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https://doi.org/10.1177/1359105320925149
Journal of Health Psychology
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DOI: 10.1177/1359105320925149
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Introduction
These are extraordinary times. Throughout his-
tory, there have been plenty of pandemics but
the human response to coronavirus disease
(COVID-19) is unprecedented. The world will
never be the same again. It is estimated that
close to 4 billion people are living in social iso-
lation during this mother of all pandemics
(Sandford, 2020). Unless there is a revolt, poli-
cies of social isolation in one form or another are
expected to continue until a vaccine is available
6, 12 or 24 months from now. The cumulative
impacts of social distancing will be truly pro-
found. This article has the following two pur-
poses: (1) To review the science of human needs
as they can be expected to play out over a pro-
longed period of domestic confinement and (2)
to make preliminary recommendations concern-
ing necessary self-care focusing on exercise.
The COVID-19 pandemic involves a novel
coronavirus characterized by a respiratory illness
that results from a severe acute respiratory syn-
drome coronavirus 2 (SARS-CoV-2) infection
(Centers for Disease Control and Prevention,
2020). The disease was first reported in Wuhan,
China, on 31 December 2019 and symptomatic
patients frequently present with a dry cough,
fever and shortness of breath within 2 to 14 days
after exposure. The COVID-19 pandemic is
receiving intensive interest at all levels: political,
Human needs in COVID-19
isolation
Thiago Matias1, Fabio H Dominski2
and David F Marks3
Abstract
To reduce the spread of COVID-19, the World Health Organization and the majority of governments
have recommended that the entire human population should ‘stay-at-home’. A significant proportion of
the population live alone or are vulnerable to mental health problems yet, in the vast majority of cases,
individuals in social isolation have no access to mental healthcare. The only resource is people themselves
using self-help, self-medication and self-care. During prolonged COVID-19 isolation, an in-built system of
homeostasis can help rebalance activity, thought and feeling. Increased physical activity enables a reset of
physical and mental well-being. During periods of lockdown, it is recommended that exercise should be as
vigorously promoted as social distancing itself.
Keywords
communicable diseases, COVID-19 pandemic, exercise, mental health, needs, psychological homeostasis,
self-esteem
1UFSC, Brazil
2UDESC, Brazil
3Independent Researcher, France
Corresponding author:
Thiago Matias, UFSC, Campus Universitário Reitor João
David Ferreira Lima, Florianpolis 88040900, Brazil.
Email: thiago.matias@ufsc.br
925149HPQ0010.1177/1359105320925149Journal of Health PsychologyMatias et al.
research-article2020
Editorial
2 Journal of Health Psychology 00(0)
economic, social, scientific and in health care.
The epicentre of the COVID-19 outbreak moved
from China to Europe and a few weeks later to
the United States. As of 28 April 2020, there
were 3,050,308 confirmed cases including more
than 211,325 deaths have been reported world-
wide, affecting at least 201 countries, areas or
territories (Coronavirus COVID-19 Global
Cases by the Center for Systems Science and
Engineering (CSSE) at Johns Hopkins
University, 2020). Most cases are in the United
States (988,469 cases), followed by Spain
(229,422) and Italy (199,414) (Coronavirus
COVID-19 Global Cases by the Center for
Systems Science and Engineering (CSSE) at
Johns Hopkins University, 2020).
Owing to the absence of a prophylactic vac-
cine, official control measures have been imple-
mented to reduce the spread of COVID-19,
such as restrictions on people’s movements,
including social distancing, closing of gyms
and parks, travel restrictions, quarantines and
stay-at-home guidance. In China, some drastic
control measures substantially mitigated the
spread of the disease (Kraemer et al., 2020).
However, the popular policy of confinement
has significant health, economic, environmen-
tal and social consequences. In the psychologi-
cal sphere, recent evidence shows that similar
pandemics increased the prevalence of symp-
toms of post-traumatic stress disorder, as well
as confusion, feeling of loneliness, boredom
and anger during and after quarantine (Brooks
et al., 2020). Stressors during this critical period
include fear of infection, fear of death, uncer-
tainty, loss of social contacts, confinement,
inadequate information, conflicting advice, loss
of outdoor activities, disconnection from nature,
loneliness, depression, helplessness, anger, low
self-esteem, financial loss and obstacles to sup-
plies of food and water (Brooks et al., 2020;
Jiménez-Pavón et al., 2020; Xiang et al., 2020).
