Outdoor exercise during COVID-19

Are you confused about getting outside for exercise during this trying time of COVID-19? If so, you’re not alone. Like so much about the current situation, the advice about exercise right now can be confusing.

As a sports medicine specialist, I like to think physical activity is an elixir for better health and should be prescribed to most everyone. It’s one of the most effective treatments for multiple health issues (like cardiovascular disease, hypertension, depression, obesity, diabetes and others), and even moderate exercise has been shown to boost the immune system. Exercise is a medical prescription everyone should follow. However, the long-term benefits of exercise need to be pursued while also being smart about the serious risks of exposure to the virus.

As part of our state’s Stay Home, Stay Healthy order, many businesses including gyms are closed. Therefore, exercise needs to be done at home or outside. Yet, many options are unavailable—like parks, beaches and hiking trails that are closed to facilitate social distancing. In addition, the WHO and CDC are now recommending universal wearing of masks when leaving your home, but a mask can make exercise more difficult. All of this information can be hard to sort through.

So how do we exercise—while exercising caution—during the current public health crisis?

Is it safe to exercise outside?

Let’s start with what we know. We know that the virus that causes COVID-19 is spread through droplets released by infected people, such as when they sneeze or cough—and possibly even when talking or breathing. We know these droplets can hang in the air, especially in enclosed spaces. We also know people breathe more deeply during aerobic exercise. A person who is infected may have no symptoms and not know they are contagious. For these reasons, it is of the utmost importance to keep your distance from people you don’t live with—both to protect yourself and to help flatten the curve.

There is also much we do not know yet—but we can apply some common sense. When virus-carrying droplets occur outdoors, it is reasonable to think the concentration will be lower due to the open space. It is possible this would make the “viral dose” you might be exposed to less dangerous. You can lower your risk outdoors even more by maintaining a social distance of greater than 6 feet. One white paper (not yet peer reviewed) recommends staying out of the direct path or lane of people exercising 30-60 feet away, to avoid catching particles in their slipstream.

If you are running, walking or cycling, there is a risk of moving through a coronavirus droplet cloud—however, my assessment is this risk is small overall, so long as you follow the social distancing rules and avoid crowded areas. My recommendation for safety is to maintain a distance greater than 6 feet if you or others are running or cycling outdoors.

Do you need to wear a mask when exercising outside?

If you can use a mask when exercising outdoors, it too would help minimize your overall risk. However, I don’t believe it is absolutely necessary, and it may be difficult to do when exercising heavily. The CDC has information on wearing a cloth mask to slow the spread of COVID-19.

Remember, a cloth or paper mask plays the same role as covering your cough or sneeze: it protects those around you. And since any one of us may be infected with the coronavirus and not have symptoms, wearing a mask when exercising near others can help slow the spread of this disease.

Key takeaways. The risks of exercising outside can be minimized if you follow some guidelines:

• Avoid crowded areas.
• Head outside during slower times. Depending on your area, these may be early morning, during the day when others may be inside working, or in the dinner hour or evening.
• Cover your mouth and nose with a light mask, if feasible, while you exercise.
• For vigorous workouts, try cooler hours, when a mask might be more comfortable (or perhaps unnecessary, if fewer people are out).
• Keep your distance from others. Aim for more than 6 feet if you are walking, running, climbing stairs or cycling, or around others who are pursuing such activities.
• Avoid touching your face during your workout.
• When you return home, take off your gear/clothes and wash your hands thoroughly before touching your face.
• Avoid touching household items (knobs, counters, fridge door, etc.) until you have cleaned your hands.
• If you wear a cloth mask, clean it in a washing machine regularly.

There is risk in life and everyone needs to decide how much they are willing to accept. I think exercise is an important part of life, and while exercising outside has risks, these can be minimized.

I wish you the best in finding ways to maintain your health through exercise, while also taking precautions that make sense.

Chris Maeda, MD, practices sports medicine at Pacific Medical Centers. He sees patients at the PacMed clinics in Beacon Hill, Northgate, Canyon Park (Bothell) and Totem Lake. To schedule an appointment with Dr. Maeda, please call 1.888.472.2633.

Let us know if these tips helped you at StayHealthy@pacmed.org. Read more about PacMed’s response to COVID-19.