If you are one of the many New Yorkers who have missed the bench press, the elliptical, and the free weights at your local fitness center, you are in luck. Governor Andrew M. Cuomo officially gave the green light for gyms throughout New York State to open on Monday, August 24, with Mayor Bill de Blasio authorizing indoor workouts throughout the five boroughs starting in September.

Establishments will need to operate with a limited capacity and follow a slew of safety protocols. However, there are still a few things New Yorkers should keep in mind before heading back. Waleed Javaid, MD, Associate Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai, explains what every fitness enthusiast needs to know before heading back to the gym.

What precautions should you take when heading back to the gym?

There are three critical elements that we all need to consider:

Wear a face covering during all social interactions—this includes your gym workouts. Be sure to have on a surgical mask or a cloth face covering that shields your nose and mouth.

Hand hygiene is extremely important. When you enter and leave the gym, you should wash your hands with an alcohol-based sanitizer. Also, sanitize your hands when switching between machines or using new equipment.  

Maintain social distance as much as possible. Make sure you are keeping six feet away from everyone all the time. There will be exceptions to this rule when we might have to walk past somebody. That is fine, but should be limited.

Last, remember that we are still in the midst of a pandemic. So, if you are ill, you should not be going to a gym or be out in any public setting.

Are there health practices that gym goers should look for at their fitness center?

The Centers for Disease Control and Prevention (CDC) has come out with recommendations for gyms that include social distancing, masking requirements, making sure that hand sanitization is available, and limiting the amount of people who will be in the gym at any given time. In addition to the CDC’s guidelines, the New York State Health Department has issued air filtration guidance for establishments. Those planning to head to their gym should check that it regularly follows these guidelines.

I plan to hit the gym. Are there activities that are high risk for spreading COVID-19 that I should avoid?

Higher risk activities include anything that requires you to be close to another person—for example, bench presses. If your workouts involve close contact with another person, it might be helpful to have a regular gym buddy or maybe even a small group of people that you work out with regularly. But, you will need to make sure that everybody you work with or work closely with is extremely careful with their activities outside of the gym. Also, any activity that will require you to take your mask off should be avoided. For example, if you typically run on the treadmill for an hour, may not be able to wear a mask.  

Everyone should prepare to adopt these key practices for next six to eight months while we work on an effective treatment or vaccine for COVID-19.

Is the virus spread through sweat?

There is no clear evidence that COVID-19 is spread through sweat. We do know that the virus is spread through contact with respiratory droplets emitted from the nose and mouth. So, if a person with COVID-19 touches their face, they can contaminate their hands and other surfaces with the virus.

Studies have shown that people touch their face, on average, five times an hour. So, in terms of COVID-19 prevention, I would not worry about sweat in the gym. I would be more concerned about wiping down equipment with a disinfectant before use.

How risky is it to head back to the gym?

I’m not sure if I can put a number on the risk. It’s important to remember that any activity that increases our social interaction is going to increase our risk. Going to the grocery store, going out on the street with many people—that is risky. Heading to an indoor gym where people might be breathing heavily and where there might be close contact with others is certainly a higher risk.

One thing that New York City has recommended is that gyms install enhanced filters to increase air circulation. In addition to wearing a face covering, practicing social distance, and having excellent hand hygiene—I believe increased air circulation in these enclosed spaces might decrease the risk.

Do you have any additional advice for those thinking about hitting the gym?

I think following COVID-19 prevention guidance is going to be important. Social distance, wear a face covering, wash your hands extensively, and stay away from those who are obviously ill.

In the case of gyms, it will be especially important to make sure that machines and any fitness equipment that you use are disinfected properly. This should enhance your ability to stay away from this illness while working out at the gym.

After months of staying close to home and maintaining social distance, many in the New York metropolitan area are ready for a change of scenery. However, with COVID-19 still prevalent throughout the United States and border restrictions limiting international travel, is leisure travel safe?