A survey in China during the initial outbreak of
COVID-19 found that 54% of respondents
rated the psychological impact of the outbreak
as moderate or severe, 17% reported moderate
to severe depressive symptoms, 29% reported
moderate to severe anxiety symptoms, and
8% reported moderate to severe stress levels
(Wang C et al., 2020). Given that a significant
proportion of the population live alone or are vul-
nerable to mental health problems, the impacts
of the COVID-19 pandemic on mental well-
being are only now just beginning to be felt.
In the light of the aforementioned issues,
systematic psychological self-care must be
given a high priority in coping with the detri-
mental impacts of COVID-19 and social dis-
tancing. Here, we discuss one of the most
fundamental tools of self-care for health
enhancement: increased physical activity.
Governmental recognition of the benefits of
exercise is evidenced by permitting exercise
outdoors during social isolation for indefinite
periods of weeks or months. Yet rarely is the
issue adequately addressed; an International
Task Force of experts to review and advise on
psychological and physical self-care would be
welcomed.
Consequently, during the COVID-19 pan-
demic special attention to systematic psycho-
logical health care is required by health care
staff and patients (Zaka et al., 2020; Zandifar
and Badrfam, 2020). Interventions to deal with
the pressing psychological needs of individuals
during the pandemic are being investigated but
in most parts of the world seriously lacking
(Wang Y et al., 2020; Xiang et al., 2020). One
example is physical exercise, which has been
observed to be one of the most important tools to
prevent mental illness and improve well-being
(Mandolesi et al., 2018). However, few public
health guidelines include daily physical exercise
routines for people living in varying degrees of
isolation during the pandemic (Chen et al., 2020;
Jiménez-Pavón et al., 2020).
Before discussing specific self-care meas-
ures to enhance ‘lockdown’ health, we briefly
introduce the psychological theory upon which
these measures are founded.
Psychological homeostasis
At every level of existence, from the cell to the
organism, from the individual to the population,
and from the local ecosystem to the entire
Matias et al. 3
planet, homeostasis is a drive towards stability,
security and adaptation to change. In a general
theory of behaviour claims that striving for bal-
ance and equilibrium is a primary guiding force
in all that we do, think and feel. A behavioural
type of homeostasis has been given the des-
criptive term: ‘Reset Equilibrium Function’ (or
‘REF’; Marks, 2018). The REF is thought to be
omnipresent, whatever we are doing and wher-
ever we are doing it, which includes the monot-
ony of COVID-19 isolation. When we are in
isolation, the REF stays with us, considers how
to restore equilibrium and reduce feelings of
unrest. The REF’s monitoring is not normally
attended to, but the REF’s products are feelings
of distress, boredom, loneliness and instability
can all be a focus for concern. Competing
drives, conflicts and inconsistencies all pull the
flow of thought and feeling ‘off balance’, trig-
gering an innate striving to restore equilibrium.
Individuals resort to a variety of methods to
restore a sense of balance and equilibrium.
Body and mind continuously regulate and
control many domains and levels simultane-
ously, with multiple adjustments to voluntary
and involuntary behaviour guided by two types
of homeostasis: Type I – inwardly striving or
physiological homeostasis, H[Φ], and Type II
– outwardly striving or psychological homeo-
stasis, H[Ψ]. Physiological regulation involves
drives such as hunger, thirst, sex, elimination
and sleep. The REF operates across all behav-
ioural systems that are investigated by psycho-
logical science.
The REF is a general control function that
automatically restores psychological processes
to equilibrium and stability. The REF is trig-
gered when any processes within a system
strays outside of its set range. The REF is innate
and exists in conscious organisms, which all
have Types I and II homeostasis. The two types
of homeostasis work in synergy. Psychological
and physiological processes operate in tandem
to maximize equilibrium for each particular set
of functions.
These include cognition, affect, chronic stress
and subjective well-being, and also out-of-
control conditions such as isolation, boredom,
addiction or insomnia that are in need of self-
care. When there is goal to make a behaviour
change, conscious awareness of the goal and
full engagement of one’s personal resources are
necessary preconditions for purposeful striving,
for example, the need to reduce boredom and
instability in COVID-19 isolation.
