In Norway, Gymgoers Avoid Infections as Virus Recedes

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Like many countries, Norway ordered all gyms to close in March to prevent the spread of the coronavirus. But unlike any other nation, Norway also funded a rigorous study to determine whether the closings were really necessary.

It is apparently the first and only randomized trial to test whether people who work out at gyms with modest restrictions are at greater risk of infection from the coronavirus than those who do not. The tentative answer after two weeks: no.

So this week, responding to the study it funded, Norway reopened all of its gyms, with the same safeguards in place that were used in the study.

Is there hope for gymgoers in other parts of the world?

“I personally think this is generalizable, with one caveat,” said Dr. Michael Bretthauer, a cancer screening expert at the University of Oslo who led the study with Dr. Mette Kalager. “There may be places where there is a lot of Covid, or where people are less inclined to follow restrictions.”

Norway is bringing its epidemic under control, and the number of new infections has fallen. But the incidence of the infection in Oslo, where the study was conducted, resembles that in such cities as Boston, Oklahoma City and Trenton, N.J.

The trial, begun on May 22, included five gyms in Oslo with 3,764 members, ages 18 to 64, who did not have underlying medical conditions. Half of the members — 1,896 people — were invited to go back to their gyms and work out.

They were required to wash their hands and to maintain social distancing: three feet apart for floor exercises, and six feet apart in high-intensity classes. The subjects could use the lockers, but not the saunas or the showers. They were not asked to wear masks.

Another 1,868 gym members served as a comparison group; they were not permitted to return to their gyms.

During the two weeks of the study, 79.5 percent of the members invited to use their gyms went at least once, while 38.4 percent went more than six times. Some were overjoyed to restart their routines.

Goril Bjerkan, a 53-year-old economist who lives in Baerum, just outside Oslo, went to the gym three to four times a week during the study, using the treadmill, taking classes and doing strength training.

“It was fantastic to get back to the gym again after almost 11 weeks of closure,” she said. “I suspect it was more risky to visit the shopping center than to visit the gym.”

Heide Tjom, a 57-year-old architect who bicycles into Oslo, leapt at the opportunity to return to the gym four times a week, where she works with a personal trainer and takes group cardio classes.

“Keeping fit is very important to me,” Ms. Tjom said. “I feel it is important to my existence.”

Over the study period, there were 207 new coronavirus cases in Oslo. Study participants and gym staff members were tested for the infection on June 8. (Antibody tests of participants are now being conducted.)

Dr. Bretthauer and Dr. Kalager also examined Norway’s extensive electronic health records database for outpatient visits and hospitalizations among the participants.

The results? The researchers found only one coronavirus case, in a person who had not used the gym before he was tested; it was traced to his workplace. Some participants visited hospitals, but for diseases other than Covid-19, the illness caused by the coronavirus.

There was no difference in hospital visits between the groups, and there were no outpatient visits or hospitalizations because of the coronavirus. The findings were posted online on Thursday, but had not been peer-reviewed nor published.

Some experts felt the results demonstrated that returning to the gym was relatively safe — but only in places where there were few infections.

  • Frequently Asked Questions and Advice

    Updated June 24, 2020

    • Is it harder to exercise while wearing a mask?

      A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.

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      The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

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      The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

    • Does asymptomatic transmission of Covid-19 happen?

      So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

    • What’s the risk of catching coronavirus from a surface?

      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

    • How does blood type influence coronavirus?

      A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

    • How many people have lost their jobs due to coronavirus in the U.S.?

      The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

    • What are the symptoms of coronavirus?

      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

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      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.


“This shows us that low-prevalence environments are safe for gyms and probably just about everything else,” said Dr. Gordon Guyatt, a professor of medicine at McMaster University in Canada. “It is very unlikely you will get infected.”

“If you were in a different environment where there is a substantially higher prevalence, we don’t know what will happen,” he added.

But Jon Zelner, an epidemiologist at the University of Michigan, did not find the study to be fully convincing: “These findings don’t tell me that going to the gym isn’t riskier than not going to the gym, even in Oslo,” he said.

A larger study is needed in places with a relatively low prevalence to determine whether the virus is more easily transmitted in gyms, Dr. Zelner added. Alternatively, a study with fewer people, but in a community with a high prevalence of infection, could answer the question.

Such a study may raise ethical concerns, since it may not be safe to send people to gyms in high-prevalence communities — “kind of a Catch-22,” Dr. Zelner said.

Still, how low does risk have to be before it is acceptable to reopen gyms and fitness centers?

Dr. Guyatt said the risks of infection in a community where the prevalence is low are outweighed by the advantages to society.

“You can’t stay locked down forever,” he said. “We are never going to be completely free of this thing. And in a low-prevalence environment, the risk is low wherever you go — gyms or grocery stores or even restaurants.”

Now, Dr. Bretthauer and Dr. Kalager want to see whether the social-distancing measures they used in the study were necessary.

They hope to randomly assign 150 gyms to operate without restrictions or to maintain those in place now, then compare infection rates among gymgoers. The study is only in its planning stages.

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