🔒 How physical activity can make 60 the new 40 – and beat Covid-19

In this podcast, BizNews editor-in-chief Alec Hogg talks to Gareth Friedlander, deputy CEO of Discovery Life, and Dr Maritha van der Walt, Discovery Life’s chief medical officer. Based on data starting to come in about claims related to Covid-19, Friedlander and Van der Walt share insights about the categories of people who are more likely to suffer severe symptoms if infected with Covid-19, and they share lifestyle advice to minimise the chances of suffering severe Covid-19 symptoms should you be infected. It turns out that high physical activity can be a critical factor in preparing your body to deal with the coronavirus. It’s known that the older you are, the more at risk you are, but, says Friedlander, “if you take a 40 year old who’s doing no physical activity and a 60 year old who’s doing high physical activity – we actually see the exact same probability of admission”. And people should not be fooled into thinking that it’s only the people with underlying conditions who are dying from this disease. – Nadya Swart

Gareth Friedlander is the deputy CEO of Discovery Life and also on the call is Maritha van der Walt who’s the chief medical officer of Discovery Life. Good to have the two of you here together. With Covid-19 having hit the country, are you seeing excess deaths coming as a consequence of this? 
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It’s probably too early to say excess deaths. I think we need to see how this plays out over a couple more months. We certainly are seeing claims coming through. We’ve now paid over 50 death claims for clients who died due to Covid-19 and just under a hundred income protection claims for clients who weren’t able to work due to Covid-19. 

So, the claims are starting to come through, but we are right at the beginning and moving into the peak now. So, I think it will become clearer over the next few months. As these claims continue – we’ll be able to do the analysis of whether they are truly excess claims and to what extent.

Maritha, from your point of view, obviously it makes sense for Discovery Life if fewer people die of Covid-19. Is there much that you can do to suggest to people that they act differently to reduce the mortality potential? 

Very, very important – there’s so much we can do. Of course, all the preventative measures like washing hands, keeping social distance, wearing masks, avoiding crowded places that we all know about by now. But furthermore, a healthy lifestyle is even more important now in the time of Covid. Discovery Health has done an analysis and it has shown that you can reduce your risk of getting Covid complications – if you should get the infection, that you can reduce your risk substantially by exercising. 

And, of course, a healthy diet would boost your immune system. And then obviously excess alcohol and smoking is never a good idea, and more so in the time of Covid. But definitely – a healthy lifestyle. Over and above that, we have identified those of our clients that we feel could be more vulnerable if they get Covid. And we have sent out communications that we think provide extra care to prevent the disease – that’s the best cure at the moment. 

And then also, we’ve made provision that when you get Covid, that you are provided with an oximeter, which is a little device that measures the oxygen in your blood, because we know… people’s oxygen levels dropped substantially and dangerously and they still feel okay. And then it’s actually almost too late when they get to the hospital. So those are all the proactive things that we’ve done from a Discovery Group point of view. 

How has it been impacting the normal mortalities? In other words, we hear that people aren’t going into hospitals, because they are too scared they might pick up Covid. But if, for instance, they’ve got cancer or heart disease or some other issue, Gareth, are you seeing a rise as a consequence of this? 

Not yet. Again, we’re going to have to monitor that as we go, but we have just released our 2019 stats. So that will obviously give us a good base to compare against once 2020 is over and we can start seeing how it’s played out in terms of other claimed causes. There’s a number of hypotheses out there that we’re going to have to monitor and try to understand. 

Are there people potentially not going to hospitals and potentially under-diagnosing conditions? At this point in time, we know that people are scared to go to doctors unless it’s incredibly necessary at times like these. So there’s the possibility that you might see fewer claims now and more claims later. But that’s probably too early to say at this point in time. But we certainly have analysed our 2019 claims, statistics and details, and there are some fascinating things coming out of that. 

Read also: How to craft a diet to beat Covid-19 blues – Wall Street Journal

You asked Maritha about the impact of lifestyle on Covid-19. I thought about something fascinating to throw into the mix: we’ve done a study which looks at the ability through regular physical activity to reduce your probability of admission, given a Covid-19 infection. And it’s very well known that age is a huge factor and as you get older, your probability of being more severely ill due to the virus, due to the disease is higher. 

But what we’ve seen is that if you take a 40 year old who’s doing no physical activity and a 60 year old who’s doing high physical activity – we actually see the exact same probability of admission. So, by doing physical activity and leading a healthy lifestyle, you can actually almost reverse out the age risk factor that is inherent. Unfortunately, we can’t change our age, but we certainly can change our risk according to lifestyle changes. 