The needs hierarchy
Human experience is controlled by needs and
behaviours to satisfy needs. A general theory of
behaviour includes Maslow’s (1943) influen-
tial statement about human needs (with a few
minor modifications). It is assumed that needs
occupy a hierarchy of seven overlapping levels
(Figure 1). Like any hierarchical structure, the
stability of the system relies on the strength of
its foundation level. The first level – Immediate
Physiological Needs – incorporates physiolog-
ical homeostasis (Type I) and the sustenance of
all physiological needs. Higher level needs
from level 2 upwards are served by psychologi-
cal homeostasis (Type II). There is a progres-
sion in developmental priority as the individual
matures. The motivational hierarchy reflects
evolutionary function, developmental sequenc-
ing and current cognitive priority. Individuals
who are unable to meet their immediate physi-
ological needs at Level 1 are at a disadvantage
in meeting higher level needs. Think of a build-
ing with seven storeys. If Level 1 of the build-
ing is not strong, then the higher levels will be
vulnerable to collapse.
We consider next the likely impact of
COVID-19 social distancing in the light of the
hierarchy of human needs. We consider only
needs most directly impacted by social distanc-
ing at Levels 1–4, which we discuss in turn.
Immediate physiological needs (Level 1)
Physiological regulation involves the drives of
hunger, thirst, sex, elimination and sleep. Level 1
is a bedrock for all higher levels. We consider
first food, drink and other necessary products,
which have been an issue from the very start of
the pandemic with ‘panic buying’ and stockpiling
4 Journal of Health Psychology 00(0)
reported everywhere causing supermarkets and
stores to run out of supplies. In the United
Kingdom, in packaged food and beverages, the
highest growth has been evident in cereals (38%),
vegetables (37%), cocoa (25%), rice (22%) and
pasta (19%). There has also been an increase in
bottled water and indulgence foods, such as
chocolate (23%), olives (68%) and beer (20%)
(Kantar, 2020). Comfort eating and drinking is a
common strategy of individuals seeking ways to
ameliorate anxiety and distress associated with
lockdown. Comfort eating and drinking is associ-
ated with weight gain and the development of
obesity and eating disorders, especially in condi-
tions of isolation and boredom (Crockett et al.,
2015; Marks, 2015; Figure 2). Sadly, there is
likely to be an acceleration in the already high
prevalence of obesity over the lockdown period.
As the lockdown period is indefinitely extended,
with increasing joblessness and poverty, food
insecurity is likely to become a major concern for
many people.
A well-known and, to many, surprising
COVID-19 phenomenon has been the preva-
lence of toilet-tissue stockpiling (TTS). In the
United Kingdom, for the week ending 8 March
2020, the sales of toilet tissues rose by 60% year-
on-year (Kantar, 2020). Why should this be? In
fact, this behaviour is perfectly logical and in line
with the needs hierarchy where utmost priority is
given to needs at Level 1. TTS provides long-
term hygienic support to the necessary act of
elimination, which, during isolation, is more fre-
quent at home because people are unable to do it
at the workplace. Thus, TTS is consistent with
Level 1 of the hierarchy of needs.
Level 1 needs are automatically more com-
plex in cases of addiction to drugs, alcohol,
tobacco and other substances. If any of these
addictions are present, the entire needs structure
can be placed in jeopardy. In any case, disrup-
tion of sleep patterns is one prevalent conse-
quence of pandemic distress. A European task
force concluded,
Figure 1. The Hierarchy of Human Needs. Homeostasis operates at all seven levels. Physiological, or Type
I, homeostasis operates at Level 1. Psychological, Type II, homeostasis operates at Level 2 (self-protection)
and above. Reproductive goals are in the order they are likely to appear developmentally. Later developing
needs are overlapping with earlier developing needs. Once a need develops, its activation is triggered
whenever relevant environmental cues are salient. Reproduced from Kenrick etal. (2010) with permission.
Matias et al. 5
In the current global home confinement situation
due to the COVID-19 outbreak, most individuals
are exposed to an unprecedented stressful
situation of unknown duration. This may not only
increase daytime stress, anxiety and depression
levels but also disrupt sleep. Importantly, because
of the fundamental role that sleep plays in
emotion regulation, sleep disturbance can have
direct consequences upon next day emotional
functioning . . . Managing sleep problems as best
as possible during home confinement can limit
stress and possibly prevent disruptions of social
relationships. (Altena et al., 2020: 1)
It has been established that physical exercise
improves sleep for people of all ages (Flausino
et al., 2012; Reid et al., 2010; Yang et al., 2012).
We return to this later.
