Medical Endorsement of Exercise & Lifestyle Management  

As medical and health professionals, we know people must stay physically active to maintain and promote good health. We are writing to encourage public health and government officials to allow health and fitness clubs adhering to rigorous safety protocols to remain open and continue serving the public. 

Prior to COVID-19, the U.S. was already facing epidemics in obesity and chronic disease. Six in 10 Americans have at least one chronic disease, and four in 10 have two or more. Exercise has always been vital to health and well-being and to reversing these existing epidemics. It is even more so now, as many physical inactivity-related comorbidities are risk factors for developing severe COVID-19 illness.

COVID-19 has had a severe impact on mental health. Depression rates, suicidal ideation (especially among young adults), drug use and overdose have all increased during the pandemic. Things are especially bleak among our own colleagues, with healthcare workers experiencing heightened levels of burnout, stress, insomnia, depression, and anxiety. At this moment, we cannot take away one of the most effective and essential coping strategies while the healthcare systems fail to treat a myriad of lifestyle diseases.

Health and fitness clubs are vital, essential and safe. Data consistently shows that health clubs are not primary drivers of COVID-19 transmission in the community, an assertion supported by industry analysis, state contact tracing, and published research. Mask-wearing, social distancing, adequate ventilation, and cleaning are key strategies to reducing the airborne transmission of COVID-19 that are already in place in health clubs across the U.S. These clubs provide a place for our patients to work on their physical and mental health and experience much-needed socialization in a safe, controlled environment. They are primed to help the state conduct accurate and efficient contact tracing if needed, and should be considered essential partners in protecting population health.

The winter months often come with seasonal depression and a decline in outdoor physical activity, which added to the ongoing pandemic could lead to greater stress, depression, anxiety, and social isolation. We need the safe, controlled opportunity for stress relief and socialization that health clubs provide. 

As outbreaks continue globally, the scientific community and the industry continue to research and understand factors that facilitate widespread COVID-19 transmission—such as airborne particles. The fitness industry will continue to evolve and adapt to create the safest possible 

environment for their members and communities to be physically active. For all of these reasons, policy and health authorities should allow health clubs with strict safety protocols to continue operating and serving their vital role in the community.

Sincerely,

Hasan Abed, MD

Advanced Pain Management

Samantha Adams, RN, MSN-CNL

Aya Healthcare 

Steven J. Adashek, MD

Steven J. Adashek MD PA

James J. Annesi, PhD

University of Alabama Birmingham

Amy Bantham, DrPH, MS, MPP

Move to Live More

Mark Baran, MD

Padonia Pediatrics and Medicine

John Harley Barrow, Jr, MD

The Center for Women

Jason Beck, MD

Jason R Beck PA

Roger S. Blumenthal, MD

Johns Hopkins Ciccarone Center

Andrew Burleson, MD

Beacon Orthopaedics 

Scott David Cardone, MD

Baylor Scott and White Health

Missy Clifton, MD

Premier Dermatology

Lori Deemer, MD

Hancock Wellness Centers 

Gregory G. Degnan, MD

Sentara Martha Jefferson Hospital, Atlantic Coast Athletic Clubs

Kurtis S. Elward, MD, MPH

Sentara Family Medicine-Belvedere 

Bialines Espinosa, MD

Dominion Women’s Health

Melissa Fraley, PA-C

OSF St. Francis 

Corina C. Fratila, MD

Ideal Endocrinology

Paige Partridge Hix, MD

Parkhill Clinic for Women

Robert Sparks Hix, MD

Parkhill Clinic for Women 

Lee Johnson, MD

Sparks Regional Medical Center 

Frank M. Lawrance, MD

Russeville Eye Clinic 

George Lawrence, MD

Regional Family Medicine

Duncan A. Macfarlan, MD

Smooth Skin Laser, and Hospice of the Piedmont

Samuel Moore, DO

Bowen Hefley Orthopedics

Robin Motter-Mast, DO

Greater Baltimore Medical Center

Maria Pane, MD

Greater Baltimore Medical Center

Martin Passen, MD

Crossroads Weight Management, LLC

Seema Patel, MD

Stephanie Peabody, PsyD, HSPP

The Brain Health Initiative

Ferdinand M. Plecha, MD

Southwest General Health Center

Tony Rosales, DNP

The Club Northwest 

Jake Ruff, DPM

OSF Medical Group

Jonathen Schaaf

Executive Health Group

Rob Stoltz, MD

Greater Baltimore Medical Center

Rachel Taves, AG-ACNP

Promedica 

Victor Troha, DPT

Cinicnnati Sportsclub 

Karen Walker Jefferson, MD

Virginia Women’s Center

Sources

Six in 10 Americans have at least one chronic disease, four in 10 have two or more. CDC. 

Many physical inactivity-related comorbidities, including cardiovascular disease, diabetes, chronic kidney disease, and obesity, are risk factors for developing severe COVID-19 illness resulting in hospital admission, ICU admission, ventilation, or death. CDC.

Individuals with the highest risk lifestyle factors (smoking, physical inactivity, and obesity) were four times as likely as those with the lowest risk lifestyles to have COVID-19. Unhealthy lifestyles could be attributed to 51% of  severe COVID-19 cases among the population. Brain, Behavior, & Immunity.

Researchers using genetic markers to assess obesity, alcohol use, lifetime smoking, and physical activity found a two-fold increase in risk of respiratory COVID-19 and COVID-19 hospitalization for people with obesity and lifetime smoking, and a five-fold decrease in risk of respiratory COVID-19 for people who were physically active. MedRXiv.

Depression rates have tripled during COVID-19, from 8.5% to 27.%. BUSPH.

Forty states reporting an increase in opioid-related mortality. A Baptist Health survey found a 55% increase in alcohol use and a 36% increase in illicit drug use, and 

One quarter of young adults (ages 18-24) seriously considered suicide in the 30 days prior to the survey. CDC.

Healthcare workers are experiencing heightened levels of burnout, stress, insomnia, depression, and anxiety. 

A US industry analysis conducted by MXM of 2,877 health and fitness clubs reported only 1,155 COVID-19 cases out of 49.4 million visits as of August 7, or an infection rate of 0.002%. 

Contact tracing in several U.S. states, including Colorado, Louisiana, Massachusetts, and Washington, shows that health clubs make up a small proportion of total outbreaks and cases. 

There was no statistically significant association between visiting a gym and testing positive for COVID-19. People who tested positive for COVID-19 were more likely to have dined in a restaurant or have had close contact diagnosed with COVID-19. CDC.

Experts in aerosol science have identified four key strategies to reduce the airborne spread of SARS-CoV-2 indoors: mask-wearing, adequate ventilation, physical distancing, and cleaning.