Coronavirus Advice for All from Geriatric Medicine

                                                      published in Times of Israel

Israel took early steps toward slowing the transmission of Covid-19 and according to a Hong Kong-based statistical study it is the safest country to be in during the pandemic. Israel’s percentage of deaths per number of people infected is one of the lowest in the world.  Nevertheless, we have had more than 80 people die in which coronavirus played a role and we have over 10,000 known cases of coronavirus so far.

Our very strict rules that allow for leaving home only to get groceries or medicine or to be outside for a short time within 100 meters of one’s home have helped to limit the spread of the virus. With the exception of essential services, most people are working from home or are not working. There’s no visiting friends or relatives even during the Pesach holiday and, starting next week, we cannot go outside without wearing a mask. Certainly no gyms or pools are open; beaches are off limits; and long hikes and bicycle rides are not an option, at least not in the urban areas where 70% of Israelis live.

Yet, according to specialists in geriatrics, exercise should not be thought of as something optional; it is not simply recreation, conditioning, and good for one’s frame of mind. It is basic hygiene. This is because moderate exercise has a positive effect on one’s immune system, which is made up of cells and antibodies that protect us from invading microorganisms. When our immune system is weak, our bodies are less able to fight off harmful pathogens such as bacteria, parasites, and viruses.

A basic principle of geriatric medicine is to help patients move and remain active to the extent that is possible for a particular individual. Patients who need time in rehabilitation hospitals are not only recovering from medical procedures and illnesses but are also recovering from prolonged periods of immobilization. Getting the patient moving is a significant part of the health plan.

Those of us who are relatively healthy may find ourselves becoming less resistant to disease if we drastically limit our physical movement. The best advice during “stay-at-home” is to let go of our usual concepts of exercise in which we need the gym, open space, a swimming pool, a team sport, or exercise equipment. When we’re stuck at home we need to keep our immune systems strong and even to make them stronger. 

This can mean daily stretching, jogging in place, walking up and down stairs, putting on music and dancing along, doing yoga, sit-ups, jumping jacks, pilates, push-ups, or walking around the house. Following any of the hundreds of exercise videos on YouTube can help. Exercise that is also utilitarian counts too: the everyday bending and stretching of house cleaning, rearranging furniture, doing home repairs, gardening, and so on. The key is movement even while we are “locked down.”

Interestingly, while there is medical evidence that moderate exercise builds up the immune system, such evidence does not exist for vitamin supplements. Of course, if one has a particular vitamin deficiency or if one’s diet lacks any of the food groups--dairy, meat, some grains, fruits, or vegetables--supplements can be necessary.

We know that the psychological toll of begin stuck at home is helped by trying to exercise to the extent one can within the limits of one’s physical condition and the space available. But more than that, it may be essential toward fending off viruses.

Medical information provided by Jerrold Schwartz, MD, former medical director of Bridgewater Center for Rehabilitation and Nursing in Binghamton, New York and currently a physician with Sharan Medical Care at Home in Bnai Brak.