Community Transmission of SARS-CoV-2 at Three Fitness Facilities - Hawaii, June-July 2020

This study reported that on 2 July, 2020, the Department of Health in Hawaii notified the public that a fitness instructor had signs and symptoms of COVID-19, which is a coronavirus infection caused by SARS-CoV-2. The instructor was one of the individuals who became infected with COVID-19 before the onset of symptoms. The average attack rate in classes taught by the instructors was 95% or less of 21 students. Among the 21 primary cases, 20% had symptoms of SARS-CoV-2 illness. It was not required for fitness facilities to require masks. The Hawaii Department of Health placed individuals with exposure to instructors in different facilities under quarantine. Those with exposure to the most recent symptom were not quarantined. Facility Y placed barriers between stationary bikes and the room. It also instituted a single-direction foot traffic flow. During this investigation, participants were exposed to fitness instructors who had taught before their symptoms onset. Although they were most likely infected, the transmission rate was highest among the instructors on the day of their symptoms. Not wearing face masks and prolonged close contact were identified as factors that led to the transmission. During this SARS-CoV-2 community transmission, fitness facilities should implement effective ventilation and other administrative controls to reduce transmission. Physical distancing and wearing a mask are also important to prevent hand-washing. The CDC's guidance for fitness centers states that the use of exercise equipment or activities that are entirely outdoors could reduce the risk of respiratory illness transmission among users. An additional set of administrative controls includes modifying fitness areas to provide a distance between patrons and staff members. Also, implementing visual cues to make foot traffic flow through the facility easier.