Play and playfulness for health and wellbeing: A panacea for mitigating the impact of coronavirus (COVID 19)

In the early part of 2020, the coronavirus pandemic challenged human sociability as social distancing measures were introduced in an attempt to break ‘the chain of infection’. A central component of human sociability is our innate ability to play and be playful, individually or together, for our own enjoyment or for the benefits of others. This article explores the adaptive benefits of play and playfulness for health and wellbeing, at a time when community assets such as family, friendships, neighbours and community groups are physically inaccessible as we abide by the UK government requirement to Stay at Home, Protect the NHS, Save Lives. Using the Five Ways to Wellbeing, numerous examples showing how people have been able to ‘connect, be active, take notice, keep learning and give’ during the coronavirus crisis, exemplifies the transformative power of play and playfulness and the best of human endeavour.


Introduction
When this article was originally submitted in the early part of 2020, a global pandemic had just been declared by the World Health Organization. In the United Kingdom, restrictions on livelihoods, routine movement, access to public services and liberty, all seen as fundamental to our normal way of life, presented challenges that could not have been imagined at the turn of the year. Although efforts were made to ensure that basic needs linked to income, homes and security were being safeguarded by national governments, there were justifiable concerns for the health and wellbeing of large sectors of the population, as the emergency deepened and the juggling of work, life and family commitments changed in response to the coronavirus crisis (Stephens, 2020). G€ oncü and Vadeboncoeur (G€ oncü & Vadeboncoeur, 2017) remind us that 'experiences mean something in the moment, and this meaning evolves and changes over time and in relation to others'. As the pandemic extends into a second year, our understanding of, and responses to, this unprecedented crisis are in constant flux. Any social commentary can therefore only ever be a reflection on one moment in time.
Humans are known as the mammalian bee due to the similarity of the two species' complex sociality, which has emerged as an evolutionary survival response (Public Library of Science, 2016). Sociality exemplifies the benefits of living together in groups, providing a safe environment in which we help one another to thrive and grow. From the primitive, nomadic lifestyle of early humans to the complex, interwoven communities that characterise life today, humans require a high level of social interaction (Stenros et al., 2009).
A central component of human sociability is our innate ability to play and be playful; as children and adults, as individuals, families and communities (Stenros et al., 2009). De Koven (De Koven, 2017 states that 'so much of what we call fun, happiness, joy comes to us when we let ourselves connect to something larger: family, community, planet'. In this context, community approaches to health and wellbeing explicitly identify the role of 'community assets' such as friendships, neighbours, local groups and community associations, facilitated through the public, private and voluntary sectors (Public Health England, 2018). The benefits of community life and social connections are integral to health and wellbeing and are known as important facilitators of public health (Whitaker et al., 2019a). A lack of social connection is bad for physical and mental health and 'loneliness increases the likelihood of premature mortality by 26%' (Pubic Health England, 2018).
The advent of new mutations of COVID-19 with greater transmissibility has forced the UK into a further extended lockdown (Kupferschhmidt, 2021), increasing concern around the detrimental impact on mental health. For many people, one of the most distressing features of the coronavirus response remains the need for strict social distancing (Winder & Shaw, 2020), which contradicts everything that drives us as a social species. As humans have evolved, so has our ability to manage social interactions and, at a time when we want to come together, we are being urged to stay apart. The National Health Service (NHS) is promoting a simple message that challenges our primal instincts -Stay at Home, Protect the NHS, Save Lives. This has become the mantra by which we must all abide and, linked to the sentiment We are all in this together, physically distancing means that everybody can contribute to the current situation in one way or another (Department of Health & Social Care, 2020).

