COVID-19 outbreak among attendees of an exercise facility—Chicago, Illinois, August–September 2020
Open accessAbstract
On September 8, 2020, the Chicago Department of Public Health (CDPH) was notified of a potential outbreak of coronavirus disease 2019 (COVID-19) at an exercise facility.COVID-19 cases were identified among 55 (68%) of 81 attendees of in-person classes held during August 24-September 1, 2020, including 49 (60%) cases confirmed by real-time reverse transcription-polymerase chain reaction (RT-PCR) testing and six (7%) probable cases among attendees who had compatible symptoms but negative or no RT-PCR test results.Overall, 43 (78%) attendees with COVID-19 participated in multiple classes while potentially infectious.*Twenty-two (40%) attendees with COVID-19 attended on or after the day of symptom onset.Among 58 exercise class attendees who provided information on in-class behaviors, 44 (76%) reported infrequent mask use, including 32 of 38 (84%) attendees with COVID-19 and 12 of 20 (60%) without COVID-19.The increased respiratory exertion that occurs in the enclosed spaces of indoor exercise facilities facilitates transmission of SARS-CoV-2, the virus that causes COVID-19, in these settings (1,2).To reduce SARS-CoV-2 transmission in exercise facilities, employees and patrons should wear a mask, even during high-intensity activities when ≥6 ft apart.In addition, facilities should provide engineering and administrative controls including 1) improving ventilation; 2) enforcing consistent and correct mask use and physical distancing (maintaining ≥6 ft of distance between all persons and limiting physical contact, class size, and crowded spaces); 3) reminding infected employees and patrons to stay home and away from others for ≥10 days after symptom onset or, if asymptomatic, after a positive test result, as well as to observe quarantine guidance after close contact with a person with COVID-19 and while awaiting test results; and 4) increasing opportunities for hand hygiene.Conducting exercise activities entirely outdoors or virtually could further reduce SARS-CoV-2 transmission risk.* The infectious period was presumed to begin 2 days before symptom onset or positive SARS-CoV-2 test result, whichever was known to be first, and presumed to end ≥10 days after symptom onset or positive test result as long as other symptoms (except loss of taste or smell) were improving and the patient had been fever-free for 24 hours without fever-reducing medication.https://www. cdc.gov/coronavirus/2019-ncov/if-you-are-sick/end-home-isolation.html
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Laboratory, field, modelling, and case studies have shown that airborne transmission through inhalation of virus-laden aerosol is important, if not dominant, for COVID-19.
“Laboratory, field, modelling, and case studies have shown that airborne transmission through the inhalation of a virus-laden aerosol is important, if not dominant, for COVID-19.119, 120, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132”
From The Lancet Commission on lessons for the future from the COVID-19 pandemic (2022) · cites this paper as [128]
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van Doremalen, N., Bushmaker, T., Morris, D. H., Holbrook, M. G., Gamble, A., Williamson, B. N., Tamin, A., Harcourt, J. L., Thornburg, N. J., Gerber, S. I., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmc2004973 · Cited by 9,951 · see citing works
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Mass masking in the COVID-19 epidemic: people need guidance
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The Lancet Commission on lessons for the future from the COVID-19 pandemic
Sachs, J. D., Karim, S. S. A., Aknin, L., Allen, J., Brosbøl, K., Colombo, F., Barron, G. C., Espinosa, M. F., Gaspar, V., Gaviria, A., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(22)01585-9 · Cited by 842 · see citing works
Modeling the Impacts of Physical Distancing and Other Exposure Determinants on Aerosol Transmission
Wagner, J., Sparks, T. L., Miller, S., Chen, W., Macher, J. M., & Waldman, J. M. (2021) · Journal of Occupational and Environmental Hygiene · doi:10.1080/15459624.2021.1963445 · Cited by 21 · see citing works
- Authors
- Lendacki, F. R., Teran, R. A., Gretsch, S., Fricchione, M. J., & Kerins, J. L.
- Affiliations
- Chicago Department of Public Health (US)
- Corresponding author
- Lendacki, Frances R.
- Venue
- MMWR. Morbidity and Mortality Weekly Report
- Published
- 2021-03-05
- Volume
- 70
- Issue
- 9
- Pages
- 321-325
- ISSN
- 0149-2195 (ISSN-L)
- 1545-861X
- PMC
- PMC7948936
- OpenAlex
- W3130246716
- Cited by
- 55
- References
- 8
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 5 · 2023: 7 · 2022: 14 · 2021: 26
- FWCI
- 5.02
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- MMWR Morbidity and Mortality Weekly Report (publishedVersion)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Keywords
- COVID-19 pandemic, SARS-CoV-2 transmission, masking, social distancing, ventilation, infectious period, quarantine, hand hygiene, outbreak control measures, Chicago, RT-PCR testing, contact tracing, outdoor exercise, asymptomatic transmission
- MeSH terms
- COVID-19, SARS-CoV-2, COVID-19 Nucleic Acid Testing, Adolescent, Adult, Aged, Chicago, Disease Outbreaks, Female, Humans, Male, Middle Aged, Fitness Centers, Young Adult
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