By Michael Stack
Exercise Physiologist & CEO
Applied Fitness Solutions
If you haven’t read What the Fitness Industry isn’t saying about COVID-19 you may want to take the time to do so. It will provide good context for this article.
As a frequent gym-goer, you might be wondering what you should do, and how you should consider the risk associated with going back to the gym. Maybe you’re a gym owner, manager, or employee at a gym. You might be wondering how can I maximize the safety of my members, while at the same time propagating health and fitness that is so vital to the betterment of society? I don’t claim to have all the answers (or even all the considerations). I do want to provide a perspective lens through which we all—members and industry officials alike—can make decisions in the best interest of “do[ing] no harm.”
Like many of the cost-benefit analyses we’re doing with regard to returning to “normal” life, there isn’t a straightforward answer. I’d ask you to objectively and dispassionately consider the evidence and your own life circumstances, such as your health and the health of those you live with, and make your decision based on that. Keeping that in mind, I’m a list guy, and I feel that statement is not very instructive, so I do aim to provide some more precise considerations below. Nothing I say abdicates your personal responsibility to conduct your individual cost-benefit analysis; I merely wish to provide you a starting point with some context for that analysis. Right now, based on the evidence (and relative lack of understanding of this novel virus) I’ll propose a binary hierarchy that seems appropriate: high risk and moderate risk. I use this hierarchy largely because even if the risk to you individually is low, the risk of infecting others you live with (or in society) who are more vulnerable makes even low risk individuals a greater risk (to others) as a result of the dynamics of a pandemic.
High Risk
I’ll start with where there are the clearest indications of being very cautious with returning until there is a vaccine, robust therapeutics, or the virus has otherwise abated: the high risk category. If you are over the age of 60 years old, you have any chronic health condition (particularly diabetes, cardiovascular or pulmonary disease), or any disease that compromises your immune system, you should seriously consider the potential risks of contracting a more severe form of COVID-19 at the gym and weigh that against the benefits of going. If you (and/or your doctor) feels decisional balance falls on the side of not returning just yet, consider if there is an alternative way to accomplish your exercise that doesn’t involve going back to a gym at this time (pro tip: there are several ways). If you do choose to return, it will be important to take proper precautions: wear a mask and ensure your gym is implementing all reopening guidance from state and federal officials, as well as industry professional organizations. If your gym offers a time for seniors or immunocompromised clients, try to take advantage and go at that time. One important note: I do realize there are people over the age of 60 who are very fit and in better shape that many 40 year olds, 60 is just an evidence-based cutoff point put in place by public health experts. If you are the outlier in terms of health in later age, that should factor into your decision. Finally, as I mentioned above, if you are uncertain of your risk, talking with your doctor is a wise first step in the risk assessment.
Moderate Risk
Moving down the risk hierarchy, if you’re younger or middle-aged with minimal chronic health conditions (none of the above conditions mentioned in high risk, and no conditions that affect immune function), your decision can largely be based on the gym environment you’re returning to and what you can do to protect yourself when in that environment. Here are some specific mitigation strategies you can look for to ensure your gym is meeting the latest state, federal, and industry guidance:
- Document policies and procedures to mitigate COVID-19, including posted client (or member) codes of conduct
- Social distancing and attendance control procedures (e.g., scheduling, decals on the floor, etc.)
- Amplified disinfecting protocols
- Limiting locker room and shower use
- Requirement for masks in all non-exercise areas. Encouragement of masks when exercising
- Staff wearing appropriate PPE (mask or face shields always, other PPE when required)
- Improved ventilation/HVAC
- Pre-screening/symptom checking of members/clients and employees
- Contact tracing mechanisms to inform the local health department and members/clients of potential exposures
Keep in mind, as I said previously, considering your own health status is not enough here. You need to consider the health status of those you are in close contact with, particularly the people you live with. If you are in the moderate risk category, but someone you come into close contact with frequently is higher risk, that might put you in that higher risk category (for their sake, not yours).