Daniel Caplivski, MD, Director of the Travel Medicine Program at Mount Sinai, and Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai, explains what you need to know about getting out of town as the nation continues to battle COVID-19.

Would you recommend leisure travel this summer?

I do think it’s possible to safely travel within the United States, but there are caveats.

It is important to assess the risk of COVID-19 for each traveler. The CDC has a nice set of recommendations to help you figure out who is the highest risk for having a very severe reaction to COVID-19. This list includes those who are diabetic or obese and older people—particularly those above age 60 or 70.

That is the first thing a traveler should consider—what is my risk of a severe outcome. Younger people can get very sick from COVID-19, obviously, but it’s a different set of considerations for older people and those with underlying medical conditions.

And then, what is the risk of acquiring the virus when visiting a particular area?  The CDC also has outlines to help people think through this process. In the early spring, New York City had the most cases and the highest level of transmission. But now, the focus of the epidemic has shifted towards the south with states like Texas and Florida reporting a high number of cases.

So, those considering vacations this summer should look at the guidelines from the CDC to assess their risk and the risk of transmission within their destination.

If you will be travelling, what is the safest mode of transportation?

The CDC does a nice job of assessing each one of those modes of travel for risk and there’s some commonalities to all of them—any scenario where you are going to be in close contact with a lot of other people will increase your risk of contracting COVID-19.  Whether in an airport or a train station, if you are in a location where it’s hard to socially distance, you will increase your risk.

In terms of mitigating that risk, wear a face covering throughout your trip—as appropriate—and have hand sanitizer with you at all times. Airlines are now allowing, travelers to carry larger bottles of hand sanitizer in their carry-on, which is helpful.

How high is the risk of contracting the virus from other passengers?

The risk from fellow passengers is probably highest from those who are within about two feet—so, within one row in either direction. That’s fairly small in terms of the overall number of people on the plane. Also, the air in planes is constantly being circulated with the outside air and filtered using high efficiency particulate air (HEPA) filters. That adds to some risk reduction. But you should still wear face coverings and use hand sanitizers, especially after engaging with high-touch surfaces like restroom handles.

If you are travelling by train, you can be a lot more spaced out. So, if you can find a seat that’s more distant from other people, that would mitigate your risk, along with wearing a face covering and using hand sanitizer. It’s also worth noting that Amtrak trains have an air filtration system as well.

Given that air and train travel—even when using proper precautions—involves encountering unknown people who may have the virus, is travelling via car or RV with family or friends the safest?

Since you are traveling with people that you know, that’s generally a safer scenario. But, usually you have to stop for gas, snacks, or even the restroom. So, hand hygiene remains important especially after using public facilities.

Once you reach your destination, are there activities that you should avoid?

Travelers should apply the same principle when traveling as they do in the New York metropolitan area. People have gotten used to the concept of wearing some sort of face covering, practicing social distancing, and avoiding scenarios where it’s very difficult or impossible to socially distance, especially when indoors. We know that the transmission of the virus in indoor facilities is much more efficient than in outdoor scenarios. So, whenever possible, try to look for outdoor activities as opposed to indoor ones.

Beaches are an example where, generally, it is possible to socially distance from people and reduce your risk of contracting the virus. Swimming pools can also be a safe place to go if you’re able to maintain social distancing as the chlorine in the water is considered to inactivate the virus. With these locations, travelers should be hyper vigilant in bathrooms, locker rooms, and changing areas where it may be more crowded and there are more high-touch surfaces.

Should you self-isolate after your vacation?

This depends on where you’re coming back from right. New York State has some guidelines for travelers returning from states where there’s a lot more COVID-19 cases.

There are going to be recommendations at the state level for self-isolation or self-quarantine for asymptomatic returning travelers. Travelers should keep an eye on state recommendations as well as the CDC map of where there are high levels of COVID-19 activity.

If you are going someplace that doesn’t have a high level of COVID-19 cases but you have contact with someone who is at high risk of a severe case of the virus, should you take extra precautions on your return?

