A person is seen walking along the city of Marquette’s multi-use path. Engaging in regular physical activity, including walking, is considered as a “form of medicine” that can promote good health, bolster immune function, and potentially improve prognosis in those individuals infected with COVID-19, according to Michigan Tech University. (Journal file photo)

“Wear a mask, Watch your distance, and Wash your hands.” Promotion of the 3-W’s has served as the primary public health strategy used to manage the novel coronavirus, SARS-CoV-2. While these guidelines serve as a critical first line of defense in reducing viral transmission, another potentially important second line of defense is using healthy living behaviors to enhance general health and improve disease resilience.

We suggest a 4th “W” — “Walk to stay active” be added to the current public health message. Engaging in regular physical activity, including walking, is considered as a “form of medicine” that can promote good health, bolster immune function, and potentially improve prognosis in those individuals infected with COVID-19. Accumulating evidence also suggests that lack of physical activity — i.e., physical inactivity — is a risk factor for COVID-19 hospitalization. Because it may take considerable time for widespread vaccinations and populations to reach levels of herd immunity, it is imperative to promote behaviors that keep individuals and communities safe and healthy.

Numerous health organizations, including the World Health Organization and Centers for Disease Control and Prevention have emphasized the importance of increasing healthy living behaviors during the COVID-19 pandemic — i.e., physical activity, good nutrition, not smoking, health body weight. Notably, regular physical activity can prevent and treat many medical conditions that significantly increase the risk for hospitalization and death in those individuals with COVID-19, including hypertension, cardiovascular disease, obesity, diabetes, and cancer.

Regular physical activity is also linked to increased immune function and decreased inflammation which have been suggested to increase the likelihood and speed of recovery following COVID-19. Taken together, the evidence to support health benefits of regular physical activity is unequivocal and promoting behaviors that increase physical activity to improve health and potentially alter severity and survival rate of COVID-19 infections is paramount.

For health benefits, adults should engage in at least 150 min of moderate-to-vigorous intensity physical activity each week and limit time spent sitting. Any amount of weekly physical activity, even levels below the ideal range, are beneficial compared to no activity. Physical activity should include both aerobic — e.g., walking — and muscle strengthening — e.g., weightlifting — forms of movements.

We cannot underscore enough the notion of “Walk to stay active”, as walking provides an easy way for individuals with a wide range of abilities to safely engage in physical activity. In addition to walking, physical activity can include a variety of tasks such as cleaning, gardening, dance, yoga, and performing body weight movements.

In summary, we suggest that the current public health message be expanded to promote physical activity as a critical strategy to combat COVID-19. As vaccination efforts continue, we encourage everyone to remain vigilant and follow the 4-W’s – “Wear a mask, Watch your distance, Wash your hands, and Walk to stay active”. Doing so will help to slow virus transmission and better protect individual and community health.