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What's the best way to exercise to maintain a strong immune system? – The Globe and Mail

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A man exercises on Streatham Common as the coronavirus outbreak continues in London on March 27, 2020.

HANNAH MCKAY/Reuters

Before and after the 1901 Boston Marathon, a Harvard doctor named Ralph Larrabee took blood samples from four of the runners. Their white blood cell counts, a key measure of immune function, were way out of whack, indicating that “the exertion had gone far beyond physiological limits.”

Scientists have been debating the link between hard exercise and the risk of catching passing infections ever since, and the question has never been more salient than now, thanks to the rapidly spreading coronavirus pandemic. For some, self-isolation is severely curtailing their usual exercise habits; for others, a sudden and unwanted excess of free time is allowing them to train harder than ever before. Neither approach, it turns out, is ideal.

Exercise immunologists usually describe the relationship between infection risk and exercise dose (which is a combination of duration and intensity) as a J-curve. Doing regular moderate exercise lowers your risk compared to doing nothing; studies typically find that near-daily moderate exercisers report about half the typical number of upper-respiratory tract infections. That’s an important message for anyone who’s tempted to slack off their fitness routine until life returns to normal.

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But according to the J-curve theory, if you ramp the dose up too high, your risk climbs steadily until you’re more vulnerable than if you’d done nothing at all. For that reason, Oregon-based elite track coach Jonathan Marcus recently argued on Twitter that athletes should avoid the type of gut-busting workouts that might put them at higher risk. “To train hard now is irresponsible,” he wrote.

Figuring out what counts as “too hard” is tricky, though. Neil Walsh, an exercise immunologist at Liverpool John Moores University in Britain, compared the effects of two hours of low-intensity running with 30 minutes of high-intensity running. The longer bout disrupted immune response more than the shorter one, suggesting that duration is a bigger risk factor than intensity.

That may be because prolonged exercise depletes the fuel stores that your immune cells rely on – an effect that seems to kick in after about an hour and get even worse after 90 minutes, according to research from Appalachian State University immunologist David Nieman.

Not everyone agrees with this take, though. In a 2018 paper in Frontiers in Immunology, University of Bath researchers John Campbell and James Turner questioned the idea that hard exercise, on its own, suppresses immune function, even in an extreme challenge such as running a marathon.

“If people do get an infection, it’s probably due to their attendance at a mass-participation event, where lots of people, and their bugs, are gathered,” Campbell argued.

Travel and big crowds aren’t an issue for self-isolating solo exercisers. But other external factors such as stress and disrupted sleep – not exactly rare in the midst of a pandemic – also wreak havoc on immune function, says Walsh. He and his colleagues found that anxiety and psychological stress, as measured by a simple questionnaire, had just as much influence on the immune system’s response to exercise as the length and intensity of the workout.

All of this makes it difficult to issue a one-size-fits-all prescription for how to work out. Nieman offers a simple rule of thumb: stick to 60 minutes or less at an average heart rate of 60 per cent of your maximum. Inserting some more intense surges is fine; it’s sustained intensity that seems to tax the body the most.

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The details, though, will differ depending on your fitness, your usual habits and perhaps also your psychological needs. Running for an hour might be unfamiliar, stressful and physically exhausting for someone who’s looking for an alternative to their cancelled weekly hockey game. But it might be relatively easy for a habitual runner, and an important source of stress relief, which, in turn, will have positive immune benefits.

The bottom line? Find a way to keep exercising and don’t be afraid to push hard now and then. But if you’re planning to run a hard solo marathon around and around your block, make sure to rest up and stay well away from other people for a few days afterward – you know, like you’re supposed to be doing anyway.

Yoga instructor Amber Brown walks us through two yoga poses designed to relax the body and mind at the end of the day. If you have trouble sleeping, these may offer some relief.

Alex Hutchinson is the author of Endure: Mind, Body, and the Curiously Elastic Limits of Human Performance. Follow him on Twitter @sweatscience.

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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