The Mount Sinai Health System has some guidelines for our health care workers because we come in contact with people who are immunosuppressed and have a high risk for severe COVID-19. The common sense approach for travelers is what a lot of health care facilities like Mount Sinai are doing, which is requiring that people conduct a self-symptom check.

If you are returning from a relatively low risk area, do a self-assessment. You can return to being in contact with older loved ones, as long as you do not have a high fever, a cough, shortness of breath, loss of smell, or any of the typical symptoms for COVID-19.

Are there any additional behaviors that the public should be aware of when traveling during this time?

Lodging is a big consideration. My Mount Sinai colleague, Mirna Mohanraj, MD, addresses the safety considerations travelers should make when visiting a hotel or vacation rental in this blog.

Additionally, the CDC recommends bringing sanitizing wipes when you travel for high touch surfaces, like doorknobs and bathroom fixtures. The CDC also recommend basic things that have become second nature to many within the New York metropolitan area like no contact service and avoiding buffets, group gatherings, and gymnasiums.

As the New York metropolitan area continues to keep the COVID-19 curve flat, more establishments have opened. But, before hitting the pool or booking an appointment at the day spa, be aware that the risk of contracting the virus has not dissipated.

“Any place where we have public interaction beyond our immediate family or immediate contacts, we are exposing ourselves to the virus,” says Waleed Javaid, MD, Associate Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai. “The more people we meet, the more interactions we have, the expansion of our social circle; this increases our risk.”

Dr. Javaid explains what questions you should ask before visiting your local pool or spa to ensure the safest possible visit.

What precautions should you take before heading to the pool?

I think it will be important to make sure that the pool or hot tub that you are entering is following up on disinfection protocols. The cleaners and disinfectants used in and around the area should be registered by the US Environmental Protection Agency to kill the virus.

Do saunas and steam rooms pose a risk of spreading COVID-19?

If you’re not following social distancing guidelines, there is a risk. But it really depends on the size of the facility and how they may be modifying their business practices due to the virus.

Masking is not going to be effective in a sauna or steam room because—besides being incredibly uncomfortable—the moisture will likely reduce the efficacy of a face covering. So perhaps it is best to do individual saunas.

Not every place is going to do the same thing, so people should be proactive in asking about what kind of protections are in place for safety before entering an establishment.

Since there is no standard protocol for these establishments, what should people ask before visiting?

Before visiting a pool or spa, people should ask two questions: What is the facility doing to prevent the spread of COVID-19 and what is the process they are using to ensure the virus does not spread throughout their establishment.

From there, you can go into some specifics.

• What disinfectant is in use?
• What is the social distancing process and how is it being reinforced?
• How many people are allowed in the facility at any given time?
• How often are shared spaces being disinfected?
• Is shared equipment being cleaned between each customer?

Additionally, I would recommend that people review guidance from the Centers of Disease Control and Prevention on public pools, hot tubs, and water playgrounds.

Despite spas being allowed to open, at this time gyms throughout the New York metropolitan area remain closed. Why are gyms particularly risky? Is the virus spread through sweat?

At this time, we do not believe that the virus is spread through sweat. However, the risk with gyms is related to the amount of people in an enclosed area. I continue to recommend that everyone stay safe by keeping their distance. So, individualized outdoor exercise like walking, jogging, running, or even outdoor yoga is better than exercising indoors.

Gyms have many people exercising indoors—whether on machines or in fitness classes—and sharing equipment. Contrast that with a spa where the activity—like a facial or a massage—though indoors, is individualized. So spas—where the interaction is often between one or two individuals—present a more controlled environment.

At least, that is how I think this decision is being evaluated.

Do you have any other advice about how to stay safe as we continue this reopening effort and begin to expand our social circles?

Everybody needs to take charge to protect their health and the health of those around them. If, for example, you feel unsafe in a grocery store because there’s too many people, don’t be afraid to remove yourself from that situation.

Also, just because more places are open doesn’t mean that you have to enter them, especially if strict social distancing is not being practiced.