How Covid is crippling our fitness
Britons returning to their keep-fit routines are struggling to beat a lack of motivation and energy, let alone their personal bests
by Simon Usborne
Saturday January 15 2022, 6.00pm, The Sunday Times
It’s the question on the lips of frustrated pavement pounders and weekend warriors up and down the country as they wheeze their way up hills: can I blame Covid or is it just Christmas? Amateur athletes who are struggling to recover their fitness having succumbed to Omicron over the holidays are in good company.
After catching Covid before Christmas, the British tennis star Emma Raducanu returned to competition on Tuesday after three weeks off court only to be thrashed 6-0, 6-1 in a warm-up tournament for the Australian Open. “I could have easily said it’s too soon … but I wanted to really test where I’m at,” she said afterwards.
She’s not the only one. As Omicron sweeps through the country, one of the big unknowns is what long-term impact, if any, the coronavirus has had on fitness levels. A keen cyclist, I’m one of those who has been anxiously checking their speed. I was barely symptomatic with Covid in the first week of January but felt depressingly sluggish on the bike for a while afterwards. My social media feeds are full of reports of thwarted workouts and bad times being posted to fitness sites such as Strava.
“First little stretch following 12 days of Covid! Think I’ve just coughed up a lung!!” one runner tweeted on Wednesday, with a Strava link to a two-mile jog in Surrey. “Poor old post-Covid lungs not quite doing as they should!” a cyclist posted after a 17-mile ride near Elgin in Moray. “Slowly, slowly we’ll get there though.”
Gareth Snelson, a personal trainer who organises the Milton Keynes Parkrun, says several runners have stopped showing up after Covid breaks because they’re too demoralised or embarrassed about their speed.
“There’s also this thing now where people who do come back are saying, ‘Oh, we’re going to be really slow now’,” says Snelson, who himself suffered with a tight chest after catching Covid at Christmas.
While I’m pretty much fine now, some athletes struggle for much longer, particularly those who are suffering from “long Covid”, a loosely labelled condition with symptoms ranging from coughing to headaches that last for more than four weeks.
“Watching my fitness plummeting was difficult to grasp,” says Farah Khasawneh, a trainee surgeon in Leicester. She caught Covid from a patient in December 2020, before she was eligible for a jab.
The 32-year-old doctor used to go to the gym almost daily and regularly went on 15km runs. “Suddenly I couldn’t get out of bed for a month, and for the next three months I’d walk one kilometre and could barely breathe — it was pathetic,” she says.
Research into the effects of both Covid and long Covid on exercise is gathering pace. “As soon as the first lockdown was even mentioned, we knew that it would be a once-in-a-lifetime natural experiment,” says Stefan Kluzek, a doctor specialising in sport and exercise medicine, and a clinical associate professor at Nottingham University.
Last year, Kluzek and a team at Nottingham launched Running Through, a research project that takes activity data from the fitness accounts of more than 3,000 people. They, and thousands of other volunteers who are not being tracked, answer regular surveys about their progress, including detailing positive tests and any Covid symptoms. The project, which is working with Parkrun (sic), Strava and Garmin, is inviting people who have had Omicron to sign up.
Patterns are emerging. “The biggest problem people are finding is overall fatigue,” Kluzek says. “They just can’t push themselves as far as they want to.”
Though people with even mild symptoms — or none at all — may not feel rough, their bodies are responding to the virus under the surface. The immune system triggers the production of anti-inflammatory molecules called cytokines, which not only cause fatigue but affect the production of the mood chemicals dopamine and serotonin. So you’re not just deprived of energy but motivation too. These effects can take longer to shrug off, even at the elite level.
Researchers at Reading University and Düsseldorf’s Heinrich Heine University recently analysed tracking data for footballers who had returned to playing in the top German and Italian leagues after Covid. They detected a months-long drop of 9 per cent in the minutes they played and a 6 per cent drop in the number of passes they completed.
For a minority of people, the inflammation in the lungs persists and causes scarring and stiffness that makes it hard to complete even daily tasks. An estimated 20 per cent of Covid patients requiring hospital treatment go home with damaged lungs. Research is taking place into whether some of this scarring might be permanent — and how it can be treated.
What complicates assessments of the direct impact of the virus are its knock-on effects. Fatigue and a drop in motivation inevitably lead to inactivity. The medical advice is to take it easy while recovering from Covid. Raducanu blamed a lack of playing for her defeat last week rather than lingering symptoms.
For amateurs, the effect of even a short enforced break can be worse than expected. “Your heart muscles shrink quickly,” Kluzek explains. “And while your skeletal muscles may not get much smaller, they start to become less vascularised and have more fat.”
In other words, your heart has less oomph to send blood to muscles that suddenly have less capacity to use it. No wonder your Parkrun personal best is out of reach.
Returning to sport can pose further risks, particularly if frustration and ego bring on a severe case of overdoing it. Injury rates have been higher in this period even among the ultra-fit; Kluzek has had an early look at research showing an eightfold increase in injuries for a cohort of US college athletes after having Covid.
Even inactivity caused by lockdowns has had this effect. A separate study of top-flight German footballers showed injury rates were 0.27 per match before the league stopped in 2020 — and 0.84 after it restarted. Kluzek worries people who were inspired to do more exercise, particularly in the rush outside during the sunny first lockdown, may be put off by injury or poor performance and suffer worse health long-term. “We already know that, for example, knee pain changes behaviour in a way that increases your cardiac risk over time,” he says. “You die earlier.”
There is an elephant in the super-spreader gym here, and that is festive indulgence and inertia. Was it the virus that slowed me down on the bike in early January, or that massive tub of Cadbury Heroes I demolished at my mother’s house? This is not just a Christmas issue.
“People expect to put on a bit of weight when they’re stuck at home, but they’re not necessarily noticing that they’re also going through an extra packet of digestives a week,” says Snelson, who offers Covid comeback training to dozens of new clients.
Booze, meanwhile, affects heart rate and hydration, ties up the liver, which would otherwise be making energy in the form of glucose, and causes weight gain.
In Leicester, Khasawneh did not require hospital treatment but was signed off work for three months. She prioritised being able to stand for hours in an operating theatre over a return to running or the gym. But she steadily felt more able to exercise. On a New Year’s Day run, the sun shone and her smartwatch began telling her that she was running at a pace she had not managed for more than a year.
“I suddenly realised I wasn’t getting tired and breathing wasn’t painful any more,” she says. She kept going, eventually running 10km in under an hour — a time she had not managed for years. “I’d got to the point where I knew I had recovered,” she adds.
”It was the best day I’ve had in two years.”