Need for self-protection (Level 2)
Self-protection needs during the COVID-19
pandemic are paramount. The World Health
Organization (WHO, 2020) and national gov-
ernments have required a lockdown of the
population with ‘social distancing’ and ‘stay-at-
home’ isolation. These policies have stoked fear
of death and infection while incentivizing indi-
viduals to carry out frequent handwashing,
wearing masks along with social isolation. The
advice to stay at home has been the main topic
of messaging from health authorities during the
pandemic.
An individual’s responses to COVID-19
lockdown are shown in Figure 3. In lockdown,
unmet self-protection needs become ‘normal’
and individuals experience systematic frustra-
tion of a deep-seated need to ensure protection
of self and their family. This high level of frus-
tration causes fear, anxiety and distress as
individuals feel incompetent to guarantee the
safety and protection of loved ones, family and
self. Fear, anxiety and distress are also associ-
ated with insomnia, irritability and aggression.
Especially, if an individual uses alcohol or
drugs to assuage their fears, aggression may
turn into physical violence to family members,
women, children and pets (Peterman et al., in
press). There are increases in the incidence of
homicides and suicides (e.g. Campbell, 2020).
Need for affiliation (Level 3)
The almost total cessation of full frontal face-to-
face affiliation outside of one’s domestic ‘bub-
ble’ is mandated by policies of home confinement
and ‘social distancing’. Connecting with others
normally helps individuals to regulate their
emotions, cope with stress, and remain resilient
(Williams et al., 2018). Loneliness and social
isolation, however, worsen the burden of stress,
and often produce deleterious effects on mental,
cardiovascular and immune health (Haslam
et al., 2018). Older adults, at the greatest risk of
severe symptoms from COVID-19, are also
Figure 2. Panel A shows the homeostasis system linking low self-esteem with negative affect, comfort eating
and overweight. Intervention to alter the dynamics of the system towards that shown in Panel B replaces
comfort eating with exercise designed to increase self-esteem and control weight gain (Marks, 2015).
6 Journal of Health Psychology 00(0)
most susceptible to isolation (Luo et al., 2012).
Intergenerational social support, self-esteem and
loneliness are all strongly associated with sub-
jective well-being (Tian, 2016). These effects
are not peculiar to older people. Even among
adolescents, loneliness is associated with physi-
cal inactivity (Pinto et al., 2019). Thus distanc-
ing threatens to aggravate feelings of loneliness
that likely will produce negative long-term
health consequences in many vulnerable people.
During the COVID-19 pandemic, the popula-
tion of people at risk is enormous. After the
lockdown period ceases, sadly mental health
services are expected to be overwhelmed.
People with unmet needs for affiliation at
Level 3 are also at risk of failing to meet needs
for status and self-esteem at Level 4.
Need for status/self-esteem (Level 4)
As noted, status and self-esteem needs are vul-
nerable if needs at Levels 1–3 are unmet. Failure
at Levels 1–3 accumulates with larger knock-on
effects as cumulative failure develops.
Furthermore, the pandemic is producing huge
increases in unemployment and poverty, vul-
nerability factors for lowered self-esteem and
social status (e.g. Goldsmith et al., 1997). Self-
esteem is associated with responses to success
and failure (Baumeister and Tice, 1985). Low
self-esteem also creates a vulnerability to
depression (Sowislo and Orth, 2013) and to
drinking alcohol (Hull and Young, 1983) – if
affordable. Self-esteem moderates the associa-
tions between body-related self-conscious emo-
tions and depressive symptoms (Brunet et al.,
2019). Self-esteem also appears to be an impor-
tant antecedent of the development of self-com-
passion (Donald et al., 2018).
From the above review, it can be seen that
COVID-19 lockdown has created a ‘perfect
storm’ of vulnerabilities that huge numbers of
people, and services, are ill-prepared to manage
with uncertain long-term consequences. What
solutions are available?
The role of physical activity
One underutilized tool that is freely available to
almost everyone can bring profound benefits if
applied systematically – regular physical exer-
cise. The impact of exercise is one of the most
powerful examples of regulation created by
homeostasis. Regular physical activity not only
has obvious physical benefits but significant
psychological benefits also. During COVID-19
isolation, exercise offers the capability to reset
body and mind to a state of equilibrium.
Figure 3. Behavioural systems at Level 2 of the needs hierarchy in COVID-19 lockdown. Panel A shows
a typical response early in lockdown for a person in self-quarantine. In panel A, fear and frustration are
accompanied by heightened surveillance of the external environment through TV news channels and social
media. Panel B shows a person who has adjusted to the self-quarantine. In panel B, fear and frustration are
replaced by self-compassion and empathy and surveillance is replaced by reaching out to others.
