When Can Mask Restrictions Ease for Gym Members?

As more Americans become fully vaccinated and cases begin to decline in many regions, some fitness centers are wondering when they can start to allow members to exercise without face coverings. Some states have removed all restrictions, leaving the decision up to businesses, while others still have mandates in place. The CDC has been slow to ease mask recommendations in any indoor setting, and has only just eased them outdoors for those who are fully vaccinated.

Removing outdoor mask mandates has gained much more traction recently, given evidence that transmission is much more likely indoors, with experts in the Atlantic, Wall Street Journal, and other media discussing the merits of easing outdoor mask wearing. Many policymakers are likely grappling to balance the limited evidence available with evolving public sentiment.

States who have not removed restrictions have begun outlining their timelines for doing so - for example, Rhode Island will lift most by Memorial Day, and Massachusetts will return to almost normal by August 1. However, neither state removes indoor mask requirements even as all other restrictions are removed. In states with restrictions still in place, mask wearing is close to last on the list of restrictions to ease.

However wearing a mask inside a gym is a different issue from universal mandates for places like the grocery store, movie theaters, and crowded concert venues. We know crowded, poorly ventilated indoor spaces (like parties or sports arenas) are high risk. We know outdoor, non-crowded spaces are relatively safe. Less is known about clubs specifically, but available evidence suggests clubs with good ventilation and other safety measures are relatively low risk venues for COVID-19 transmission. The question is: what does this mean for mask policies in gyms?

Mask wearing is still relatively popular, and effective

Given the CDC’s most updated guidance, it is clear the public health community is not ready to recommend an easing of widespread mask use. Part of the reason is that it is fairly easy to find data that masks work. It's harder to find evidence that their benefit is negligible, or that they have become redundant.

As far as the pandemic goes, the U.S. is currently at a crossroads, where more contagious variants are increasing as a proportion of infections at the same time as more and more people are getting vaccinated. We are in a race to get a large number of people vaccinated before cases can increase again, and while the signs are good, we are not at the finish line.

Mask Requirements May Discourage Returning to Exercise, Especially in Gyms

While it is safe for most people to exercise, even at higher intensities, with face coverings on, many still find doing so uncomfortable. Given the importance of physical activity for physical health and mental health, and the evidence that physical activity may be linked to lower odds of severe COVID-19, policies should make it as easy as possible for people to start or resume physical activity. This includes allowing people to exercise without face coverings when the evidence suggests it is safe to do so. In fact, the WHO recommends against exercising in a mask, advising “even when you’re in an area of COVID-19 transmission, masks should not be worn during vigorous physical activity because of the risk of reducing your breathing capacity. No matter how intensely you exercise, keep at least 1 metre away from others, and if you’re indoors, make sure there is adequate ventilation.”

Data Points to Consider

When is it safe to do so? A few key metrics can help elaborate.

1. COVID vaccination rate. As the proportion of people who are partially and fully vaccinated increases, the argument for easing restrictions, including masks in gyms, gets stronger. Especially considering the proportion of high risk individuals - those older than 65 and with chronic health conditions - is likely already high. As of this writing, 30% of Americans over 18 and 68.4% of adults over 65 are fully vaccinated.

2. COVID case numbers. The case for easing mask requirements in gyms will be stronger when cases are falling and COVID-19 test positivity rate - the percent of COVID-19 test results that return a positive result - is low. A small percentage of positive test results indicates lower community spread. The WHO recommended a percent positivity rate under 5% before governments reopen, and according to COVID Local, ideally before returning to normal, the test positivity rate is 1% or lower.

3. Fitness center specific outbreak data. Several reports got a lot of media attention in January describing outbreaks in fitness centers earlier in the pandemic. However, state level outbreak data indicates health and fitness centers represent a very small proportion of total outbreaks. Data demonstrating a low number of outbreaks in clubs in your state can contribute to the case for easing face coverings during exercise.

4. Other aspects of the fitness center space that influence risk. These include ventilation and square footage. While having a mask policy continues to be an important safety protocol, a number of other factors inform the safety of a health and fitness center. Scientists from MIT have developed an app that can help business owners, including club operators, understand the different modifiable factors in their facility that can impact COVID-19 safety, and the impact these adjustments can have on risk.