When businesses and things started shutting down in March due to the Covid-19 pandemic, I realized that life was going to be quite a bit different for an uncertain period of time. Given that, I started thinking about what I would need if I had to quarantine, or if I just no longer had access to the things that I was used to. One of those things that help me with my well-being, mood, sleep, and everything else, is exercise - so I wanted to make sure I could find a way to continue to do that.
Luckily I do have access to a reasonable, but seldom-used stationary bike. I recently heard of a free trial available for the Peloton app I decided to give it a go. To be clear, I am not being reimbursed by Peloton but I honestly have found the app enjoyable - especially with the various cycling workouts which give me direction and motivation to get on the bike.
Now I don’t have the fancy bike with all the bells and whistles which connects remotely with Peloton, but my stationary bike is doing the job and, in reality, the principles behind the bikes are pretty simple. There are just 3 aspects to consider when working out on it.
Output:
Simply how hard you are working. You can consider it the amount of energy you are spending or your level of effort. This is a result of the other two components:
Resistance:
How hard it is to pedal. This can adjusted by twisting the little knob on the bike to increase or decrease the effort required.
Cadence:
How fast you are pedaling. This one’s pretty obvious - the faster you go, the more work required.
And that’s it. Your output is a result of your resistance and cadence. And practically speaking, the output is all I tend to care about during my workouts - how much effort I’m putting in. Whatever resistance or cadence I’m using to achieve that doesn’t really matter to me, as long as I’m reaching the effort I desire. And the same output can be maintained even if you reduce the resistance, as long as you increase your pedaling rate accordingly. Or you can decrease your output by either decreasing the resistance or the cadence. They’re all connected, but the output is my focus.
What the heck does this have to do with Covid-19??
Well, I see a lot of discussion going on about whether Covid-19 is that serious or not. Is its case fatality rate similar to the flu or much worse? How do we manage and assess our risk when there are so many people that seem to be asymptomatic or have only minor symptoms? Are we overreacting?
While I don’t believe we are overreacting with how serious we are talking this virus, I do agree that it can be confusing and hard to get a sense of what everything means. We often focus on the number of cases when we know there is a huge variation in the amount of testing different countries and regions do. We focus on risk and prevalence of Covid-19 when there is so much talk of asymptomatic or pre-symptomatic transmission.
But there is no question that the hard numbers – deaths, ICU admissions, and ventilator use – are definitely real and have devastated families, as well as countries and communities. This is the (clearly negative) output of Covid-19 – the result we should focus on and try to decrease.
So what is this output a product of? Not resistance and cadence, but we can easily consider their equivalents. Resistance in this case could be seen as how deadly or serious Covid-19 is in terms of case fatality rate (how many people die out of those infected) or what percentage of infected people require admission to hospital. The counterpart for cadence in regards to Covid-19 would be its infectious rate (the number of people each infected person goes on to infect). The higher these numbers are, the higher the “output” or the number of people who will die or will require ventilation. While it is may be hard to know the exact case fatality rate or infectious rate (although we have an idea of them), the hard numbers involving deaths and ICU admissions are pretty concrete and are our hard targets.
So even if the “resistance” is less than what we initially thought, it doesn’t change the effects this virus has hand around the world in terms of “output” so that just means that Covid-19 must spread easier (i.e., we are pedaling faster).
And regardless of the actual numbers of case fatality rate, the infectious rate, hospital admission rate, or the percentage infected patients that end up on a ventilator, we need to remember that the goal and the focus is to reduce those firm endpoints of death, ICU admission, and ventilator use. We can then use this bike analogy to think about how to do so even without knowing those specifics.
We can decrease the resistance by improving the care we provide those patients infected with Covid-19. We can learn what’s worked best in other countries in the management of patients in hospital, both on and off ventilators. We can also hope to discover new, safe, and effective treatment options against this virus. Hopefully this way, even if patients are admitted to hospital, fewer will need intensive care or ventilators, and fewer will die.
We can decrease the cadence by decreasing the transmission rate and infectious aspect of the Covid-19. We do this by adhering to physical distancing and staying home as much as possible. We wash our hands often. We cover our mouths when we cough/sneeze. We avoid touching our face. We consider wearing masks when physical distancing is not possible. And we hope for a vaccine.
This simple little analogy between Covid-19 and a spin bike may be a bit silly and simplistic, but it’s how my brain works, and it does demonstrate the importance of keeping the focus on the end goal we are working towards - reducing deaths and ICU admissions - and visualize how we can best do that.
And right now the best thing we can do as a population is hold the line, continue physical distancing, and follow the advice of the public health experts to get us through this. We’ve already seen the incredible difference these interventions are making so let’s keep it going and continue flattening the curve.