Matias et al. 7
There are the following two major aspects
of exercise: (1) the role of exercise in the
immune system through regular physical activity
(Campbell and Turner, 2018; Simpson et al.,
2020) and (2) the role of exercise in psychologi-
cal well-being (Mandolesi et al., 2018). However,
exercise is certainly no panacea. It must be
applied with caution by people with chronic con-
ditions. If a person has a heart condition, strenu-
ous physical exercise may put them at risk, or kill
them even (Keteyian et al., 2016). Also in some
chronic conditions such as ME/CFS, exercise
makes the majority of patients feel much worse
(Geraghty et al., 2019). However, if used safely
and appropriately, the majority of people can
quickly feel physical and mental benefits from
regular exercise.
Some significant effects of physical activity
can be explained by physiological mechanisms
(Lopresti et al., 2013). Exercise within the con-
text of psychological health promotion has also
been an active research area (Chekroud et al.,
2018; Curioni and Lourenco, 2005; Mikkelsen
et al., 2017; Tiggemann and Zaccardo, 2018).
Some researchers have focused on neurophysio-
logical mechanisms, which aim to identify the
positive outcomes of the relationship between
exercise and mental health (Eyre and Baune,
2012). Exercise is understood as a relationship
between intensity and frequency, and positive
outcomes are mostly based on which exercise
protocol will determine a better neurophysiologi-
cal response (Lopresti et al., 2013). Exercise is
recognized as a mediator of primary monoamine
neurotransmitters, namely, serotonin, noradrena-
line and dopamine. These three neurotransmitters
receive reciprocal regulation, while exercise
intensity modulates the stimulation of monoam-
ine system (Lin and Kuo, 2013). However, it is
also important to recognize the affective responses
of physical activities and psychological variables
are likely to mediate the relationship between
exercise and mental health (Rodrigues et al.,
2019). There is a sound empirical basis for an
integrated account of the emotional effects of
exercise. A recent study with a representative US
sample of 1.2 million individuals linked exercise
to mental health and exercising was associated
with reduced self-reported mental health burden.
Furthermore, motivation and mindfulness-based
techniques were discussed as mediators for these
relationships, which seemed to account for the
strongest effect of the exercise on fewer days of
poor mental health (Chekroud et al., 2018).
In the context of social isolation, exercise
can be an inherently rewarding activity that
contributes joy, happiness and satisfaction
(Ryan and Deci, 2017; Standage and Ryan,
2012). The positive outcomes also appear as a
function of affective consequences of exercise
or anticipation of its affective response – the
hedonic principle of the law of effect (Marks,
2018). In general, the expected pleasure versus
displeasure is a determining principle of the
motivation to repeat behaviour (Kwasnicka
et al., 2016; Williams, 2008).
Isolation and quarantine are a disagreeable
experience, which may lead to sadness and
even impose dramatic mental illness for those
who undergo it (Brooks et al., 2020). In this
context, a daily exercise routine can be crucial
to modulating pleasurable situations at some
point during the day. People can feel more
deeply satisfied through the experience of
choice and volition, reinforce their sense of
autonomy and competence, and renew a sense
of joy (Lubans et al., 2017; Ryan and Deci,
2017; Standage and Ryan, 2012).
The rationale for the positive side of exercis-
ing at home is that exercise can be experienced
without any strong social pressure, having a
totally internal source of inspiration. The behav-
iour might be accompanied by higher self-
esteem and lower psychological ill-being, since
people are free to choose the types of exercise,
schedule, frequency and intensity. The fulfill-
ment of basic psychological needs appear
within this context.
The benefits of exercise depend on the
degree of internalization of the behaviour. In
our daily lives, exercises are normally per-
formed in order to achieve goals, such as social
aesthetic standards (Sperandei et al., 2016).
These goals are separable from the purpose of
the exercise (a person may not enjoy exercising,
but will do it to obtain a result); and therefore,
8 Journal of Health Psychology 00(0)
people are generally not ‘authentic’. The lack of
authenticity represents a person doing an activ-
ity for contingent reward or punishment, feeling
tense and pressured, lacking intentionality and
being oriented to avoid guilt, angst and social
judgement or to protect contingent self-worth.
