- COVID-19 safety precautions and their enforcement can vary widely at different gyms in different areas.
- Health experts advise against working out at indoor public gyms at this time.
- Instead, experts suggest exercising outdoors or virtually to reduce your transmission risk.
Avid gym-goers may be wondering: Even when safety guidelines are followed to the letter, is it really safe to attend indoor fitness centers and exercise classes during the pandemic?
Multiple outbreaks of COVID-19 have been linked to fitness facilities since the pandemic started, including dozens of cases linked to a fitness center in Chicago, Illinois.
In the latest issue of the Centers for Disease Control and Prevention (CDC)’s Morbidity and Mortality Weekly Report (MMWR), officials from the Chicago Department of Public Health shared findings from their investigation into the outbreak.
“I think this report really highlights what many of us already assumed in the first place: exercising in an indoor facility during a pandemic like COVID, especially with high-intensity activities, is a major risk,” said Dr. Keri L. Denay, the medical director of Briarwood Family and Sports Medicine and an assistant professor at the University of Michigan Medical School in Ann Arbor. Denay wasn't involved in preparing the report.
The Chicago fitness facility temporarily shut down on Sep. 1 after learning that one of its patrons had tested positive for the virus that causes COVID-19.
Investigators later found that 55 out of 81 people who attended high-intensity exercise classes at the facility from August 24 to September 1 developed confirmed or probable COVID-19.
Patrons wore masks ‘infrequently’
At the time of the outbreak, the fitness facility was running 4 to 8 high-intensity indoor exercise classes per day.
Class sizes were limited to 25 percent capacity. Patrons brought their own mats and weights to classes, where they were positioned at least 6 feet apart.
The facility also required mask use, temperature checks, and symptom screening when patrons entered the facility. However, patrons were allowed to remove their masks while exercising.
“I think the biggest error, and it's still done in some places, is requiring masks when you enter the facility and then allowing people to take them off when exercising,” Denay told Healthline.
“That makes absolutely no sense. If you put individuals into a high intensity activity where you're huffing and puffing, that only exacerbates things,” she continued.
Most of the facility’s patrons told investigators they infrequently wore masks during classes. Mask use was less common in patrons who developed COVID-19 than those who didn't.
Heavy breathing adds to spread
In another investigation published in the same issue of MMWR, health officials in Hawaii linked 21 cases of COVID-19 to two fitness instructors that taught classes shortly before testing positive for the virus.
Even when people stay 6 feet apart while exercising, that doesn’t appear to be enough to stop virus transmission.
“It is becoming more evident that 6 feet of distancing alone is inadequate as a means to reduce transmission when unmasked people are exercising in enclosed environments with poor or inadequate ventilation,” said Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City.
“Rapid and sustained breathing for prolonged periods of time increases the risk of viral spread by aerosols, which can remain in a room up to 3 hours, particularly in poorly ventilated settings,” he added.
Strategies to reduce the risk
To limit the spread of the virus at fitness facilities, the authors of both MMWR reports emphasize the importance of wearing face masks, physically distancing, and proper ventilation.
They advise patrons and staff to wear masks, even when they’re maintaining distance from other people and exercising at high intensities.
It’s also important for patrons and staff to isolate at home if they develop symptoms of COVID-19, test positive for the virus, or are waiting for test results after possible exposure to the virus.
“A few things are quite clear — it’s vital that all patrons be masked while exercising, adequate ventilation be in place to reduce risk, and staff and patrons who are ill or at risk should not come to the facility to work out,” said Glatter.
Forty percent of patrons who tested positive for the virus in the Chicago outbreak attended exercise classes on or after the day when their symptoms began.
Finding creative alternatives
While certain precautions may help reduce the spread of the virus in fitness facilities, “exercising outdoors or virtually could further reduce SARS-CoV-2 transmission risk,” write the authors of both MMRW reports.
“My personal opinion as a physician, at this point in time, is that it's not the right time to return to fitness facilities,” Denay said.
“I want to support our fitness facilities in every way that I can, but the health risks of returning are very real,” she added.
In a call to action issued by the American College of Sports Medicine, Denay and co-authors write that creativity is “crucial” for finding ways to stay active — especially for people who live in crowded areas or neighborhoods where the outdoor environment isn’t safe for exercise.
For one of Denay’s patients, getting creative has meant reviving an old VHS player and collection of exercise tapes. People with home internet access may find a variety of fitness videos on YouTube and other sites.
When people have access to safe outdoor spaces, those offer another alternative to hitting the gym.
“Go for a walk. Go for a bike ride. Go snowshoeing,” suggested Denay.
Exercising outdoors may help you maintain plenty of distance from other people. Wind currents also help disperse saliva droplets and aerosol, cutting your risk of exposure to the virus.
Even so, Glatter still recommends wearing a mask while exercising outside.
“It’s still advisable to wear a mask — even if you will be exercising outdoors and more than 6 feet apart from others. It adds an ‘additional layer’ to further reduce transmission,” he said.
“Neck gaiters made with polyester and spandex, while more comfortable, have not been found to be as effective as masks in reducing escape of droplets,” he added.