The adaptive benefits of play and playfulness
Ackerman (Ackerman, 1996) suggests 'for humans, play is a refuge from ordinary life, a sanctuary of the mind, where one is exempt from life's customs, methods and decrees', while the World Economic Forum (World Economic Forum, 2018) ask 'Can play save the world?' Both these assertions support a substantial and growing evidence base that demonstrates the importance of play and playfulness as positive contributors to human experience, facilitating psychological health and individual wellbeing (Lockwood & O'Connor, 2016). Maslow, who is synonymous with the concept of self-actualisation through the fulfilment of basic needs, listed playfulness as a 'being value', necessary for reflecting on the way the world appears and allowing us to freely express our authentic selves (Maslow, 1970). This reflects a world view of play 'as a vehicle to enliven the human spirit and promote optimal development' (University of Alberta and pl, 2021).
Play is complex and hard to define due to the range of activities and contexts in which it occurs (Lockwood & O'Connor, 2016) and defining play 'may lie in the experience of the player or within the characteristics of the play itself' (Whitaker et al., 2019b). The value of play is being increasingly recognised for adults as well as children, and is associated with characteristics such as fun, challenge, flexibility and uncertainty (Play Scotland, 2021). Defined by Play England (Play England, 2020) as 'what children and young people do when they follow their own ideas and interests, in their own way, and for their own reasons', play is often commonly defined as intrinsically motivated, pleasure seeking and open ended with no fixed outcome (G€ oncü & Vadeboncoeur, 2017). However, research demonstrates differences in play across cultures, with variations in expectations linked to activity, participation and sociocultural perspectives (G€ oncü & Vadeboncoeur, 2017). Canella and Viruru (Canella & Viruru, 2004) contest the dominant, cultural construction of play, questioning the role of pleasure as a motivator; a view which corresponds with recent research demonstrating affective experiences of play can be enjoyable and troubling for children and adults alike (G€ oncü & Vadeboncoeur, 2017). This has been seen during the pandemic, which has highlighted social discrepancies in access to opportunities for play and playfulness, whilst also generating new evidence of the ways in which creativity and culture can be used to support the most vulnerable members of society (Culture, Health and Wellbeing Alliance, 2020).
De Koven (De Koven, 2014) describes playfulness as a gift that 'allows you to transform the very things you take seriously into opportunities for shared laughter.' Humour, a character strength that provides meaning and connection with other people, offers an excellent example of the transformational potential of play and playfulness. Humour has been utilised by the medical profession for centuries as an effective means of communication (Parums, 2015) and, in the current climate of fear and anxiety generated by the coronavirus pandemic, playfulness is being used as a recognised coping strategy to frame and re-frame situations during times of stress and emotional distress (Lockwood & O'Connor, 2016). As Dean (Dean et al., 2003) states 'Humour…has considerable merit in providing a means of access to otherwise inaccessible territory. As well, its power to transform the moment is too vital to be ignored'.
At a societal level, prolific examples of play-related responses to the impact of the coronavirus crisis abound, as exemplified through social media which is enabling people to share their lived experiences through platforms such as Twitter, Instagram, Facebook, YouTube and TikTok. An informal review of the literature paints a diverse picture of creativity and innovation across age and cultural groupings, and this is often associated with the adaptive and flexible nature of play, across cultures and age. The remainder of this article captures just a few examples of how play and playfulness are manifest in the societal response to the coronavirus crisis in the UK, framed in terms of the Five Ways to Wellbeing, a set of evidencebased public health messages aimed at the general population (New Economics Foundation, 2011).

Five Ways to Wellbeing
In 2008, the Foresight Project on Mental Capital and Wellbeing completed a large-scale government review around positive mental health with the intention of providing future public health messages. Foresight commissioned the New Economics Foundation (NEF) to create a similar promotional message to the popular 'eat five portions of fruit and vegetables a day', which helps to maintain good physical health (New Economics Foundation, 2011). The NEF developed five key messages that reflect positive behaviours known to improve people's mental health and wellbeing.
The Five Ways to Wellbeing are:

