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Brian Lehrer: Brian Lehrer on WNYC. Never mind schools, gyms in New York City and New Jersey have been cleared to reopen this week after they were closed, obviously, to prevent the spread of COVID 19 since back in March. Yesterday was day one in New Jersey, today is day one in New York City. Gym owners, gym workers gym rats, are you ready for this?

Joining me now to discuss what the rules and protocols are for reopening gyms and how to stay safe while working out in gyms, and how New York City and New Jersey will regulate gyms, are Dr. Amesh Adalja, infectious disease doctor and senior scholar at the Johns Hopkins University Centre for Health Security, and Ben Yakas, arts and culture editor for Gothamist. By the broad definitions of the pandemic era, I guess gyms count as arts and culture. Dr. Adalja and Ben, welcome back to WNYC.

Ben Yakas: Thanks for having me.

Dr. Amesh Adalja: Thank you.

Brian: Listeners, we'll open up the phones right away. Any gym owners listening from gyms that will be reopening in New Jersey and New York City? 646-435-7280. We know Long Island and the northern suburbs in New York State were already opening. What changes did you have to make to your gym? How much did it cost? Are your employees comfortable coming back to work? Anything you want to say or ask to our guests, you can tweet @BrianLehrer or give us a call 646-435-7280, 646-435-7280. That's for people who own or work in gyms.

If you're planning on heading back to your gym to work out or trying to figure out if you're comfortable with that, why is it worth the risk to you? How do you calculate the risk? How do you reconcile your need for those weights and those machines and the cardio stuff or the classes, not sure the classes are starting again, with the fact that you can potentially put yourself at greater risk for COVID-19? Tweet @BrianLehrer or give us a call now, 646-435-7280, 646-435-7280.

I'll throw in one last thing, not every type of gym or fitness studio is allowed to reopen, at least, in New York City. Do we have any yoga teachers or Pilates instructors listening? Zumba studio owners? How do you feel that being left out? Tweet @BrianLehrer or call 646-435-7280, 646-435-7280. Ben Yakas from Gothamist, there are many different kinds of gyms, we should say, from the YMCA, which often has pools, or the YMHA and YWHA and the CA and those kinds of places to fitness studios, to boxing gyms, what kind of gyms can reopen in New York City today?

Ben: Basically, if you belong to a gym, where you can go in and run on a treadmill or lift weights, those theoretically can open starting today, assuming that those gyms have passed the initial inspection with the city, but as you were alluding to, there are some major rule changes that are limiting the kinds of activities that can happen. The big rule changes are, gyms can only have 33% capacity. People have to wear masks or face coverings while inside, that includes while you're using the machines or running or anything. There needs to be social distancing between people inside and implicated in that is between the machinery itself. You can't have two people too close together on machines, you have to spread out as well like that.

Now, the big, big thing that is limited is that the state has made it so different localities can decide whether or not to allow activities like indoor fitness classes, and New York City has opted out of allowing indoor fitness classes and indoor pools entirely for the time being. An indoor fitness class is defined as any activity in which two or more participants are led by an instructor. If you're a business who relies on indoor classes, which is like a yoga studio or a fitness studio or a pool, you're out of luck, but you can still hold fitness classes outside.

Brian: I'm saying that they will be able to hold fitness classes in New Jersey. They're a little looser on that compared to New York, but they're going to limit the occupancy of any indoor premises to 25% of the stated maximum capacity in New Jersey, it's 33% in New York, so some slight differences there. Dr. Adalja, for listeners out there who are itching to get back to their workouts in the gym, where would you start? What personal health factors should people be considering before venturing back or even to figure out whether this is safe for them?

Dr. Adalja: Well, they should think about what their personal risk factors are for severe disease. Are they somebody that's older? Do they have diabetes, high blood pressure? Are they obese? All of those individuals are going to be having to really make a risk calculation with any activity they do, whether they're going to gym or--

Brian: Those are the exact reasons for going to the gym, usually, right?

Dr. Adalja: Right, exactly. Yes, that's a paradox, that the people that we want to be physically fit and taking care of their health from exercise, gyms might cause an increased risk. Hopefully, with the new precautions that are being put into place, with the decreased capacity, with the spacing, with the enhanced cleaning, the face coverings, all of that will make it easier for those individuals to go.

