Image Source: Getty / Andreas Rentz
Back in April, to slow the spread of the novel coronavirus (COVID-19) pandemic, the Centers For Disease Control (CDC) advised Americans to use cloth face masks in public where social-distancing measures are difficult to maintain. And, as gyms begin to open up around the country, some are deciding, based on location, whether or not to require face masks indoors.
In terms of outdoor workouts like running, as long as you don't think you'll be in close proximity to people, then it's OK to go without a face mask. But, the World Health Organization (WHO) has continued to advise against working out in a mask at all, saying it can affect the way you breathe (WHO posted a graphic on Instagram on June 16, then followed this up with a short video on Aug. 3). Two experts we spoke to disagree, arguing that masks are essential when you're in close proximity to other people during exercise. Many factors come into play, so let's break it down.
What Is WHO Saying About Working Out With Face Masks?
When POPSUGAR reached out to WHO for further comment, it said wet masks from sweat and moisture have "increased resistance to airflow." Wet masks are also "more likely to restrict breathing or take in air where the seal to the face is not strong (the sides, top, or bottom of the mask) rather than through the intended filtering layers," a spokesperson explained via email. "This was the rationale in our recommendation that exercise activities should be performed without the use of a mask as the mask (whether fabric or medical) is more likely to become wet from exhaled breath and sweat during strenuous activity and subsequently may either restrict breathing or become ineffective as a filter."
Additionally, "if a crowded indoor space within an area where there is widespread community transmission of COVID-19 is using fabric or medical masks as their primary infection prevention strategy and has not attempted to implement a comprehensive mitigation approach through a combination of administrative and engineered controls, then this is not a strategy endorsed by WHO."
Translation? Masks can't be your only form of protection from COVID-19. That's why a lot of gyms are administering social-distancing guidelines as well as stricter cleaning protocols. POPSUGAR reached out to the CDC as well and did not get a reply.
Is It Safe to Work Out With a Face Mask On?
The concern about masks making it difficult to breathe during workouts is legitimate. Lina Miyakawa, MD, a pulmonologist and assistant professor in the department of medicine at Mount Sinai Beth Israel, told POPSUGAR exercising with a face covering will most likely make those workouts harder. "There is definitely a period of acclimation, I think, with people wearing masks and exercising, but the human body is pretty adaptable, and so people will have a tough time in the beginning," she said.
Exercise scientists who spoke with The New York Times in June said that your heart rate will be higher, and some people could experience lightheadedness. Rapid, shallow breathing also keeps you in a high state of alert.
Dr. Miyakawa points to athletes who've always worn masks to simulate different types of strenuous exercise. Though this is more extreme than wearing cloth masks during exercise on a normal day-to-day basis, she said on that same note, people will be able to adapt. She told POPSUGAR she's heard anecdotally that having masks on while walking around and going out in public gives people a greater chance of getting used to face coverings worn in workouts as opposed to someone wearing a face mask for the first time during a workout setting. She also suggests trying to breathe through your nose if it's comfortable for you because breathing through your mouth creates more humidity in an enclosed space (aka, when you have your face mask on).
That being said, Dr. Miyakawa agreed that masks will not be effective if they become wet, so she advises you bring extras. And, if you have lung conditions like asthma or heart conditions, she wants you to be more cautious when working out with a face mask. You should talk to your doctor and always use caution, she said, remembering to take breaks as needed and listening to your body.
Why Some Experts Suggest Working Out With a Face Mask
It's important to note that the suggestion to wear face masks while working out isn't based on science that's 100 percent proven; rather it is based on reports that support the recommendation of face coverings due to the spread of COVID-19 through respiratory droplets and other reports that suggest situations where exercising with people could put you more at risk. To start, the CDC states that though a person can get COVID-19 by touching infected surfaces, transmission through respiratory droplets is the main concern. There's also increasing evidence that COVID-19 is airborne through smaller aerosols released by humans when they talk, sing, and even breathe.