Connect
Be active Take notice Keep learning Give Since the inception of the Five Ways to Wellbeing, the model has been used by individuals, groups, communities and organisations to create policies and strategies for directly and indirectly promoting wellbeing both nationally (New Economics Foundation, 2011) and internationally (Mental Health Foundation, 2018). For example, in New Zealand, research with Maori communities has identified that doing activities as part of a family is more beneficial to personal wellbeing than engaging in individual pursuits (Mental Health Foundation, 2018).
Public Health England (Public Health England, 2018) promotes the role of social prescribing by medical practitioners for addressing the holistic needs and development of patients, with many of the featured activities underpinned by play based strategies linked to leisure and recreation ( Fig. 1). All can be linked to at least one of the Five Ways to Wellbeing. Although the NHS (NHS, 2019) identifies that reliance on technology and social media is not ideal, online technology has been at the forefront of facilitating connection, particularly for those who are vulnerable and being 'shielded' by the rest of society to protect them from coronavirus (Culture, Heatlh and Wellbeing Alliance, 2020). In some instances, carers have been able to use their mobile devices to enable families to engage with loved ones through platforms such as Facetime, allowing visual contact with elderly relatives. For those facing social isolation through lack of access to technology due to hospitalisation, #TabletswithLove has called upon manufacturers and retailers of digital tablets to donate 100 tablets each to the NHS or care homes, to enable families to connect with patients or residents through video messaging platforms (Helpforce, 2020). 'Seeing a loved one's smiling face is akin to having them hold your hand during this madness. Nobody needs to be alone. Let's connect the nation' (Helpforce, 2020).
However, there is no doubt that pre-existing inequalities in access to digital resources (for social communication and play) have been laid bare by the pandemic. The digital infrastructure in the UK has provided a platform for continued integration and socialisation during lockdown, yet nine million people are digitally excluded (Howarth, 2020), heightening the potential consequences of social isolation. Projects such as Butterflies, a charity in the North East of England, uses volunteers to make telephone calls twice a week to people with dementia (Culture, Health and Wellbeing Alliance, 2020), providing one example of an alternative community initiative for reducing the impact of isolation.
Many religious rituals and celebrations contain playful elements (Lockwood & O'Connor, 2016;Whitaker et al., 2019c) e.g. the Spring Hindu festival of Holi, known as the 'Festival of Colour' (Tonkin et al., 2016). It is notable that seasonal festivals such as Christmas, Easter and Passover, which are characterised by families coming together, have moved online (Carman, 2020). Many churches continue to livestream services through YouTube channels and Facebook Live, which has unexpectedly broadened attendance, bringing connectivity to audiences who might previously have had difficulty attending services. For Jewish families, Zoom has provided an alternative format for Rabbis to host a first night seder during Passover, which may also be accessed by Jewish care homes throughout the UK (Carman, 2020). According to guidance from The Muslim Council of Britain (Muslim Council of Britain, 2020), Eid Al-Fitr, a time of great celebration around the world which marks the end of Ramadan, should be shared 'from home, and virtually with friends and family', with gifts being exchanged by post instead of in person. The iconic Diwali celebrations in Leicester also moved online in November 2020, with religious elements being performed alongside Indian dances, drum and bass performances, story-telling and a virtual switching on of lightsbilled as an experience that could be shared with family or friends 'wherever they are in the world' (Patel, 2021).

