How can you stay fit and healthy when cooped up inside for most or all of the day? This is the question now facing every Briton aged over 70, who are expected to be ordered to self-quarantine at home for up to four months to help delay the spread of Covid-19, which has already infected at least 1,372 people in the UK, 53 of whom later died. The isolation order will come “within weeks”, according to Matt Hancock, the health secretary, although those concerned will be permitted to go for walks.
Why such drastic action?
Your likelihood of dying from the disease rises steeply if you are aged over 70, according to Paul Hunter, professor of medicine at the University of East Anglia, who says the government’s septuagenarian quarantine is “absolutely the right thing to do” because it will “stop a substantial number of deaths”.
This is largely because older people have weaker lungs, making them an easy target for the new coronavirus, which locks onto receptors on cells lining the lung. The elderly are also more likely to suffer from chronic inflammation, which undermines the body’s response to the virus.
Is quarantine dangerous?
In short: yes, but not as dangerous as catching Covid-19. In recent years, doctors have become increasingly concerned with the importance of getting out and staying active in your seventies, eighties, and nineties; a report published in 2015 by the Academy of Medical Royal Colleges emphasised the dangers of bed rest, which is said to weaken your heart, muscles, and lungs.
Sir Muir Gray, a professor of public health at the University of Oxford and director of the Optimal Ageing Programme, fears that four months of house-bound isolation could have the same “deconditioning” effect, aggravating “patterns of inactivity” and making over-70s like himself increasingly frail and more likely to develop dementia.
“There’s no doubt – the evidence says you can prevent and delay dementia by getting people more active,” he says.
How to keep fit indoors
It is not yet clear what a four month quarantine would entail; Grant Shapps, the transport secretary, has said that over-70s will still be able to “go out and walk the dog” as long as they keep away from crowds. Sir Muir recommends that over-70s still get out of the house regularly, if they are allowed to do so. “We need to be careful that people don’t just assume they’re going to be housebound.”
And when they can’t get outside, he recommends an indoor exercise regime focusing on the four S’s: strength, stamina, suppleness, skill. Men should build strength by completing 70 press-ups each day – in two batches if needs be – while women should lift weights whenever advertisements come on television; 1kg bags of sugar are useful.
Squats will help to strengthen your quadriceps, or you can kneel on the floor and get up, one leg at a time, without holding anything. To improve your balance, try brushing your teeth while standing on one leg with your eyes closed, he says.
How to keep mentally engaged
A national quarantine of the over-70s would also carry a sharp psychological penalty: research has linked social isolation to higher rates of heart disease, obesity, depression, Alzheimer’s, and cognitive decline.
William Keevil, professor of environmental healthcare at the University of Southampton, recommends treating your elderly relatives to an iPad, and teaching them how to use it, so they can stay in regular contact over Skype or FaceTime. If they receive visits from a care worker who now cannot attend, he says, “be prepared to bring food and medicine yourself. These can be left on the doorstep, or open the door and have a friendly chat without going in.”
Sir Muir says that if over-70s can use the internet they should try taking part in online games, like chess or bridge, or joining an online yoga class. They could also learn a language or instrument, or join an online book group. “The best type of cognitive behaviour is working with others, being a volunteer,” he says. “That’s difficult if you can’t get out but there are things you could do.” He suggests getting involved in online tutoring, for example.
Do I need to stockpile prescriptions?
Details remain unclear, but Hancock has said that housebound over-70s will “get the support they need” in terms of food and medicine.
Sir Muir says he is “not worried” about medicines running out because of Britain’s “very well organised pharmacies”, and so advises against stockpiling. Michael Osterholm, meanwhile, a professor of public health at the University of Minnesota, has warned against stockpiling in case it causes a shortage for others who need it.