In general, that group of people are going to have to be much more careful than the average person when they're partaking in social interaction. It's unfortunate because the way they're high-risk factor prevents them from exercising, which is what gives them the higher risk for severe disease. It is a vicious cycle. Hopefully, gyms are able to figure this out, and maybe they will make some modifications that make it easier for those individuals to feel comfortable, having special outdoor classes, that type of thing that makes it less likely to come into contact with the virus.

Brian: Let's take a phone call. Gwen on the Upper West Side, you're on WNYC. Hello, Gwen.

Gwen: Hi. I have a private studio that I opened about a week ago. I'm the only one that teaches, and I am seeing clients who have been coming and asked to come. Again, it's a Pilates studio. I'm cleaning the machines with bleach on the CDC requirements and waiting in between, masks are required, so I feel good about it. It was nerve-wracking at the beginning, but I decided it was something I needed to do.

Brian: Did you say you're only taking clients individually, one at a time?

Gwen: Correct. I have a private studio. It's a Pilates studio. I only see one person at a time so there's no risk of them interchanging or crossing over.

Brian: Gwen, thank you very much. Let's go to Damian in Westerlo. Damian, you're on WNYC. Hello.

Damian: Hi, good morning. I'm actually in the category that you guys were just talking about. I joined the gym in January purposefully to lose a lot of weight this year. I stopped going in March, for obvious reasons. The fact that I was obese, high blood pressure, gave me the impetus to actually lose a lot of weight without going to a gym. I guess my comment is, going to a gym is a social function as much as an exercise function, and exercise isn't necessarily the best way to lose the weight. I've done it with minimum exercise. I've dropped 45 pounds, and I'm still not comfortable with going to a gym. In fact, I went past my gym just a couple of days ago, and everybody was outside, everybody was within 2, 3 feet of each other, clapping, encouraging one another, et cetera. I'm not going back.

Brian: It seems too dense to you. Did you say you lost 45 pounds through Zoom exercise? [chuckles]

Damian: No, not Zoom, mostly diet. 70% diet, 30% exercise, and that's since March.

Brian: Thank you very much. Dr. Adalja, that would get us back to a pre-COVID exercise conversation, which is, you have to change your diet, you can't do it just by working out, right?

Dr. Adalja: Right, but remember that exercise isn't just to lose weight. Exercise is about cardiovascular fitness. Lots of people think about exercise solely in terms of weight loss, but there are other cardiovascular benefits that you get from exercising. You can be skinny and be unhealthy, so remember that exercise is part of a normal way to keep your physiology functioning. Even if you can't go to the gym, think about other activities.

There are recommendations for how much vigorous exercise you need to do per week, and I think that's important to remember that we do want people to exercise. There are going to be people that are uncomfortable going to gyms, so there are alternatives, like you just said, the Zoom classes for exercise. I wouldn't tell people to completely abstain from exercising. There are alternatives to going to a gym, and I think that people should take care of those or we'll see consequences from those other health problems if we end up decreasing their rate of physical fitness of the country.

Brian: Ben Yakas, the first caller who's got the one-person at a time Pilates studio, is that the loophole in the restrictions? You can't have studio classes unless it's called personal training? Meaning, if it's one person at a time, it's not a class?

Ben: Actually, yes, that is exactly right because they define the classes as two or more people, so any sort of one on one personal training sessions are allowed. Even within that, there are a couple of rules and regulations. You still have to maintain 6 feet from one another. You have to clean any shared equipment between the uses between people, and the big thing is that they're discouraging hands-on activities.

The things that fall under that are like martial arts and boxing, at times, could fall under that, but then, there's a lot of gray area because, what if you're boxing with your own gloves and you bring them with you and there's no physical skin to skin contact? That most likely is okay, but anything in which-- They want to just discourage physical touching and any sort of contact between people.

Brian: The science, Ben, tells us that proper ventilation is going to be pretty important for shared indoor spaces in slowing the spread. Are there any specific guidelines either for New York City or New Jersey when it comes to ventilation in gyms, in particular?