Contrarily, people are authentic when exercise
choice is aligned with personal goals, interest
and is assimilated with the individual’s charac-
teristics, ability and identity (Deci and Flaste,
1995). Identity is associated with ongoing posi-
tive experiences attendant on the behaviour
(Kwasnicka et al., 2016), such as exercising at
home.
Notably, the COVID-19 pandemic causes
fear and the lockdown imposes limits on peo-
ple’s movement (Brooks et al., 2020; Xiang
et al., 2020). Another helpful process is that of
self-compassion – the ability to treat oneself
with the same concern and support in distress-
ing situations; it is related to self-kindness,
common humanity and mindfulness. In fact, it
is associated with self-regulation when per-
forming health-promotion behaviours (Holden
et al., 2020; Semenchuk et al., 2018). Exercising
at home, in a crisis situation, can be performed
without self-criticism, which could hinder the pro-
cess by increasing pressure and self-judgement,
which in turn may provide adaptive coping,
problem-solving and psychological well-being.
Research has provided empirical evidence on the
positive relationship between self-compassion
and exercise (Holden et al., 2020; Semenchuk
et al., 2018), providing exercise maintenance
and enhancing positive emotions.
Thus, exercising at home can increase the
individual’s sense of control. Research suggests
that self-mastery is a crucial criterion for pro-
moting positive effects on psychological out-
comes (Mikkelsen et al., 2017; Ryan and Deci,
2017). In the face of this pandemic, we have
seen many examples across the world showing
that exercise can create a social arena in which
individuals learn social skills and build social
networks by adhering to exercise challenges,
exercising in condominiums and encouraging
others. These virtual social connections enhance
feelings of autonomy and being fully alive.
When autonomous forms of regulation guide
behaviour, positive affective responses are
expected (Ryan and Deci, 2017; Standage and
Ryan, 2012). One example is the QuaranTrain
launched at HAN University of Applied
Sciences in the Netherlands, an online fitness
programme promoting evidence-based infor-
mation on exercise and resources to stay active
during COVID-19 pandemic through blogs and
videos (HAN University of Applied Sciences,
2020). They provide daily online support,
according to World Health Organization advice
on physical activity. Users post their workouts
routines in social media using the trending
hashtags #quarantrain and #quarantraining,
with more than 5000 posts worldwide.
Being engaged in exercise may result in
higher levels of self-efficacy (Bandura, 1997)
which can have the knock-on effect of improv-
ing one’s ability to carry out other activities
(Mikkelsen et al., 2017). The relationship bet-
ween changes in the ability to perform activi-
ties successfully and increased self-efficacy is
fundamental, considering the observed associa-
tion between depression and low self-efficacy
(White et al., 2009). In the context of social
isolation, physical activity may be one key to
enhancing people’s feeling of competence. In
addition, achievement of internal goals and sat-
isfaction has been related to greater psychologi-
cal wellness (Ryan and Deci, 2017; Standage
and Ryan, 2012). This hypothesis has been con-
firmed by an experimental protocol in which
mindfulness self-efficacy appeared to mediate
the indirect effects of exercise on mental health
and perceived stress (Goldstein et al., 2018),
reinforcing the positive account of emotion for
a better quality of life (Joseph et al., 2014).
Moreover, we recommend that people in
social isolation should try to create peer support
through social networking services by involv-
ing friends and relatives in their exercise rou-
tines or challenges.
Mikkelsen et al. (2017) observed that exercise
influences self-esteem through self-efficacy or
mastery, and mood, distracting individuals from
negative and worrying thoughts and rumination,
improving the retrieval of positive thoughts and
Matias et al. 9
allowing time away from negative or stressful
aspects of everyday life, and especially, the
COVID-19 pandemic itself. These moderating
factors might also explain the protection effect of
exercise on mental health (Mikkelsen et al.,
2017). Physical activity programmes to improve
self-esteem to people of all ages can be effec-
tively delivered at home by DVD (e.g. see Awick
et al., 2017).
Conclusion
The negative impacts of COVID-19 lockdown
on mental health can be ameliorated by the use
of exercise, which should be as vigorously
promoted as social distancing itself. The suc-
cess of social isolation policies will depend on
minimizing long-term depreciation of mental
health. In this context, keeping moving seems
to be the key.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of inter-
est with respect to the research, authorship, and/or
publication of this article.
Funding
The author(s) received no financial support for the
research, authorship, and/or publication of this
article.
ORCID iDs
Fabio H Dominski https://orcid.org/0000-0003-
1767-6405
David F Marks https://orcid.org/0000-0002-4096
-2883
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