Fellow Fitness Professionals
I want to close by speaking to all my brothers and sisters in the industry. I know that many of you are facing the survival of your businesses too: having issues paying bills and are struggling to take care of employees and clients you love dearly. I also realize, from personal experience, you have a very vocal minority of clients who are telling you how excited they are to get back into your facilities and return to “normal.” I also know, full well, how passionate all of you are at helping the people you serve lead a more fulfilled life through fitness. All of these factors are real, and nothing I say can change any of them. I am wrestling with these very same things myself right now.
What I’d ask you to do is consider looking through the lens I’ve provided in this piece and reflect on some important questions (and by no means are these all the questions, just a starting point for reflection):
- How do we “first, do no harm” as an industry?
- Why do we do what we do on a daily basis? What is our deepest purpose and motivation?
- What is our true purpose as an industry? What is our role in allied health?
- What are we doing right now to support that role in the short, intermediate, and long-term? Could we be sacrificing the long-term for the shorter term (like our clients do so many times with their health)?
- How informed are we truly on the issues we’re facing right now, both on the economic and public health level?
- How transparent are we really being right now and is there a way to increase that level of transparency?
- How can we innovate, change, and pivot to accommodate the needs of communities we serve given the constraints of COVID-19?
- What will be the legacy of our industry (and you, for that matter) during this pandemic? How will history remember us?
- Finally, how can what we do now set the stage for our industry to be a more active constituent in allied health for decades to come? How can this impact global health and wellbeing? How might our struggle lead to our triumph?
It’s not for me to answer these questions for you. I don’t even think I have all the answers to them for myself right now. All I respectfully ask you to do is consider my lens and perspective. Take the time to contemplate and reflect, then act in a manner that is consistent with the deepest values that led you to this industry (and to helping so many people) in the first place. I implore you to go beyond “do no harm,” and ascend to the higher plateau of optimizing health and wellbeing. We have the opportunity for this to be a truly momentous inflection point in how society views our industry; let’s capture this moment in time and have it create the lasting legacy our industry deserves.
A New Way Forward in Health Care
The World Health Organization’s (WHO) definition of health: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
Sadly, “disease and infirmity,” as the WHO puts it, have been on the rise globally far before we ever heard of SARS-COV 2 (the virus that causes COVID-19). The statistics on obesity rates, health disparities, and chronic health problems plague the developed Western world. Food insecurities, access to basic medical care, infant mortality and a whole host of additional complexities result in developing nations struggling in the fight for even basic levels of health. Beyond this, mental health is a salient issue that is coming to the forefront of the wellbeing and health discussion as a result of the high prevalence of depression and anxiety in the Western world, particularly in the United States and even more so during this time of social isolation. Taken together, in their totality, all of these health issues predispose individuals to more severe cases of COVID-19.
We can take solace in the fact that as a society it seems like we’re starting to recognize the need to address these issues of disease and infirmity through more than just reactive methods used by our traditional healthcare system. Proactive wellness and fitness initiatives are progressively becoming part of our culture. Healthcare is, in some cases, incentivizing proactive health behavior change and weight loss as a means to affect the upstream causal factors associated with chronic disease. Indeed, a larger comprehensive care model is beginning to emerge. Yes, it’s long overdue, but as a practitioner in this “prevention” space I couldn’t be more excited for the direction we’re moving in. I just hope the fitness industry’s old habits don’t trip us up before we get there—especially given the discourse and messages I’ve observed from my contemporaries, as we emerge from the COVID quarantine and attempt to reopen our industry. Nearly irrespective of organizational size, from massive big box gyms to smaller boutique fitness studios, the narrative seems to be the same. We’re saying a lot of positive things as an industry, but we appear to be failing on the most basic levels to offer transparency that is desperately needed right now.
As an industry (and a society for that matter) we seem to be at a tremendous inflection point on many levels. It cannot be understated, how the fitness industry conducts itself in the coming months will forge the foundation for our future as an industry. It will alter our legacy and ultimately determine our place a constituent within public health. If we are truly to become agents of change that don’t merely improve fitness, but fundamentally alter the trajectory of disease and infirmity in our society, it is incumbent we start now with transparency, truthfulness, and most importantly a collective heart and mind that strives to “first, do no harm.”