Social distancing and exercise – is 1.5 metres enough?

Social distancing and exercise – is 1.5 metres enough?

With gyms closed, many more people are taking to the streets to get their daily exercise, but what does this mean for social distancing? We asked respiratory expert Christine Jenkins about the science behind the 1.5 metre rule and how best to protect yourself when exercising outdoors.

How far can your breath actually travel?

The amount of water vapour you have in your breath is an important determinant of how far it travels. Different portions of your exhaled breath, depending whether they contain mostly large or very small droplets, will travel different distances. As you would imagine, there is an intense area immediately around your face and then it progressively falls off, dispersing and distributing more sparely though the surrounding air as it gets further away from you. This radiation effect is not unlike the ripples you might see on the top of the water if you throw a stone.

Air travels out from a normal exhaled breath roughly 1 to 1.5 metres before it becomes exceedingly diluted, and water droplets are barely detectable. The extent of spread, and the dilution effect very much depend on the rate at which you breathe and the force with which you propel it - if you cough or sneeze, that greatly increases the distance your breath and the droplets within it will travel.

Is that the reason why we have the 1.5 metre rule?

Precisely. When you’re walking at a leisurely pace that does not require an increased ventilation rate then you’re not likely to be spreading droplets much further than a metre - a metre is a safe distance. There is a margin of error there, and the variability depending how fast you’re breathing may in fact mean it can go a bit further, but 1.5 metres is a safe distance in terms of the droplets in your breath.

By water vapour or droplets, do you mean spit basically?

The droplets in exhaled air are not from saliva. Sometimes when people forcefully cough there is saliva in the exhaled breath, because it’s a combination of what comes out of your air passages as well as what comes out of your mouth, but normally exhaled air contains droplets predominantly from within the air passages in the lungs.  

Droplets held within the exhaled air are actually part of what we would call your ‘insensible loss.’ They include fine droplets less than 10 microns in size and many droplets of 10 to 100 microns. Your “insensible” water vapour loss from the respiratory tract is the amount of water vapour there is in your exhaled breath. It’s warm inside your lungs - 37 degrees is your physiological temperature - and there is a certain humidity attached to that too, and your breath contains that moisture and hence there is evaporative loss as you breath in and out and as your airways cool as well.

So this water vapour in your breath that isn’t saliva and is coming from within your lungs, and is a reflection of the relative humidity of the air you’re breathing out. Water lost from the lungs in this way is increased if you have a fever, and if you are breathing rapidly.

When we run and we are doing physical activity we are exhaling a lot harder. How does that alter the physical distancing measurement?

Well there are different parameters around how far the breath and the droplets within it are travelling and indeed they may be travelling a great deal further than 1.5 metres in this case. It depends on the forcefulness with which somebody exhales. Many of us would know when we’re out walking that many runners who pass by are breathing very heavily. Others will know that sometimes runners pass you by and you hardly know they’re there except for their footfalls. In other words, they are either very accustomed to running or very fit, and they don’t necessarily breathe out particularly hard or forcefully.

So it’s going to be very dependent on the rate at which the person is running, whether they cough when they’re running, whether they’re forcefully exhaling and how close they are to you. Of course it does greatly increase the possibility that you will be exposed to a greater amount of their exhaled air if you are less than 1.5 metres apart. But it is also about the forcefulness of the exhalation. Some runners may pass you by a little more quickly as well, and they can be breathing in when they pass you by. It is important to appreciate this is not a simple 2- dimensional problem!  

Exercise is important for physical and mental health at this time but there’s also a need to maintain social distancing but there’s a lot of people out and doing different exercise and you do think am I running into someone else’s droplets here?

Unfortunately you could well be, and perhaps we all have to be courteous to each other when we are doing some very vigorous aerobic exercise - running particularly. We need to remember that we owe it to the people we are passing by to keep a wide berth and that berth probably has to be wider than even 1.5 metres for runners who are breathing very heavily. And similarly for runners, walkers whatever you are doing, coughing and sneezing and proper hygiene around that - covering up, using the elbow to cough or sneeze into, are crucial steps we must all take when we are out. The fresh air around us is still potentially laden with organisms and our lungs are normally very good at handling this but in a situation where there is an increased risk of infection, those risks do increase. Now I would not want to deter anyone from outdoor exercise at this point in time when we have a very low rate of community transmission.  However, I do think courtesy is crucial and for people who are running especially, just a giving a little bit more of a wide berth would be a very safe thing to do.

And maybe hold your breath as you pass?

Indeed, and I would try to breathe out if somebody passes you by too closely. I would think to myself ‘well this is a time to be breathing out a bit more rather than breathing in’. I know we can’t do the breathing out all the time, but nevertheless a little bit of common sense here is really valuable. If someone passes you by very closely and is breathing heavily, I wouldn’t be taking a big deep breath in immediately after if I could avoid it.

Joint statements of support for the WHO

The George Institute has worked with its partners and collaborators to issue joint statements in support of the World Health Organization.

The George Institute researchers, Professor Jacqui Webster, Director, WHO Collaborating Centre for Salt Reduction and Professor Margie Peden, Co-Director, WHO Collaborating Centre for Injury Prevention, along with other global health experts issue a joint statement in support for WHO funding.

Professor Margie Peden, along with other members of the United Nations Road Safety Collaboration also issued a statement recording appreciation and support for the outstanding role and leadership of the World Health Organization (WHO) in global road safety.

The George Institute along with more than 1,000 organizations and individuals including charities, medical experts and healthcare companies from around the world have written to the White House arguing the Trump administration should reverse course and keep funding the World Health Organization (WHO), making a case that the coronavirus pandemic can't be brought under control without the WHO.

