Featured photo: Gold’s Gym on Battleground Ave. in Greensboro. (photo by Sayaka Matsuoka)

It’s 6:30 p.m. and the parking lot in front of Gold’s Gym in Greensboro is packed. Muscly men and leggings-clad women walk in and out of the glass doors in the Brassfield Shopping Center, some wearing masks, others without. In recent weeks, several gyms in the state have opened their doors to customers, citing a June 5 letter from the NC Attorney General’s Office.

“The governor interprets Executive Order No. 141 to allow the use of indoor gyms or fitness facilities when that use is prescribed by or directed by a medical professional,” the letter states.

The letter was initially addressed to Chuck Kitchen, an attorney representing a group of state gym owners in a pending suit against Gov. Roy Cooper. A follow-up statement by the NC Health and Human Services Department, or DHHS, clarified that those wanting to use gyms must “present a note or other written communication from the medical professional or healthcare professional to the facility operators to confirm that each individual’s use of the facilities is indeed ‘prescribed or directed’ for that individual.”

However, many gym owners are citing the Americans with Disabilities Act and the Health Information Portability and Accountability Act, or HIPAA, which protect the medical privacy of individuals, to say they cannot ask patrons for the letters, creating a catch-22 in which gyms are opening back up, but are not asking individuals to show proof that they need to be there.

‘I’m taking a calculated risk’

At the Gold’s Gym on Battleground Avenue in Greensboro, signs with updated gym hours and encouraging visitors to use hand sanitizer are stationed at the entrance. Inside, a staff member pre-emptively points a no-touch thermometer at patrons’ foreheads and asks them to sign a waiver. In the background, people run on treadmills and use the squat rack at the back of the facility. The staff member does not ask gymgoers for a medical note.

A sign outside of Gold’s Gym in Greensboro shows the updated hours. (photo by Sayaka Matsuoka)

A manager of the Gold’s Gym could not be reached for comment.

Jose Gonzalez leaves the gym wearing a mask and walks to his car. He says he has been self-quarantining for the last six months and started coming back to Gold’s a few days ago.

“They’re doing pretty good,” he says about the protocols in place.

Usually, Gonzalez says he comes to the gym right around 2 p.m. when staff have just finished deep cleaning the facility from 1 to 2 p.m.

“There’s usually only about 10 or 15 people at most,” he says. “I left early today. I didn’t finish my workout because there were too many people coming in.”

Gonzalez, a former bodybuilder, says he has weights at home but needs a more extensive setup to maintain his muscle mass.

“I’m taking a calculated risk,” he says.

Across the street, Strive Performance Fitness Center also welcomes patrons back into their facility. Like Gold’s, Strive does a temperature check on visitors and has signs asking people to wipe down equipment after they use it. At the front desk, the attorney general’s letter is taped to the counter explaining why they can be open. Next to the letter, another document cites the ADA as justification for not asking patrons to not disclose medical information to gym staff.

Amy Ellis, a spokesperson for DHHS, said in an email to Triad City Beat that the agency “is not aware of any law, rule or regulation, including the Americans with Disabilities Act (“ADA”), which would prevent indoor gyms, indoor fitness facilities, and indoor exercise facilities from obtaining a doctor’s note from those individuals seeking to use their facilities under the medical exception.”

The manager of Strive declined to comment.

Valeria Oha says she started going back to Strive about a month ago to get back in shape because she’s in the Army Reserves. She says she uses the treadmill in the gym and prefers it to running outside because she can keep track of her pace better.

“Whenever they see people using one machine a lot, they’ll shut it down and clean it,” she says. “They also have a sign that says you have to wear a mask, but some people don’t wear one.”

Oha says that she was never asked for a doctor’s note.

In addition to traditional gyms like Gold’s and Strive, group fitness boutiques, yoga studios and other fitness-related businesses have also been weighing their options for reopening.

A representative of the Cycle Loft in Greensboro, a cycling studio, said in a Facebook message to TCB that the business is open for “those who are prescribed or directed by a medical professional to workout” and that all regular memberships are on hold, but that staff doesn’t ask for doctor’s notes. “No one is allowed to ask another person for disclosure of medical information or disabilities,” they said. When asked how they know that people need to work out for medical reasons, the spokesperson said that they go on the honor system.

‘It’s a grey area’

Nick Petruzzi, the owner of 9Round Fitness, a 30-minute kickboxing studio in Greensboro, told TCB that he chose not to open using the medical condition loophole because he doesn’t want to take the risk.

