Purvi Parikh, MD, Immunologist, Allergy and Asthma at NYU Langone Health talks about COVID-19 concerns and how to stay healthy with gyms reopening.
Certainly, in this crisis with COVID-19, you’re concerned with asthma, allergies and lungs. This must have been a concern for the patients that you see.
Dr. Parikh: As immunologists we treat people with asthma and allergies. And because they suffer from a chronic lung condition, they must be extra careful with any virus, not just COVID-19, because most viruses tend to hit the lungs harder for those people who have asthma or COPD. But I also treat people that have under-functioning immune systems or nonfunctioning immune systems – people with what we call primary immune deficiencies. They are also susceptible to all sorts of infections. So, it’s been a high stress and high anxiety time for many of my patients because they’re very concerned that if they get COVID-19 that they’ll end up in the hospital or worse. So, it’s been challenging because we want to keep them healthy. We want to keep them out of the hospital. For that reason, we are still seeing people through the whole pandemic because I’d rather see someone come to our office for an emergency than have an over-flooded emergency room that’s filled with COVID-19. So, it’s been a unique and challenging time because I must keep my patients safe, my staff safe, myself safe. So, it’s been a crazy time in New York City and then to make things even worse, allergy season started at the same time as the surge. So, everyone was very confused. Is this my normal allergies and asthma? Because we have people come in with high incidences in asthma attacks, E.R. visits and emergency visits that time of the year anyway. So that extra factor made it even more confusing to discern what was going on and caused a lot of anxiety and stress for a lot of my patients.
How important is cardiovascular health, especially when you struggle with lung problems like asthma and some other conditions?
Dr. Parikh: Cardiovascular health is extremely important because, you know, no two organs are separate systems. They all communicate with each other. So, if your heart is not in prime shape, then your lungs suffer and vice versa. If your lungs are not in prime shape, your heart suffers and your whole body, so you need your heart and lungs to live. Secondly, we found at least in New York the worst outcomes from COVID-19 and those who passed away were those with heart disease. Heart disease, obesity, diabetes were the top three comorbidities where people had very bad outcomes. So, you know good cardiovascular health is very important in general and especially we’re finding in the pandemic as well.
What should people be watching out for when they’re going to these spaces, especially for the first couple of weeks while everyone’s still getting used to what they should be doing and what they should not be doing?
Dr. Parikh: It’s very important in a place like a gym where it’s crowded, and people are sweating and breathing heavily. This is kind of a perfect storm I would say for the spread of any virus but especially COVID-19. So, the important things I would ask your gym are what precautions that they’re taking. I would hope that people are very spread out. I would argue even more than six feet, more like 10 feet or so because the big problem is when you’re breathing hard and panting at the gym, you’re spreading more of the virus than if you’re just sitting and not exerting yourself. So, everyone at the gym is technically a super spreader. And especially this time of year if people are coughing or sneezing because of allergies, then it’s even more so. So, I would make sure everybody is very spread out. I would ask what their disinfection procedures are because every machine should be very thoroughly cleaned between each client, because you don’t know what the person before you have been exposed to. You’re touching everything. There’s sweat everywhere. And I would also ask in terms of workout classes if they’re limiting how many people are coming in, if things are spread out, how that equipment is cleaned. I’ve heard many workout classes are now moving outdoors so, I thoroughly encourage exercise, but it should be done safely. And then locker rooms are a whole other challenge. I’ve been telling people not to even use the locker rooms because I think it’s impossible in that small of a space especially during peak times of the day when many people are in and out. I think it’s actually safer to go home and shower because at least that way you’re showering off everything that you’ve collected outside of the home by the time you come home and you know that your own shower and towel and everything else are clean. Gyms are I think going to be very challenging for all those reasons.
You’re saying you’re probably better off going to your own house?
Dr. Parikh: I would wash everything once you get home. So many health care workers including myself do this. When we go to the office or the hospital as soon as we get home, we leave the shoes outside and whatever is on our body immediately goes into the wash. So, that’s what I would probably do in that type of environment. Rather than showering there and then coming home, who knows what you’re carrying on you.
Should people be wearing masks while they’re doing heavy cardiovascular workouts? And if not, should they look at other options?
Dr. Parikh: In an enclosed space I think a face covering is needed even if it’s not a mask. You don’t need to wear those medical grade masks like an N95. That’s really suffocating. There’s no need to wear that when you exercise but you should have some type of covering over your nose and mouth even if it’s just a cloth or a bandana because it can stop the spread immensely. And if you are going to be working out in an enclosed space, I would recommend it. If you can’t wear it then what I would recommend is working out outdoors or somewhere where there is that ventilation or you might work out by yourself. Because again even though we talk about the virus on surfaces, the biggest form of spread is through the respiratory droplets. And by everyone having something over their nose and mouth that stops that spread immensely.
What should we think about when we go back to our weightlifting routine and when we’re in a gym where there are weights being exchanged by a lot of different people or machines that are being used consistently by several people?
Dr. Parikh: Ask your gym what precautions that they’re taking, and you should also take your own precautions. So, I know it seems like overkill, but I think it’s worth it that any time you touch anything or are about to touch anything that it’s completely wiped down with a disinfectant wipe whether it be a weight or a machine. And when you’re using some of these machines where you’re lying on a bench that’s a big surface area. So you want to make sure anything that touches your body is thoroughly wiped down and clean because you don’t know if someone sneezed on their hand and you touch that same bench or that bar or what have you. So, all these things will be very, very important. I don’t know if you heard but in South Korea there was a spike after an aerobics class. Someone in the aerobics class infected a bunch of people. So, it is a real possibility. I know everyone doesn’t want to hear that. Me, I love my fitness classes but I’m kind of hesitant to rush back.
Is there anything I didn’t ask that you want to make sure that people know as we start to move back to our old routines and back to the gym?
Dr. Parikh: Those common-sense techniques, frequent handwashing is very important especially if you’re in an enclosed space with a lot of people. The face coverings are very, very important. And then try to avoid touching your face as much as you can too while you’re at the gym. I know we’ve been saying those things since the beginning, but it does help reduce the spread a lot. And then make sure you do things when it’s safest. You want to have enough distance between people because at the gym things spread a lot faster than in other places because of the heavy panting and sweating and people very close together.
Maybe you look for a time when there are traditionally not as many people there?
Dr. Parikh: I would try to avoid the peak times where people go to the gym which I’m not sure what that is anymore since so many people are working from home. So that may change. Also, if you’re sick please don’t go to the gym because you could be the one spreading it to many, many people. And you shouldn’t be doing heavy workouts if you’re ill. You need to recover.
Can we bring our own wipes in and maybe do something with our hands and machines ourselves?
Dr. Parikh: I’m hoping all these gyms will have wipes by every machine or station. But I would bring your own because that’s the only way to know for sure. What if they don’t have enough wipes or whatnot? You want to be as clean as possible. But again, I would wait and kind of see how the reopening goes. If we get another spike or surge in cases, then obviously I would say wait until it’s safer to go. There’s a lot of unknowns unfortunately.
Interview conducted by Ivanhoe Broadcast News.
END OF INTERVIEW
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