By Raghav Wusirika and Janne Heinonen
Nearly six months have passed since Oregon’s Stay at Home Order was put into place, Shamrock Run was cancelled, and Team Red Lizard and other running clubs cancelled their group runs. These measures were implemented to reduce COVID-19 transmission throughout the community – to not overwhelm our healthcare system, to protect our most vulnerable community members. In Portland, most people have embraced recommendations to keep distance and wear masks, making their best effort to do the right thing.
Yet determining what is the “right thing” is not straightforward. COVID-19 is a novel virus: six months ago, we knew virtually nothing about it – how, when, and under what conditions it is and is not transmitted. In the past six months, we have observed an astoundingly fast rate of discovery about the virus, as well as the translation of that knowledge into policy and recommendations. Understanding the implications of rapidly changing knowledge for running is difficult, maybe even impossible. The best we can do is distill what we know, then consider what this might mean for us as runners.
First, a few basics about COVID-19 and how they might apply to running:
Under what conditions is COVID-19 transmitted?
High risk exposures for COVID-19 are defined as 15 minutes with a person who is COVID positive where you are not 6 feet away and not wearing medical grade personal protective equipment (PPE). This definition incorporates several components: duration of an encounter, COVID status of individuals involved in the encounter, distance, and PPE. These components together influence the viral dose (number of viral particles).
How does this apply to running? Crossing paths with someone outside is likely very low risk even without masks and physical distancing. Duration is short, wind quickly dissipates the virus, and a runner is moving swiftly. The people most at risk when running are the people you are running with not from your own household because you are likely to be with them for more than 15 minutes; keeping your distance keeps them safe.
What are the differences with all the different types of masks?
- Medical grade masks – N95 (single use, non-valved, duckbill mask) and surgical masks are very effective to prevent the spread to others and also to decrease the viral dose to the wearer during an exposure, but are of course hard to run with.
- Layered cotton masks are second tier but also hard to run with. Having a system to flip them up and down is helpful.
- Masks with valves (typically referred to as KN95 or N95 construction masks) likely protect the wearer but increase the risk to others by exhaling viral particles further away than even normal breathing would.
- Gaiters may or may not be inferior. While one small pilot study on one type of material (single layer fleece gaiter) raised questions about gaiters, other studies suggest that the material is more important than the gaiter design. Consider when it makes sense to use them, based on the type and number of layers of fabric – for most gaiters, this would be low risk situations outside.
How does this apply to running? Wearing masks may not make a huge difference to outdoor transmission when you are crossing paths when someone, but messaging and intentions are important now. Flipping up a mask lets people know that I’m concerned about them and also to try to give me space if they can without having to say those things – which is part of the reason to wear them on crowded trails and paths.
How far away is enough to prevent COVID transmission? The 6-foot rule is based on how far droplets typically travel but lots of other factors change that – breathing hard, coughing, sneezing, and being indoors are worse situations that likely require more than 6 feet, but a specific safe distance isn’t known for varying situations. Being outside and increased airflow decrease the viral density so they are less likely to result in an infection of COVID to someone else, even if there are viral particles in the air.
How does this apply to running? Risk of transmission is likely low while running outside: while heavy breathing carries higher risk, open air for viral dissipation and air flow from physical movement through the environment are likely to reduce risk. Run in areas where you can maintain distance most of the time, give people extra space where possible, flip up your face covering where physical distancing isn’t possible.
In addition to understanding about COVID transmission, there are social and other considerations for running. One important starting point is to consider why running is important to each of us. This answer is different for everyone, but often includes things like maintaining physical health, management of clinical or sub-clinical mental health conditions, stress relief, social support and connection, or provision of a healthy focal point for anxiety or goal setting.
The reality is that the pandemic will likely continue for a long time, and it is important to find a new normal that minimizes risk of COVID transmission, while also managing other aspects of health and well-being. We discuss additional considerations for running during the COVID-19 pandemic.
Have empathy for other runners who have different plans and ideas than you. Everyone really wants to do the right thing but the data are murky and constantly changing (this will likely be out of date in a month). Moreover, no one else lives anyone else’s reality. Like others, runners are dealing with a wide range of struggles – lost jobs, fear of losing a job, parenting while working, social isolation, essential workers managing immense amounts of stress. Mental health struggles are real and dangerous, so interacting with people in the safest way possible – based on our current understanding of COVID transmission – is the best we can all do. We must also recognize the connection between mental and physical health, including effects on inflammation and immune function that could impact vulnerability to COVID-19.
If you do run with others, take measures to minimize risk. Recognize that running with others involves a long period of time in which you are close to a larger number of people who may have pre-symptomatic COVID-19. Many, if not the majority of, cases appear to be linked to a super-spreader which is one person who can for unknown reasons spread it to many other people, usually before they have any symptoms. Possible measures to minimize risk include:
- Limit group size. Consider having a stable smaller than usual group of people to run with. Larger groups increase the risk that someone has the virus, as well as the number of people potentially exposed; this is why group runs are cancelled. Even moderately sized groups make it difficult to space out from each other and to enable other path users to maintain distance.
- Space out as much as possible. Running in a tight pack or drafting is likely to increase risk of transmission.
- Select an appropriate place and time. Run in areas where several people can space out without disrupting other users of the path or sidewalk. Run during less busy times of the day. Over the longer-term, consider the COVID-19 burden in your area – increasing cases in the community increase the likelihood that someone in your group could be infected.
- Encourage communication. Be sure everyone is comfortable talking out a plan ahead of time and being open about their risks.
Many people in the community are very cautious, perhaps because they are high risk of suffering severe COVID symptoms if infected, or interact with high risk friends of family. Others have a deep commitment to protecting the broader community, or are simply complying with rules and recommendations.
Recognize that even if we know that risk of transmission from a transient outdoor encounter is negligible, not everyone does. Many see the requirements that everyone wear a mask when in public places; not everyone is aware of exercise exclusions, or understands that distance is more effective than masks. Non-runners are unlikely to read running-specific articles on COVID transmission. Wearing or carrying a mask and putting it on when you encounter someone within 6 feet is required (i.e., “where physical distancing is not possible”); but is also a simple way to communicate that we care about the community, even if it were not required.
In addition, while things like spitting, snot rockets, and other common running behaviors were in the past (marginally) socially acceptable, they are now dangerous. These actions put people at risk, can reflect badly on runners, and could appropriately lead to more stringent restrictions on exercise.
We are proud of the running community and Team Red Lizard. We have helped keep runners motivated with our virtual races and challenges, and connected with our social media platforms. Let’s also support each other by keeping each other safe and healthy, recognizing that what that looks like differs for different people, places, and times.