“I’m aware of that clause,” Petruzzi says. “I have taken the position that we will open when we are able to and allowed to. It’s because there’s too much risk in opening otherwise. You cannot ask members for medical history; it’s too much risk for me.”

Instead, he says he has been offering Zoom workouts for members and recently started doing in-person outdoor workouts. Still, he says he understands why some gyms would open using the letter.

Petruzzi of 9Round Fitness says that he has been doing online and outdoor workouts with patrons. (courtesy photo)

“I think a lot of owners are pressured to open for financial reasons, but we’re not in that situation,” he says. “We are doing fine financially.”

He also says he understands why some gyms that are open wouldn’t want to talk to media.

“They’re kind of flying under the radar,” he says. “It’s a gray area.”

Libby Ramsay of Dancing Dogs Greensboro agrees.

“If there is an executive order that says specifically that fitness cannot be open, and there have been three attempted bills to open fitness that have not passed or have been vetoed, it feels like it’s in direct violation of the executive order,” she says. “I don’t think it feels authentic to how I want to be in the world.”

But like Petruzzi, she says she understands why some gyms are open right now.

“I fully acknowledge that it’s a terrible time for small businesses, specifically for fitness businesses,” she says.

Ramsay says her studio has been closed since March 17. She said she’s not getting rent relief and she used up her PPP money in the first two months. For the past few weeks, she’s been offering classes via Zoom and started teaching in area parking lots of businesses that offered their space. She, like many other gym operators, is hoping that on Aug. 7 Gov. Cooper will authorize the state to move into Phase 3, which could allow gyms to open with restrictions. Ramsay says when the governor gives the green light, her business will reopen at about 30 percent capacity and with temperature checks.

“The hardest part is that nobody knows what we’re dealing with, so I think it’s important to give people the grace to do what they think is right,” she says.

Is it safe to work out in a gym?

In the follow-up explanation to the letter, the DHHS explained that because the number of workout individuals taking advantage of the exception would be low, the risk to the public is reduced compared to opening gyms back to the public. But are there still risks involved with going to a gym whether it’s using the loophole or during Phase 3?

According to a small study published in Emerging Infectious Diseases, Korean researchers traced 112 confirmed coronavirus cases back to a nationwide fitness class across 12 different facilities. According to the researchers, the moist, warm air combined with turbulent airflow from exercising may create an environment in which droplets can be spread more readily. Researchers also found that the size and intensity of the class can impact transmission. The study detected transmission in fitness classes that were about 50 minutes long, were held in a studio measuring around 645 square feet and included between 5 and 22 people. Classes that involved less physical exertion like yoga and pilates classes saw no spread.

“Based on recent research, aerosolized droplets can remain airborne for up to three hours, making the potential for spread in crowded and confined spaces such as fitness studios problematic,” said Dr. Robert Glatter, an emergency medicine physician at Lenox Hill Hospital in New York City in a recent Healthline article. “When people breathe more rapidly and more deeply, they expel greater numbers of droplets.”

Because of this, Bert Blocken, a professor of civil engineering at Eindhoven University of Technology in the Netherlands, and KU Leuven in Belgium recently stated in a New York Times article that proper airflow is important to keep people safe.

With no wind or forward momentum to shift and disperse the droplets, they could linger for hours Blocken said in the article. He also stated that gymgoers should expect, at minimum, wide-open windows on opposite walls to help move air from inside out.

Experts also warn patrons to consider their location and whether they are in a coronavirus hot spot. According to a new, online risk-assessment map of the United States created by a group of experts including Harvard’s Global Health Institute, Guilford and Forsyth counties are both rated as orange, the second-highest risk level after red. The four levels, which are based on the number of new daily cases per 100,000 people, considers orange to be an “accelerated spread” where there are between 10 to 24 cases per 100,000 people and stay-at-home orders and rigorous testing and trace programs are advised.

Mette Kalager is a clinical epidemiologist at the University of Oslo and one of the lead scientists on a study that found that people who went to a gym in Oslo were no more likely to get sick than people who didn’t. She said that although only one gymgoer got sick, the results can’t determine whether it’s safe to go to the gym in places like North Carolina where “the incidence of COVID-19 is much higher.” But in places with low numbers of new cases, “it’s safe,” she said according to an article by Science magazine.

During the time of the study, Oslo was reporting only a handful of new COVID-19 cases per day, with a maximum of 24 in one day. In Guilford and Forsyth counties, the average number of new cases has been about double that this past week.

In the end, it seems one thing is clear, says Petruzzi of 9Round.

“It’s not just for physical reasons but for mental health too,” he says. “There are lots of reasons why people are working out. It’s important now more than ever to stay fit to boost our immune systems.”

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