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9 QUESTIONS WITH AN INFECTIOUS DISEASE EXPERT

“Why should I wear a mask?” This is one of the most common questions since the start of the pandemic.

07 Sep 2021

In an article by The Straits Times, Health Minister Mr. Ong Ye Kung shared that mask-wearing will still be key after Singapore transitions to a new normal of living with endemic Covid-19, and it may be among the last of the measures that will be shed.


The mask-on policy is vital to ensure the safety of all gym-goers. But why is it so important to wear a mask?


We spoke to Associate Professor David Lye, Director of the Infectious Disease Research and Training Office at the National Centre for Infectious Diseases (NCID) on everything we need to know about masking up at the gym.



1. How can a mask protect me in a gym setting and while working out?

In the gym, with exercise, we tend to breathe more heavily. Any virus in our mouth and nose can then be spread further than when we breathe normally. Please refer to this US CDC document: Scientific Brief: SARS-CoV-2 Transmission | CDC

 

We know the Delta variant is more transmissible and causes more severe COVID-19. Please refer to this US CDC document: Read: Internal CDC document on breakthrough infections - The Washington Post

 

Wearing a mask throughout will reduce one’s risk of passing on the virus to others or getting infected. We have shown that Delta variant causes more severe disease in Singapore, similar to what has been shown in the UK.

 

2. For members who are resting in between sets or participating in less strenuous exercises, they should put on their masks. Could you explain why is it important to do so?

 

In the gym, with exercise, we tend to breathe more heavily. Any virus in our mouth and nose can be spread further than when we breathe normally. Please refer to this US CDC document: Scientific Brief: SARS-CoV-2 Transmission | CDC

 

We know the Delta variant is more transmissible and causes more severe COVID-19. Please refer to this US CDC document: Read: Internal CDC document on breakthrough infections - The Washington Post

 

Wearing a mask throughout will reduce one’s risk of passing on the virus to others or getting infected. In fact, if one is able exercise with mask on, that will be the safest. It is entirely possible to slowly build up one’s aerobic fitness to exercise with mask on, especially on the gym floor. I have certainly been doing that since the Delta variant first arrived in Singapore in April 2021 before phase 2 heightened alert. Working out with mask on is also a way of increasing your fitness level.

 

3. Based on SportSG guideline “You may remove a mask when doing strenuous exercises but masks must be worn once the individual has ceased strenuous activity.” What type of exercise is considered as strenuous or how would you define “strenuous”?


A strenuous activity may be defined as one that increases your heart and breathing rate. When you are resting between sets (e.g. reading the phone or talking to another gym member or your trainer), that is certainly not considered as a strenuous activity.


The American Heart Association defines ‘Strenuous Activity’ to be considered where one works at 70 to 85 percent of one’s maximum heart rate. This is what the Ministry of Health (MOH) has stated: “Individuals may remove their mask while engaging in strenuous exercise (e.g. running, jogging, cycling, contact sports / games, static exercises and drills including taichi and qigong, brisk walking or walking up hilly terrain), but they must put it back on after completing exercise. Those walking at a normal pace would be required to wear a mask.”


4. Which type of mask is recommended and why? (Cloth or disposable mask)


With the Delta variant being more transmissible, the MOH recommends certified surgical mask (i.e. those that report filtration efficiency) or cloth mask that has at least 2 layers of fabric (e.g. those issued by the People’s Association or Temasek Foundation). More importantly, face masks must be worn over nose and mouth. Face masks do not work if worn below the nose or under the chin, or on your arm.



5. Why is face shield not suitable to be worn, as compared to face mask?


Face shields do not protect the wearer from being infected by COVID-19 or prevent the wearer from spreading COVID-19.


6. As members should have their mask with them at all time, what is the recommended duration for a member to use the same mask during their time in our gym and why? (E.g. If they have back-to-back sessions, would it be necessary for them to change to a new mask before starting the 2nd session?)


If the face mask is wet, it should be changed. If a gym member is doing two classes – one after another and is likely to sweat profusely, then bringing three cloth masks is a good idea, one for each class, and a third one to be used after showering.


7. What are some best practices (the do’s and don’ts) when one is exercising with a mask on?


If you have never exercised with a mask on, it is good to start off slow. When you are used to lower intensity, you can then gradually increase the intensity. Even for the fittest person, his or her performance will be lower with a mask on at high intensity. If you feel giddy or breathless then stop to take a rest.


8. What are the recommended behaviours gymgoers can adopt to mitigate the risk of COVID-19?


 The measures to exercise safely and not be part of a COVID-19 cluster are quite simple. Check in with your TraceTogether app or token. If you are exposed to COVID- 19, it helps to know earlier so that your health can be monitored. Avoid mingling. It can be common to see members mingle and talk on the gym floor before or after classes, often without their masks on.


Wear a mask when you are not doing strenuous exercise. Immediately put your mask on after finishing a set. Perform hand rub frequently if you are concerned about contaminated surfaces. The virus spreads between two persons. Half of the infected persons have shown no symptoms and we have ongoing community spread.



We are moving onto endemic COVID-19. As such, there will be more cases and spread. While the virus is more likely to cause severe COVID-19 in overweight or older people, or people with medical problems, when there is widespread community spread, younger people can have severe COVID-19 too.


An additional concern is the long-term impact of COVID-19 which may occur even in mild COVID-19 cases. Even if you do not get severe COVID-19 when infected, you can spread it to your family or friends who may then suffer severe COVID-19. If you are infected, you will be quarantined for a few weeks. If you are exposed to a patient with COVID-19 in the gym, you will also be quarantined for a few weeks. Finally, everyone should get vaccinated unless you have allergy to the first dose of the current vaccines.


9. What do you think about the regular cleaning, sanitation and disinfection by the clubs to provide a safe environment for members workout in?


Kudos to Fitness First Singapore. This reduces the risk of transmission by contaminated surfaces. It is a bonus to work out in a clean gym!