Why didn’t Boris make exercise mandatory?

What could have been…

The face mask has become the unedifying symbol of 2020, the year of the COVID-19 pandemic. Mandatory wearing of face masks was made law in the UK from the 23rd June (most countries now have some form of compulsory face mask guidance). Rather than help squash this pandemic, face masks have made little difference and, as I explained before are actually helping spread both fear and probably, via second order effects, the virus itself. Whilst seen as the de facto “solution” to the problem, they have done little to quell rising cases as Autumn hit Europe. So instead of face masks why didn’t the government make exercise mandatory…imagine the change it would have made in 5 months.

This might sound like poppycock but before 2020, so did banning you from seeing more than 6 people in your home or forcing you to wear a face mask in indoor public spaces. If there is one thing that helps prevent or battle illness, both physical and mental, it is a starting point of being fit and undertaking regular exercise.

Well before COVID-19 appeared it was clear we were heading for a car crash with our healthcare system. NHS overnight bed occupancy has been trending upwards for decades, a particular issue now as this is being used by the Government as a reason for continued restrictions. It is overburdened from the side effects of high sugar diets and poor education; diabetes, hypertension and obesity.

According to a recent parliamentary report obesity levels have risen from 15% in 1993 to 29% in 2017. More concerning is that the older you are the more likely you are overweight or obese, exacerbating age related risks and costs (see earlier linked article), and we will all be aware that the population is in general getting older. It is no coincidence that occupancy and the charts below are all interlinked.

Trying to estimate the cost to the system from being overweight and unfit is nigh on impossible, estimates start at the £10bln mark for direct costs, for the obvious first order costs in the healthcare system, but then there are the myriad second order effects, such as higher absenteeism in the workforce or being more susceptibility to injury and other illnesses.

The latter point is no more relevant than right now in the teeth of the COVID-19 epidemic. While people rightly highlight the average age of COVID-19 deaths as being 82 years old, what is often left out of the picture is the general health of an individual. This study on IFRs (infection fatality rates) across various countries shows that in high income countries (HICs) the IFR for what many deem “at risk” 70–79 age brackets is actually only 0.175% and 0.48% if you have no underlying health issues, this rises >10x if you start to have some form of comorbidity.

This point is most meaningfully made by the statistic that as of the 4th November only 332 people under the age of 60 (see yellow highlighted cells) had died of COVID-19 with no underlying health condition in hospitals. This compares to >30,000 overall hospital deaths. Furthermore of those 30,000 26% had Diabetes.

However, as we have been told time and again it isn’t just about deaths and IFRs but rather the much more dangerous issue of hospitals not coping and becoming overburdened (forget the fact they have been for years!). Interestingly, on this point the data is even more unequivocal. The more overweight you are (from a BMI standpoint) the more likely you are to need hospitalisation. Perhaps this is totally intuitive but this article highlights the true extent of this, referencing a pre-print which showed that in the US 77% of 17,000 hospitalised patients it analysed were overweight. That is a staggering statistic. Effectively it implies that if everyone were the correct weight COVID admissions would be at least half and perhaps 75% less than they needed to be.

But how can you make it a legal requirement to exercise? Well, for those that object to being ordered to wear a mask, due to there being no obvious and verifiable gain at a community level, it has nonetheless been made mandatory by law. If we are ditching any sort of libertarian and free society for the sake of the NHS why didn’t Boris, who himself decided that losing weight was the most important thing he could do, send out fitness trackers to every adult in the country?

From there some sort of central software could have been built for a fraction of the cost the government has spent in total. Whoop, the current darling in the sports professional world and the best heart rate monitor, has only had $200m of funding thus far — a snitch! All our data is sent back and monitored, if heart rate levels haven’t been elevated above the normal resting levels (yes, Whoop knows if you have been exercising or not) for the allotted time an alarm goes off.

Wipe that smile off your face

Either that alarm can trigger a group of squaddies to come round and force you on a quick march for 5k or perhaps, better still, the device emits shrieking and voluble insults, in the manner of those letters that Harry Potter and Ron Weasley used to get at Hogwarts…perhaps just as you are walking round the supermarket!

It could be made illegal to take them off. Thereby instead of the person not wearing a mask in the supermarket getting withering looks, those stares instead turn to the 30 stone person filling their trolly with ice cream, chocolate bars and pizza. After all that person made be the kindest and most incredible benefit to society but they are a walking NHS cost machine.

Instead of closing non-essential shops and supermarkets weirdly cordoning off whole aisles, Boris again could have banned the sale of sweets, chocolate bars and other minimally nutritious meals. Or perhaps supermarket chains would have taken it on themselves to install a set of scales at each checkout and, depending on your BMI, you are only allowed a certain allocation of unhealthy options. For a fraction of the cost Boris could have instituted huge discounts, via vouchers, if a certain proportion of one’s total basket contained vegetables and other healthy alternatives.

Of course this all sounds absurd in some parts and desperately cruel and inhuman in others. For many it is not the sort of society they want to be a part of. Yet, they will gladly clap for the “wonderful” NHS and heap scorn on those not doing their bit to “fight the virus”. This is the madness of it all. The solution, if we genuinely want it, lies in harsh truths and a total rewrite of priorities, rather than the half-baked hypocrisy that we are currently living through.

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