HONOLULU (KHON2) — Hawaii Department of Health officials shared their learnings from an investigation into last year’s coronavirus clusters. The report focused on one of the major clusters noted in 2020: fitness centers.

The state DOH says three fitness centers were used as focus points in highlighting lessons learned from last year’s tracking of coronavirus clusters.

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The paper, submitted to the CDC, chronicles how an asymptomatic fitness instructor unknowingly transmitted the virus to participants in a high-intensity stationary cycle class in late June of 2020.

Another instructor who attended one of the classes unknowingly transmitted the virus to participants during personal training sessions and kick-boxing lessons at another fitness center.

The DOH reported that the second instructor was hospitalized and required intensive care shortly after testing positive. A third gym, where the first instructor taught a class more than two days prior to their first reported symptom, was also investigated, but health officials say no transmission was observed.

The investigation was performed by a team led by acting state epidemiologist Dr. Sarah Kemble. The paper titled, “Community Transmission of SARS-CoV-2 at Three Fitness Facilities,” reported that more than 30 participants tested positive for COVID-19 within that cluster.

The report notes the number may have been much higher as the number of participants infected with the virus who were asymptomatic may not have been tested or may have underreported symptoms or even refused testing.

At the time of the recorded outbreak, face masks were not required in fitness centers.

“This publication is an acknowledgement of the caliber of work being done at the Hawaii Department of Health,” said Health Director Dr. Elizabeth Char. “As a result of the diligent work of Dr. Kemble and her staff on follow-up contact tracing and testing, we’ve been able to see patterns to gain more insight into transmission. This has helped us develop more effective guidance and requirements in our state, and it’s an honor to have the opportunity to contribute to the collective body of knowledge for other states to use.”

The following insights were published in CDC’s Morbidity and Mortality Weekly Report (MMWR):

  • The rate of transmission was highest on the day of symptom onset for both instructors.
  • Transmission was likely facilitated by extended close contact, poor room ventilation and not wearing face masks.
  • Transmission occurred despite spin cycles being spaced at least six feet apart.
  • Shouting throughout the one-hour cycle class might have contributed to transmission as aerosol emission.

To reduce transmission in fitness facilities, the paper offered the following recommendations:

  • Wear a mask even during high intensity activities.
  • Facilities should combine engineering and administrative controls, including improving ventilation.
  • Enforce consistent and correct mask use and physical distancing (maintaining at least six feet of distance between all persons, limiting physical contact, class size and crowded spaces).
  • Increase opportunities for hand hygiene.
  • Remind patrons and staff members to stay home when ill
  • Conducting exercise activities entirely outdoors or virtually to reduce transmission risk.