Ben: Yes. I mean, a lot of the guidelines are really set by the CDC. Like with schools, the city is telling gyms you really have to try to upgrade to a certain level of what's called MERV 13 filters or greater. Basically, these filters are rated by how effective they are at filtering the small particles and the big particles. The higher efficiency filters, your system is going to be able to reduce the virus transmission. A typical one is a 6 or an 8, so having a 13 is obviously a really big increase in performance.

A certain amount of gyms, when they're doing these virtual inspections, they have to show that they've had some upgrade to their system, and if they're not able to do that in time, there are other protocols and recommendations that CDC makes, such as making sure you can open all your windows to reduce the amount of recirculated air, keeping your systems running for longer hours before and after people are indoors, and things such as that. `

Brian: Dr. Adalja, if you are a client looking into a gym, what should you be looking out for, how can someone determine if a gym is properly ventilated?

Dr. Adalja: It's going to be hard for the general public to be able to tell how well the ventilation is. I think that you can look and ask for the gym's plan for how they've changed their operations, what types of systems are in place. Again, this is something that's a little bit controversial in our field, looking at ventilation, and different states are doing it differently because we have aerobiology studies that show, yes, there is some aerosolization that goes on, but epidemiologically, most of the infections, the vast majority of the infections are from people that are in close contact with each other, within 6 feet for 10 to 15 minutes. If you've got a fancy ventilation system, that's not going to interdict that type of transmission between people. There, it's about spacing, there, it's about handwashing and hygiene and all those common-sense types of things.

To me, going into a gym, I'm much more worried about the spacing of people and how they're avoiding congregations of individuals together because that's where I see transmission going. I'm not someone who asked so much about the ventilation. Obviously, you want gyms to have the ability to mimic the outdoors as much as possible, so increased ventilation is always better, but I don't think there's a way to scientifically say that this standard versus that standard works. I know a lot of gyms are spending a lot of money on these types of things, and I think that if they're not doing the basics of the social distancing, all of that really isn't going to make much of a difference.

Brian: Here's a caller with our name of the day, it's Evergreen in Manhattan. Evergreen, do I have that right? Do we have Evergreen in Manhattan? Evergreen, are you there? Evergreen, once-- Fir, spruce, pine, do you answer to any of those, Evergreen? Okay, I guess not. Let's try Pamela in Morristown. Pamela, you're on WNYC. Hi.

Pamela: Hi, good morning. I have a question for the doctor or your other guest about which mask types would be most effective because as someone who enjoys exercising, I'm hesitant to back into the gym. I'm happy doing virtual outdoor workouts right now, but I wonder based on what I've learned about masks, some folks wear gaiters or a cloth mask versus a surgical-grade or a more of N95-type mask. I always consider, before I go to an indoor workout, what the other participants are wearing because I wouldn't want to do put next to someone with a mask that maybe isn't really doing much for blocking aerosols and spreading them.

Brian: Great question.

Pamela: Is that something that should be taken into consideration?

Brian: Dr. Adalja, will you take that?

Dr. Adalja: Sure. This underscores the need that we have to have good research for what kind of mask the general public should wear. I think that that's starting to trickle out, but we don't have good recommendations for it. We know that people wearing cloth masks with multiple layers tend to be the ideal ones or people using hospital-grade masks that are procedure masks, the surgical masks that they may have obtained. Those tend to be better, in general, at source control. Meaning, you, the wearer, are less likely to spread it.

The issue is that there are definitely masks that are subpar. We saw a study using one type of gaiter, a fleece type of gaiter, where the actual droplets are increased when people wear them. There are people that are wearing these one-way valve masks, which they might check a box and they might let you into a store, but you're actually more dangerous than someone not wearing a mask if you're wearing some of those one-way valve masks, which I've heard described as basically a shotgun blast of droplets coming out of this one-way valves.

It is really important to realize that not all masks, not all face coverings are the same. Remember that your eyes are also something that you can get infected with, and if you're touching things in a gym, and then, rubbing your eyes or fixing your contact lenses, you can get infected that way as well. I'm somebody that likes face shields, and I know there's a lot of aerobiologists that disagree with me on face shields, but I do think they provide a lot of protection.