Do what you can. Enjoy what you do. Move your mood (Mental Health Foundation, 2018)
Getting active is difficult at the best of times and in the UK people are 20% less active today than in the 1960's (Public Health Matters, 2016). Advice around physical exercise emphasises enjoyment as central to maintaining physical activity on a long-term basis and, in this context, play can transform physical exercise into a fun activity. This can include entertaining others, as demonstrated by the Stockport Spider-Men who undertake their daily run in fancy dress (BBC News, 2020) or individuals facilitating socially distanced communal dance sessions for their local neighbours (Murray, 2020). The Ramblers Charity have launched a campaign called #RoamSweetHome, stating 'We might have hung up our walking boots for now, but our rambling spirit and sense of fun is going strong' (Ramblers, 2020a(Ramblers, , 2020b. Accepting the challenge to increase their step count from the comfort of their home by climbing Ben Nevis (8180 steps, 587 flights of stairs) or walking the South Downs Way in 30 days (7000 steps a day) (Ramblers, 2020a(Ramblers, , 2020b, people are posting pictures of themselves on Twitter, in many instances wearing full walking equipment in their own homes. Promoting physical activity from an early age is known to influence how active children will be as they grow into adulthood, yet many parents struggle when it comes to optimising physical activity opportunities (Ha, Ng, Lonsdale, Lubans, & Ng, 2019). Joe Wicks, through his well-established YouTube channel 'The Bodycoach TV', got the nation moving through his 'PE with Joe' sessions which were livestreamed every morning at 9am. These 30-min sessions were primarily aimed at children but can be enjoyed by the whole family and, on March 24, 2020, Joe set a new Guinness World Record for the most viewers for a fitness workout live stream, with 995,185 people working out together (The Body Coach, 2020).

Take notice
3.1.3. Remember the simple things that give you joy (Mental Health Foundation, 2018) One of the unintended benefits of social distancing has been the opportunity to spend time engaging with nature (Jones, 2020), exemplified by #Nature4Mind. Benefits include lower stress levels and increased feelings of calm, paying better attention to the world around us, as well as a welcome boost to the functioning of the immune system (Jones, 2020). Nature provides a rich 'natural playscape' and play in nature is perceived as being more interesting, relaxing and fun, while enhancing family relationships (Whitaker et al., 2019a). Simple games such as I-Spy or a scavenger hunt can turn the 'daily exercise walk' into a more playful experience, especially when the novelty begins to wear off. The flexibility of play in response to the environment, be it green space or urban streets, enables play to flourish (Whitaker et al., 2019a) at a time when organised sport and games played with others are not permitted outside of the shared home environment.
Not everybody will have direct access to outdoor environments, so organisations such as Kew Gardens are providing 'Inspiration for Isolation' (Kew Gardens, 2020). From virtual tours of the gardens, creating botanical art or playing games and completing challenges, the website provides numerous links to enable people to 'wallow in nature' from the comfort of their own home.
Similarly, the beneficial impact of reminiscence can evoke feelings of peace, connection and a sense of belonging. In 2017, The National Trust (National Trust, 2017) published findings demonstrating that images of places which have a personal association can elicit the same strong emotional responses as those elicited by the experience itself. Happy memories are often linked to a sense of place and reviewing and sharing family photos can revive positive emotion whilst stimulating conversation and connection between generations. Social media platforms such as Facebook help to share memories through features such as 'On this Day' which provides photos from the past, sharing them amongst people who have been tagged in the original image.
A playful means of connection that also encourages taking notice, has been the placing of objects in windows, which can be observed while undertaking permitted daily exercise. In the UK, children were originally encouraged to draw or paint pictures of rainbows, a symbol of hope, to show their support for the NHS. This has now evolved into an ambitious project to make the UK a giant art gallery, with a call for people to display homemade art in their windows or walls to cheer people up, with a new theme every fortnight: 'the doors to our collections and galleries might be shut but our imaginations are forever open' (Positive.News, 2021).  (Mental Health Foundation, 2018) For essential workers, who find themselves working for longer, in more concentrated periods of activity, the need for rest and relaxation is paramount to maintain levels of wellbeing that will sustain them during these difficult times. For others, the current social distancing requirements have denied many people the opportunity to work, whilst freeing up time that would have normally been spent engaged in activities outside the home. For some, this is the perfect time to try new hobbies or engage with unexpected opportunities that have arisen as a result of the lockdown.
In 2017, the importance of the creative arts for health and wellbeing were clearly identified in a comprehensive, evidence-based report by the All Party Parliamentary Group on Arts, Health and Wellbeing (All Party Parliamentary Group, 2017). Within the report, quotes such as '… everyone is creative and that doing art and writing can be surprising, meaningful, challenging, playful, absorbing, reflective and exciting' provides testimony to the role of play. Fig. 1 identified a range of activities that can now be accessed through online platforms, which are generally free to access (FutureLearn, 2020).
You Tube hosts tutorials enabling viewers to learn to play musical instruments, develop crafting and needlework skills, try out new ways of cooking, explore painting through different media and techniques. For those who would rather learn in the role of spectator, some of the world's greatest tourist attractions, iconic museums, theme parks, zoos and aquariums from around the world can be visited through virtual tours (Bourque, 2020;The British Museum, 2020). Performances of renowned stage show musicals and plays are being aired for free on newly created channels, to enable people to have a 'sense of occasion' as they 'attend' a virtual evening out at the theatre (The Show Must Go On!, 2020). For many, these will be new experiences, that open up a whole new cultural world that can be explored in reality in the future.
It has been suggested that many Arts organisations have prioritised digital content, excluding people with little or no access to the internet (Fun Palaces, 2020). Tiny Revolutions of Connection is an initiative of the Fun Palaces organization which provides creative activity packs to those without internet access, extending the reach of creative interventions. Art Drop, delivered by the Creative Learning Guild (Culture, Health and Wellbeing Alliance, 2020) also acknowledges the impact of limited internet access, delivering creative activity packs to 'boost wellbeing for the most vulnerable children', noting how tailored art activities can benefit those living in 'chaotic and stressed households'.