The George Institute signed a joint statement with other organisations and women working in global development on COVID-19, emphasising that 'now more than ever, countries need to unite behind a strong WHO - sharing knowledge, strategy, technical resources and financial statement to defeat the global threat we all face.'

What we are learning about COVID19 and those most at risk

Statement from The George Institute regarding suspension of US funding to the World Health Organization

As a medical research institute with a mission to improve the health of millions of people worldwide, The George Institute for Global Health is extremely concerned by the decision of President Trump to suspend funding to the World Health Organization (WHO).

The WHO plays a vital role in protecting and promoting health around the world, not only by coordinating the global response to infectious disease outbreaks, but through strengthening health systems, increasing access to medicines, and improving monitoring and information sharing, particularly in resource-poor settings.

Recognising the WHO’s crucial work to support the right of every human being to the highest attainable standard of health, the United States of America has historically led the way in terms of its support for the agency; in 2018-2019, it was the largest contributor to WHO’s budget, providing 15% of the total.

To withdraw support to the WHO just as COVID-19 sweeps the world risks worsening the already dire consequences of this pandemic, which we know is striking hardest those people made vulnerable by poverty and marginalisation.

As a global community, this crisis reinforces the need to work together and strengthen the WHO, recognising that the need for a global health agency in our increasingly connected world is greater than ever. We strongly urge US political leaders to reinstate funding to the WHO with immediate effect.

Event

A virtual conversation with Dr James Muecke AM

George Talks Dr James Muecke

You are invited to a virtual #GeorgeTalks with Dr James Muecke AM, 2020 Australian of the Year.

This webinar event with Dr Muecke will be in conversation with Professor Bruce Neal, Executive Director of The George Institute for Global Health in Australia.

As 2020 Australian of the Year, Dr Muecke wants to challenge our perception of sugar and the impact it has in the development of type 2 diabetes.

The George Institute for Global Health warmly welcomes Dr Muecke to be our special guest for this virtual #GeorgeTalks.

Speakers

  • Dr James Muecke AM

    Since starting his medical career in Kenya, Dr Muecke has been passionate about fighting blindness. His focus now is the leading cause of blindness in adults – type 2 diabetes – a spiralling epidemic that's impacting nearly one-in-ten Australians. It's the fastest growing cause of vision loss in Aboriginal people and the sixth-biggest killer in this country. Dr Muecke co-founded ‘Vision Myanmar’ at the South Australian Institute of Ophthalmology in 2000, which has developed and operated eye health and blindness initiatives in Myanmar. Inspired by this program's success, he co-founded ‘Sight For All’, a social impact organisation aiming to create a world where everyone can see. With 80% of world blindness avoidable – and almost 90% in poor countries – Dr Muecke treats blindness as a human rights issue.

    Dr James
  • Professor Bruce Neal

    Professor Bruce Neal is Executive Director at The George Institute for Global Health Australia and Professor of Medicine, UNSW Sydney. Professor Neal is a UK-trained physician who has 20 years research experience in the clinical, epidemiological, and public health fields with a focus on heart disease, stroke and diabetes. Professor Neal has a longstanding interest in the environmental determinants of high blood pressure and the potential for changes in the food supply to deliver health gains. His work has been characterised by its focus on collaboration, quantitation, translation and impact. He holds professorial appointments at UNSW Sydney, Imperial College London, Flinders University in South Australia, an honorary appointment at the University of Sydney.

    Prof Bruce Neal
The George Institute joins the fight against COVID-19

The George Institute joins the fight against COVID-19

As Australia’s governments and health systems grapple with the current health crisis, The George Institute is mobilising its talented researchers and other skilled staff to contribute to the collective response effort.

The Institute has a number of researchers who are also in clinical practice and we are actively supporting them to adjust their workload so they have more time available to spend in the health service where they are needed most.

In terms of research projects, we are supporting the Head of our Respiratory Program Professor Christine Jenkins in her role as Respiratory Specialist at Concord Hospital in Sydney to participate in a multicentre trial comparing antiviral and antimalarial drugs with standard care in people with COVID-19.

The Institute’s Aboriginal and Torres Strait Islander Health Program team are working with communities and Aboriginal health organisations around culturally appropriate COVID-19 messaging and crisis response.

Our Honorary Professorial Fellow, Richard Lindley, a clinical academic and geriatrician at Blacktown Hospital, Western Sydney Local Health District, is part of a large team working with the Western Sydney Centre for Population Health to track the burden of viral diseases in aged care facilities in the west of Sydney. The study is looking at attack rate, hospitalisation, and death rates of viral respiratory infection outbreaks in adults aged over 65 years in these facilities. As this study has been running for a few years, it is now ideally placed to immediately track the COVID-19 pandemic in these facilities.

Meanwhile, many of our researchers have been working hard designing and supporting a range of research projects and submitting proposals to help further our understanding of COVID-19, particularly as it relates to other chronic diseases.

Recognising that the COVID-19 pandemic will require a large and ongoing research response as new treatments and vaccines are developed, we are also working to establish a registry of people who want to be involved in this vital research.

In the meantime, we are asking our George Institute experts, such as Prof Jenkins and Prof Alta Schutte, President of the International Society of Hypertension, to comment on topics pertinent to the particular risks for people with conditions like asthma and high blood pressure.

In addition, we are in ongoing discussions with NSW Health regarding the potential secondment of our talented staff to help boost their capacity as they respond to rapidly changing needs.

As the nation adjusts to the ‘new normal’ The George Institute is adapting to ensure we can continue to deliver on our mission to improve the health of millions of people worldwide, even in these challenging times.