I think using a hospital mask and a face shield is likely going to give you the most protection and source control that you could imagine if you're someone that's very risk-averse and wants to avoid this at all costs. It's going to depend on the gym. I would stay away from people with those one-way valve masks because that clearly is something that-- We've been banning them off of airplanes now because people are wearing them, and they do increase transmission of the virus.

Brian: There are rules. Ben, I see New York State has some pretty strict guidelines for what's considered a proper mask in a gym, right?

Ben: Yes, and the doctor's correct, that the cloth face coverings and the disposable masks are considered the best options right now. In particular, New York State actually does not consider that bandanas, gaiters, and neck fleece are acceptable face coverings. You actually can't wear those in gyms and fitness centers. That's going to be really difficult because, for a lot of runners, the reasons why those became so popular is that they're just so much more comfortable to wear while running when you're breathing so heavily than these other masks, but obviously, there's a lot of problems with them.

The other thing, of course, is that face shields are not necessarily considered sufficient substitutes for these other masks while in gyms. While they're not banned, you may still be asked to wear a face-covering or disposable mask while in the gym.

Brian: We're going to finish up in just these last few minutes talking about gyms allowed to reopen in New York City today, in New Jersey as of yesterday, with Dr. Amesh Adalja, infectious disease specialist at Johns Hopkins, their Center for Health and Security there, and Ben Yakas, arts and culture editor for Gothamist, who's been writing about this.

I just want to touch a couple of things. One, on the difference between New York and New Jersey in fitness classes, where New York, as we mentioned, fitness classes are deemed too dangerous to resume for now at all with more than one person at a time, but in New Jersey, to be more specific, the regulations are as follows, the limit is no more than one individual per 200 square feet of accessible space, and everyone must maintain a minimum of 6 feet.

NPR reported on a study from South Korea that found COVID-19 infection spread rapidly among high-intensity dance classes with up to 22 students. In contrast, Pilates and yoga classes with eight or fewer participants saw no spread in that study. Dr. Adalja, I wonder if you've seen that study and if it's possible to pick apart the variables? Was it that the high-intensity dance classes had people expelling more so there was more COVID-19 spread, or the 22 students was too much but 8 students was okay? Any way to parse that?

Dr. Adalja: It's hard to pull apart everything, but what you can say are a couple of general principles that we've known from the beginning. The more people that there are, the more crowded of place is, the more opportunity the virus has to pass from person to person. Less interaction is always going to be less likely to result in infection. The other thing is that we know that the amount of droplets that you expel is related to how heavy you're breathing. What's going on? We've seen outbreaks related to singing. Anything that's going to increase the amount of droplets that come out of your mouth and nose is going to increase the risk of transmission.

In classes where you have people that are heavily breathing, maybe they don't have face coverings, they're close together, you're going to see a spread. It's not surprising to me. It fits the biology of this virus. I do think it helps guide gyms when they reopen, to think about social distancing, think about capacity, think about how vigorous the exercise is and what that means for the amounts of droplets that are coming out of people's mouth.

Brian: Dr. Adalja, I know you have to go. Thank you very much.

Dr. Adalja: Thank you for having me.

Brian: Ben, I want to ask you one last question before you go because some of our listeners may remember that you were on last week to discuss the fate of indoor dining in New York City, which you're also covering. In New Jersey, indoor dining is set to resume this Friday with limited capacity. That just got announced this week. Now, I see there is a lawsuit filed by some restaurants in New York. Any update?

Ben: This was the inevitable place we thought we were headed to, which is that restaurants have now begun to sue the city and state to try to force their hands, to force the return of indoor dining. This lawsuit is led by a restaurant in Little Neck called Il Bacco. It basically claims that they are 500 feet away from the border to Nassau County, and they're losing their business to restaurants over on that side where people can go and eat indoors. They've had 350 more restaurants who have signed on to this class action lawsuit. It's a $2 billion lawsuit.

The other big part of this is that the lawyer who is doing this represented 1,500 gym owners around the state who sued this state last month, which ended up resulting in Cuomo announcing that gyms could reopen at the one-third capacity. This is the big question, is whether or not these lawsuits are going to pressure the city and state to maybe change their tune or allow some small capacity percent of indoor dining. We'll see in the next couple of weeks, I'm sure.

Brian: Ben Yakas from Gothamist. Thanks as always.

Ben: Thank you.

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