Give
3.1.5. Your time, your words, your presence (Mental Health Foundation, 2018) Since its inception in 1985, Comic Relief has raised over £1.3 billion for charity. With a mission to create a 'Just World Free from Poverty', the most visible fundraising activity is the annual Red Nose Day (Comic Relief, 2021a). Members of the public undertake playful and creative fundraising events and activities in their local communities prior to the event and can demonstrate their support by purchasing and wearing themed red noses. The event culminates in an evening of televised entertainment that combines comedy sketches, performances and video clips showing how money raised has been spent on community projects in the UK and abroad. This year has the strap line Funny is Power and in the promotional video launching the event, the British actor Benedict Cumberbatch states 'I think laugher is a panacea. It is, and has always been, a national medicine. I think people reached out for it in lock-down…it was comedy rather than tragedy that the people went for' (Comic Relief, 2021b).
Play and playfulness has been at the heart of our collective response to the global pandemic. The coronavirus has demonstrated the best in human nature, as people from all walks of life have come together to offer support, encouragement and hope to one another in a time of national crisis. From small random acts of kindness by individuals, to organised charitable ventures, people have given of themselves freely. From a resident leading Zumba classes outside a block of flats, and a 5 year old child becoming a pen-pal with a 93 year old neighbour (Rice-Oxley, 2020) to the Royal Mail Postie who delivers the post in fancy dress (Reuters, 2020). All of the examples featured rely on people giving of themselves. From children putting pictures of rainbows in windows to brighten up neighbourhoods, to people chalking games such as Hopscotch or activity courses on pavements for others to play. Professional and amateur comedians, actors, performers, musicians, sporting performers, artists, knitters, quizzers, crafters and gardeners have recorded, posted and uploaded online content for others to enjoy and engage with. How apt that our basic innate predisposition to play is helping us to fulfil the requirement to stay at home.

Conclusion
Just as the coronavirus has evolved, so has human sociality. Our playful responses to this crisis have shown the best of human endeavour, demonstrating creativity and innovation in an effort to stay connected in these extraordinary times. Play may not be the panacea for all the woes that the global pandemic has imposed on the world, but as Comic Relief suggests 'this year it's never felt more important to have some fun…we need the power of funny to turn laughs into lasting change' (Comic Relief, 2021c).