grocery shopping, essential work, and outdoor exercise, we know the best practices around running are a bit fuzzy right now. That’s why we reached out to a handful of health professionals across the country to help us answer the questions we’re hearing most.
I’m feeling more fatigued and short of breath on my run than usual. How can I tell if this is an early symptom of COVID-19 or a manifestation of anxiety?
This is a really tricky one to answer, especially when the Centers for Disease Control (CDC) is now claiming that up to 25 percent of COVID-19 infected individuals may show no symptoms. The only true way to know if you have the disease, according to Dr. Christina Proctor from the College of Public Health at the University of Georgia, is to get tested — which is pretty challenging with a nationwide shortage of tests.
But the likelihood that your fatigue is due to stress and anxiety is pretty high right now. Many of us are not sleeping well, thinking about the current state of the world and how our own lives are being affected. We’re worried about our jobs, our loved ones, our health. Feeling anxious is a totally normal response to everything going on right now.
With this kind of stress comes an increase in blood pressure and higher heart rate which could definitely make your normal run feel more difficult than normal. “I know looking back at my Garmin data over the last three weeks, my resting heart rate has been higher in general and I’ve been struggling on runs,” says Dr. Proctor.
Kelly Brown, a registered nurse and runner with Denver Metro Racing recommends that you really take the time to notice when you are feeling short of breath and worn down. If it’s only when running and shortly after that you’re feeling that way, it’s likely stress and not illness.
Brown also emphasizes that, “while it is important to exercise, the bottom line is that if you think there is a chance these symptoms are not just situational and that they might be related to the virus, please stay at home.”
Now is the perfect time to prioritize mental health. If getting out for a run is ultimately causing you more anxiety than it is stress relief, there’s nothing wrong with taking a few days off. Instead, you can focus on other aspects of your training that you’ve maybe neglected in the past. Join a virtual yoga class, go for a bike ride, or just a relaxing walk in nature. There are also plenty of tele-health services available if you need to talk to a therapist right now that can be found through your insurance’s web page.
Are we at risk for catching the virus from runners passing by? Should we hold our breath when we pass others?
The experts we spoke to unanimously agreed that you should never be holding your breath during a run, but that doesn’t mean passersby are not a problem.
“It is smart to keep your distance when passing other runners,” says Dr. Proctor. “There’s a lot of body fluid associated with running: spit, sweat, and of course with seasonal allergies; sneezing and coughing.”
Really making sure you’re keeping six feet away from other pedestrians will keep yourself and others safe.
But what if it’s not possible to keep six-feet of distance either because there are a lot of people out or the trail is narrow?
The experts emphasize that there really is not enough research to determine all the modes of transmission or how quickly the virus can spread in a moment. Remember, this coronavirus has only been on scientists’ radars since December 2019. The overall consensus is to err on the side of caution—which is six feet of social distancing.
So, if there isn’t enough room to give that space, it’s time to find a new running route or go out at a during a less busy time of day. You can also go to an area that allows you to be adaptable, where you can turn down a side street if you see the area ahead is crowded.
“I know it is hard to break out of our favorite running routines and routes but now is a good time to explore new areas,” says Dr. Proctor.
How long does COVID-19 live on surfaces? Is this something runners need to be cautious about?
Running is generally a hands-free activity, but maybe you don’t realize how much you could touch on your route. There’s crosswalk buttons, drinking fountains, porta potties, the park bench you use to stretch against, plus contaminating anything that your spit or snot rockets land on.
According to a study published in The New England Journal of Medicine, the coronavirus may survive on plastic and stainless steel for two to three days, which is why infectious disease specialist Dr. Emily Stoneman recommends runners do a bit of pre-planning for these scenarios: “I would recommend pushing crosswalk buttons with your elbow and avoiding public drinking fountains. If you will need fluids during a run, bring them with you.” It may also be helpful to start carrying a small bottle of hand sanitizer with you. And don’t forget to wash your hands upon returning home.
As for spitting, there’s definitely a chance you could hit something that someone later touches. So it’s best to keep our bodily fluids to ourselves as much as possible. Dr. Proctor reminded us that during the 1918 flu pandemic the city of New York actually had to ban spitting. And yes, there were fines.