So 60 can be the new 40 if you exercise more. But, just to pick up with you, Maritha – I want to understand this better. So when you get Covid-19, once you are sick, should you exercise then or can you continue exercising or is that not a good time to do so? 

No, it’s in the phase before you get sick. And hopefully, if you still unfortunately get the virus, then you won’t get seriously ill or you will reduce your chances of getting admitted and getting complications. If you’re sick, you should not exercise because this virus specifically attacks all the cells in the body, including the heart cells and direct injury to the heart muscle cells. 

So you don’t want to exercise when you’re sick. So don’t exercise when you have a temperature. Don’t exercise even when you have normal flu or when you’re sick. But definitely – a healthy lifestyle and regular exercise will prevent you from getting severely ill. 

Just getting back to the 2019 data, because that is very interesting. The number of deaths you’ve had from Covid-19: as a percentage of the total deaths that you cover or you pay out for every year – is it still fractional at the moment? 

Absolutely, Alec. It’s very small at this stage. It will obviously change over the next few months, but right now that number is relatively small. We’ve paid out nearly a R100m in Covid-19 deaths so far. And just to put that into context, we paid out R2.3bn last year for our clients who had passed away. So, at this stage it’s still fairly insignificant, but it’s going to increase. 

Of that R2.3bn that you paid out last year: it was interesting to see that cancer and heart disease are right up there of the diseases that people die of, but also unnatural deaths are significant as well. Is that a South African phenomenon?

It is to an extent, we do definitely have a higher unnatural death rate here in South Africa. We’ve got one of the highest motor vehicle fatality rates in the world, and obviously crime-related as well. So, we do definitely have higher unnatural deaths than many developed countries. 

Read also: Mental health and Covid-19: How you’re affected even if you’re not infected

Something we saw in this space, which is quite fascinating and quite concerning at the same time, is that suicide accounted for 28% of our unnatural death claims last year – and that was just behind motor vehicle accidents. So, that is very significant and something deeply concerning and obviously something that we as a society have to really spend a lot of time understanding. 

I think mental health is becoming more and more important and there’s more spotlight being shone on it, both from within the organisation and through Vitality, but also at a societal level.

Maritha, perhaps you could pick up there, because surely that’s got something to do with mental health – if the suicide rate in our country is so much higher it appears than elsewhere? 

Yes, Alec. That is so and it’s very, very sad and very concerning, as Gareth said. Currently – also because of Covid – there is much more focus on mental health. Even in our webinars, there are so much more talks on mental health and how you can look after your mental health. I think there is a mental health month and so on. 

So, there is a lot of work being done on how you can prevent mental health problems in the workplace in general and there is more awareness. But I think we have a long way to go, and it is one of the concerns with Covid that people will have an adverse reaction to being so isolated, losing their jobs, losing their income, maybe losing family members. So it is a very, very big concern. 

Getting back to the Covid-19 claims: are you seeing any particular professions that are being affected? I know it’s still a small number, relatively speaking, but we hear that health professionals, for instance, are most at risk. Is that a similar experience with you, Gareth? 

Yes, that’s playing out very strongly at this stage of our total Covid related claims. 65% have been health care professionals – so that is ringing incredibly true. They are unbelievable servants to our society and are putting themselves at risk and hugely exposed to the disease, and that’s definitely coming through in our claims statistics.

That’s extraordinary, so almost two out of every three claims will be a healthcare professional? 

Absolutely. And that’s obviously nowhere near the exposure that we have in our total book. The amount of healthcare professionals in our book are probably between 10 and 15% of our clients. So, you can see the disproportionate number of claims that are coming through in that particular space.

So, we’re having a very similar experience to what happened elsewhere in the world where the frontline is really most at risk, and the numbers that you’ve just shared with us show what a debt we owe them. 

Absolutely. Obviously, those claims that I’m talking about are not all necessarily death claims. Some of them may be healthcare professionals who have tested positive and therefore can’t work for a period of time and we will pay out on their income protection. So, in any case they can then get back to work. But absolutely, there’s a huge debt that we owe to our healthcare professionals at a time like this. 

Maritha, what about this particular virus? Because it does attack various organs in the body. Is there anything you can tell us about that, how you can cover that kind of an unusual attack rate by Covid-19? 

Yes, Alec. A couple of months ago, we thought that it was a respiratory virus causing flu-like illness, but now we know that it’s a multi-system virus that affects the whole body – all systems. And then we also have, in the severe cases, hyper inflammatory response, which we call the cytokine storm, which is almost like an overreaction which causes more damage. 

