Global daily step counts remain significantly lower than pre-pandemic levels

Key takeaways:

• Despite global physical activity improvements after the first phase of the COVID-19 pandemic, the stretch of peak daily step counts from May 2021 to November 2021 was still 10% lower than that same period in 2019.
• Availability and pace of vaccinations, differing COVID-19 protocols, changing views on social distancing, and the timing of outbreaks could all play a role in the varying levels of recovery made in step counts by continents.

New data show global step counts decreased heavily in the early phase of the COVID-19 pandemic compared with pre-pandemic counts and continue to remain below average, even after 2 years since the pandemic began.

“As the global pandemic persists despite vaccines, understanding its long-term ramifications on physical activity — an important determinant of health — is crucial, and might help to inform public health and regional policy decisions,” Geoffrey Tison, MD, MPH, a cardiologist and an assistant professor in the division of cardiology at the University of California, San Francisco, and colleagues wrote in the Lancet Global Health.

Utilizing a health-wellness smartphone app called Azumio Argus, the researchers collected deidentified, individual data from 1,255,811 users in 200 different countries and territories from Jan. 1, 2019, through Feb. 17, 2022. Overall, 730,738 of unique users were in North America, while Asia possessed the second-most unique users at 237,172.

During that time, 140,424,429 daily step counts were measured through smartphone accelerometers, as well as Apple and Android algorithms for step counting.

Tison and colleagues found that the time between May 2021 to November of 2021 showed the greatest uptick in step counts, with 4,997 per day, though that total remained 10% lower than the period between May 2019 to November of 2019 (5,547 steps per day).

North America saw the highest step recovery in that timeframe, with a 4% lower than baseline count, followed by Europe (14% lower than baseline). The lowest recoveries include South America (29%) and Asia (30%).

Individually, the United States recovered to 97% of the pre-pandemic baseline from May 2021 to November 2021, typically averaging over 5,000 daily steps per day, “although the USA had relatively lower pre-pandemic step counts,” Tison and colleagues noted.

Notably, the median daily step count low point of the omicron variant surge in January— that resulted in over 23 million cases globally the week ending Jan. 24, per WHO — was less severe than that of January 2021, despite a year-over-year change of 20 million cases in that week.

Limitations to the study included variability in user composition and app pattern usage over the course of the study, as well as smartphone measurement errors. Additionally, the researchers were unable to adjust their analysis for sampling bias of upper socioeconomic status due to the reliance on smartphone app ownership and widespread iOS usage — which 92% of participating smartphones utilized.

“Given the limitations in our available data and study approach, these results require validation in future studies using less biased data sources,” Tison and colleagues wrote.

According to the researchers, the wide disparity between continents in building up post-pandemic step counts suggests differing COVID-19 protocols play a role.

“Patterns of step count recovery appear to reflect regional differences in the timing of COVID-19 infection surges, and might also correlate with changes in regional social distancing policies,” they said.

Tison and colleagues additionally proposed that varying paces of physical activity recovery could be the result of availability and rates of COVID-19 vaccinations. Worldwide, 63.1% of the population (more than 4.9 billion) is fully vaccinated, according to Our World in Data, a scientific publication produced by researchers at the University of Oxford.

References:

• Coronavirus (COVID-19) vaccinations. https://ourworldindata.org/covid-vaccinations. Accessed Aug. 31, 2022.
• Tison G, et al. Lancet Glob Health. 2022;doi:10.1016/S2214-109X(22)00361-8.
• WHO coronavirus (COVID-19) dashboard. https://covid19.who.int/. Accessed Sep. 1, 2022.