What if I, unfortunately and theoretically, already had it and recovered? Is it true that I’m immune? Can I go back to living life as it was before?
First, the CDC recommends any infected person continue self-isolating for a minimum of seven days after they first start showing symptoms. But even after that, you should still use the same caution recommended for everyone else.
“If you have been infected with the virus and recovered, you are likely immune,” says Dr. Stoneman, “but we are not yet certain how long this immunity lasts.”
Dr. Bryan Yipp, an intensive care physician and pulmonary researcher with the University of Calgary, recommends that infected runners really give themselves time to heal before returning to a normal regimen for several reasons. The first being that in laying around recovering from an illness, your body loses muscle mass very quickly. He cautions that it could be several weeks before you’re feeling back to your normal strength.
The second thing he sees with diseases affecting the respiratory system, like COVID-19, is the risk for secondary infection. He often sees patients who are feeling well after recovering from a viral infection but fall ill to a bacterial infection due to their weakened immune system. “Oftentimes it’s because a bacteria now has gotten into their lungs and causes a severe bacterial pneumonia,” he says.
The best thing to do is to really, really give your body enough time to heal before you’re out pushing yourself on a run.
I’ve heard rumors that lung capacity is significantly reduced after recovering from COVID-19. Is that true?
This is another complicated one. Concerns around damaged lungs came from this study out of China evaluating instances of Acute Respiratory Distress Syndrome (ARDS) in 191 coronavirus cases. According to Dr. Yipp, ARDS is a syndrome that typically comes as a consequence of a viral pneumonia and is characterized by severe lung failure. According to the study, ARDS was the cause of death for 50 of the 54 people who succumbed to their illness.
These are people who develop a severe case of COVID-19 and end up in the hospital. For people with mild to moderate cases there is no reason to believe that their lung function will be damaged, however, it’s too soon to tell and these cases are really not being studied.
“I would like to point out,” says Dr. Proctor, “that other respiratory viruses can cause decreased lung capacity for a short amount of time in athletes. This is something that we have to worry about with the flu every year. Last year, I had pneumonia and it took me several months to get my VO2 max back to its normal level.”
The best thing Dr. Yipp can compare the respiratory effects of this virus to is a viral pneumonia, which certainly has the potential to cause scar tissue on the lungs. Because of that scar tissue, Dr. Yipp says, “you might find evidence of people having moderate pneumonia years ago that still may not be as good as they once were.”
“The good news,” says Dr. Proctor, “ is that if we eat nutritious foods, give ourselves enough time to recover, and reintroduce exercise slowly, our bodies have an amazing ability to heal themselves.”
And Dr. Yipp’s lab at the University of Calgary is doing amazing research into finding ways to one day help lungs heal themselves with new healthy tissue versus scar tissue.
Will keeping a high endurance training schedule right now increase the risk for me to catch the virus?
According to exercise physiologist David Nieman, running and immunity exists on “J” curve in which moderate, consistent exercise is likely to boost immunity, while strenuous long-effort exercise can leave you vulnerable to infection for 24 to 72 hours. This is not news to marathoners and ultrarunners who are accustomed to getting a cold or upper respiratory infection at the end of their season.
Brown notes that while high-intensity exercise will not make you more likely to contract the virus, it could definitely affect how your body responds if you get it. With a weakened immune system from a strenuous routine, that could mean worse symptoms or a longer recovery.
All of our experts that we consulted recommended that runners consider dialing it back right about now. This is an opportunity to examine why we run, especially as training for races is off the radar for the near future.
It’s also important to take into account how you’re feeling. “Psychological stress has also been shown to suppress the immune system,” says Brown. As a pediatric nurse, she’s no stranger to stress and mental fatigue. She’s learned over the years that choosing rest over a hard run when you’re mentally or physically run down is always going to pay off. In the end, this is just a blip of time in our history that one day will pass.
“We will have the opportunity to train for marathons and ultras again,” says Dr. Proctor. “It’s amazing what a season of rest and easier running can do for your performance in the future.”