In the quest to conquer this virus, the body’s response is actually causing more damage. Another interesting fact that we know now is that the virus causes clots in the body. Small clots, but the clots give rise to more complications that can cause heart attacks – either by clotting – or it can injure the heart muscle cells, as I said. It can cause strokes, it can cause clots to the lungs and so on. So, it’s multi-dimensional because it’s so complicated and so widespread. 

So we’ve got to really treat this with great respect. From the Vitality perspective, and you did mention it earlier, exercising is good. But Gareth, from the data: are you seeing that people with higher Vitality status – in other words, Gold and Diamond members – are having a better experience relative to the rest of the group? 

You’re in a unique situation at Discovery because of the Vitality Programme to be able to share quantifiable data on the score. 

Yes, absolutely Alec. We’ve definitely seen that, and it relates to the point I was making earlier around people who are more physically active being able to kind of reverse out their age risk factor. So certainly, as clients engage in Vitality and become more active, their probability of admission, which is I guess a severe manifestation of the disease, comes down. 

We are continuously tracking this on an ongoing basis, but the latest statistics that we’ve released was about a 20% lower admission rate for clients in the more engaged Vitality statuses. And this is something that we will continue to track as this epidemic evolves. 

Maritha, given the insight or the perspective that you have – how are you advising your family during this period? Outside of the normal wear a mask, wash your hands, etc.. What other tips are you giving them to perhaps take it: A, seriously and B, to try not to get it? 

Yes, very important Alec. I think we must just also add that we now know that there is a huge percentage of people who actually have asymptomatic disease or very mild disease. So we don’t want to cause panic. But unfortunately, if it’s severe – then it’s very severe – as we’ve seen with the comorbidities and so on. 

And that brings me to the next point. I think anybody with a comorbidity like hypertension, obesity (the main ones). Of course, the others are lung disease and kidney disease and immuno-suppressed patients and so on. Those people must take extra care and they must really not go out and about and go to busy shopping centres and attend any kind of gathering, because the comorbidities, over and above age, is very important. I mean, look at the serious 19, 20% and the critically ill people. 

I think for us: definitely exercise. I make sure that we both exercise every day, and it’s lovely to go outside and go for a walk, but also a treadmill. But every day, I think exercise is key. It’s good for your mental health. It’s great for your cardiovascular fitness. And we know now that it has a very risk reducing effect on Covid, if you should contract the virus. 

And then, of course, a healthy diet. A healthy diet is not just about calories, it’s not just about losing weight. It’s really getting your antioxidants and your vitamins and your good quality diet. 

And maybe to close off with, Gareth – from your mortality data: are you seeing a lot of this comorbidity correlation?

Certainly, we are. That’s coming through strongly. But Maritha has mentioned them: hypertension is at the top of the list, actually, in terms of highest risk factors followed by diabetes. The large majority of our claimants have had comorbidities of some sorts, but these aren’t uncommon. There’s many people that have raised blood pressure and raised cholesterol and sugar. So, it’s not that these comorbidities are that uncommon. 

You know, you hear on the news that it’s only for the people who have comorbidities. That’s many of us. So, I think one needs to be incredibly aware of your health. That is something that Vitality and Discovery has always pushed. That’s why we send people for their health tests every single year. Those Vitality health checks to ensure that people are aware when they do have hypertension, diabetes, etc., because that allows you to address it immediately and control those risk factors. 

So yes, we are seeing it come through, but I don’t think people should be fooled into thinking that it’s only the very sick who are dying from this disease. There’s far more of us than we realise who have comorbidities. 

And the health professionals being such a big percentage of those claims that you’ve had, presumably they also had comorbidities? 

Certainly, they would have, because, as you say, they’re such a big percentage that if the overall numbers are showing comorbidities to be a risk factor – then the health professionals would certainly be seeing the same thing. And yes, unfortunately, many of our health professionals will have comorbidities. 

A couple of months ago, we thought that it was a respiratory virus causing flu-like illness, but now we know that it’s a multi-system virus that affects the whole body – all systems.

I think what’s also contributing there is just a much higher exposure to higher viral loads. And that’s meaning that health professionals are potentially presenting with more severe manifestations of the virus. But Maritha might be better placed to comment further on that. 

Yes, I think the level of exposure is just so much higher – the viral load – but also constant exposure, like every day you’re exposed to that – it is your working environment. So sadly, the exposure is very high. And then comorbidities are across the board. 

So, yes, it would be in the health professionals as well. It is also so that the average age of our GP population is actually in the older age group. So, that is another contributing factor.

So these are not necessarily people who are in ICUs or working in hospitals – the health professionals can include GPs?

Yes, well GPs if they see Covid patients at their practices or if they are working at a hospital. So the exposure is everywhere for healthcare professionals.