One report published in the Proceedings of the National Academy of Sciences of the United States of America suggested that a single minute of loud talking generates at least 1,000 virus-containing droplets that remain airborne for more than eight minutes and could then be inhaled by others. More findings show the spread of COVID-19 among a choir where people were singing in a group. "There's quite a bit of epidemiological data to suggest that there are some activities that cause people to expel these aerosols at a higher rate, possibly further," Anne Liu, MD, immunologist and infectious disease doctor with Stanford Health Care, told POPSUGAR.
There are factors to consider here when this is applied to working out: how crowded of a space you're working out in, how good the airflow is, whether you're indoors or outdoors, and if working out specifically can increase the spread of COVID-19. Some studies back up the latter. Dr. Miyakawa cited an early release paper published by the CDC which looked at clusters of COVID-19 in Japan from January to April of this year. It reads, "We noted many COVID-19 clusters were associated with heavy breathing in close proximity, such as singing at karaoke parties, cheering at clubs, having conversations in bars, and exercising in gymnasiums."
Dr. Liu pointed to another paper from South Korea published by the CDC. It suggested cardio dance classes saw a spread of COVID-19. "Those who attended the more aerobically intense classes had higher rates of transmission than those who were in a yoga class," she said.
"Being indoors with other individuals who are breathing hard right now is not that advisable," Dr. Liu told POPSUGAR. "If you have to be in that situation, wear a mask." She added, however, "aside from complete social distancing, there is no measure that is 100 percent effective" in thwarting the spread of COVID-19. Dr. Miyakawa said that she wants people to err on the side of caution. "I am definitely on the spectrum of being more careful than not because I've been humbled by this disease so many times in the hospital." It's also just common courtesy to keep a mask handy, she said.
Image Source: Getty / Andreas Rentz
A Note on Wearing Face Masks While Exercising Outdoors
Dr. Miyakawa said that as for exercising outside, if you're able to physically distance from people, then it's OK not to wear a mask. That being said, there is a pre-printed model put together by researchers suggesting general respiratory droplets could trail for almost 15 feet in the slipstream of someone briskly walking and up to almost 30 feet in the slipstream of a runner. It did not specifically test any subjects in the context of COVID-19 and has many limitations, but Dr. Miyakawa noted that it's common sense to try to leave space around and behind runners or walkers outdoors, and if you know you'll be in a crowded area outside, you should consider wearing a mask.
Dr. Liu noted that she wants people to understand this: the longer you are indoors with other people, even if they're wearing a mask, the higher the risk of transmission becomes. "Just because you're six feet from somebody, if they have been working out in that room, then they've been there generating all kinds of droplets. And if your mask slips a little, or if you move it aside to scratch your nose, then you get exposed." Being outdoors for the same activity, she said, will already reduce your risk because there is more air circulation dispersing the respiratory droplets.
If You're Working Out in a Mask, Consider Using Cloth
Dr. Miyakawa said that medical-grade masks should still be saved for medical professionals, and there are exercise-type material that is more quick-drying you might want to try. Companies like Under Armour and Adidas came out with masks of their own. Ones made from cloth, she said, are more breathable. However, you may be trading effectiveness for breathability.
Christa Janse van Rensburg, MD, a professor of exercise science at the University of Pretoria in South Africa, told The New York Times that you should choose cloth masks made with breathable, synthetic materials (cotton masks, she said, will dampen easily). She also said you should choose masks that have two layers of fabric or less to avoid facial overheating. Neck gaiters (or buffs) are a good option, too, both she and Dr. Miyakawa said, though there has since been conflicting evidence around their effectiveness. You can read Dr. van Rensburg's findings here.
Takeaways to Remember About Working Out With Face Masks
The next time you're going to work out and wondering whether or not you should wear a face mask, remember these key takeaways based on what we've discussed:
- Consider where you are working out. Will you be indoors or outdoors? Will you be in contact with people or in the general vicinity of them when you're working out?
- Remember that it's a good rule of thumb (and social etiquette) to wear face masks when social distancing isn't doable.
- Follow what your gym's guidelines are if you're working out there. If masks are required, wear one.
- You generally don't have to wear a mask if you're working out outdoors away from other people.
- Use caution and know that if you are uncomfortable, you can take breaks, change out your mask, or stop your workout. Listen to your body.
- Talk to your doctor if you have lung or heart conditions, or if you want to get more guidance on exercising with a face mask.