Wednesday, May 27, 2020

Jiu Jitsu Gyms and COVID-19: Where We Currently Stand



Since early March, I've been diligently following the development all things related to COVID-19 for the safety and well-being of my family, for my day job (as a public high school teacher), and, relevant to this post, for the sake of our gym. 

The coronavirus pandemic has absolutely ravaged our industry. Quite simply, we cannot operate a jiu jitsu (or any other combat sport) gym in a way that doesn't increase the spread of the virus. The absolute best we can do is acquire as much information as possible, weigh the many variables, develop a list of positive and negative consequences to different action plans, then make informed, responsible decisions. This post will walk readers through the process I'm using for El Diablo Combatives. Hopefully this will be of use for my fellow gym owners and managers, and can be used to spark discussions on how we can navigate the present and future. 

Dispelling Dumbass Conspiracy Theories


Before I begin analyzing the current "lay of the land", it's important to address what has become the single most annoying (and dangerous) aspect of this pandemic - the proliferation of dumbass conspiracy theories. One of the hallmarks of leadership is developing the skills to process and critically-analyze information for validity and reliability. We need to ask ourselves "Is this source of information accurate?" and "Does this source represent objective reality?

Normally, this isn't an especially difficult process for anyone who has any kind of background that involves critical thinking. But in times of uncertainty, critical thinking often gives way to skewed, emotional thinking. Like during a widespread pandemic. 

Personally, I have little to no tolerance for conspiracy theorists as their complete and total inability to think critically leads them to really stupid conclusions that are often counter-productive. In the case of the coronavirus, this means we have to ignore the stupid nonsense that's being spread via memes and Youtube videos. So...


  • No, the virus did not escape from a lab in China.
  • No, the virus is not a biological weapon.
  • No, the virus wasn't developed by the US military.
  • No, the virus is not spread via 5G cell phone networks.
  • No, this virus has nothing to do with Bill Gates and mind-control vaccines.
  • No, this isn't a hoax perpetrated in order for government to install an autocracy/ totalitarian government/ socialism/ etc. 
  • No, the government is not overstepping their authority.
  • No, this isn't a plot by big box retailers, "Big Pharma", globalists, Illuminati, lizard people, etc.
  • ... and so on.
If you buy into any of these, you're a gullible idiot. Either learn to think critically or go read some other blog. Your kind is not welcome in my sphere of influence. Each of these causes one of two effects - it either scares people into never leaving their homes, or worse, causes people to take really stupid risks that unnecessarily put people at risk in their own communities. Buying into this bullshit is grossly irresponsible and, quite frankly, disturbingly selfish. AND it's preventing us form returning to a semi-normal state.

We don't world we imagine. We live in the world that is.

Okay, now that we have that out of the way...

What Are Our Goals?


The first step of developing a plan of action is identifying our goals. In regards to COVID and bjj gyms, the goal is pretty straight-forward. We need to get back to regular training in a way that doesn't exasperate the problem of overwhelming our local healthcare infrastructure. 

Based on our current best data from the state of Colorado (folks from other states will have to dig up their own data), 5.6% of the people who test positive will need hospitalization, and 1.9% of those who test positive will require ICU interventions. (4) Our local hospital, Montrose Memorial, has 75 beds, 24 available ventilators, and 14 ICU beds with the ability to expand a bit. The hospital serves Montrose, SanMigual, Ouray, Gunnison, Delta, Hinsdale, and San Juan counties. Together, the hospital serves a population of approximately 102,000 people. 

Based off the math, this means our local hospital will likely be overwhelmed if the seven-county  region has more than about 1,260 positive, active cases of COVID-19. We can find this information on each county's respective health department websites. 

Our goal, therefore, is to get as close to that number as possible without surpassing it. 

I'll refer to this as "threading the needle" throughout the rest of this post. 

What Do We Currently Know?

As time passes and more research is conducted, we're learning more and more about the nature of the virus. While there's still a TON of questions we still can't adequately answer, we DO know enough to start making some informed decisions. 


About the Virus Itself

We know the virus is easily spread via small droplets expelled from the mouth and nose, which occurs when we sneeze, cough, talk, or exhale. These droplets are relatively heavy and do not travel far (hence the purpose "social distancing" and mask-wearing guidelines.) People mostly catch the virus by inhaling these droplets, though the virus can also be spread if the droplets land on a surface, a person touches said surface, then touches their eyes, nose, or mouth (hence the purpose of washing your hands and frequently cleaning surfaces.) We think people can transmit the virus even if they're not showing symptoms. (5

After a person is exposed to the virus, symptoms typically appear in five or six days and symptoms typically last 10-14 days. We think people are no longer contagious 72 hours after symptoms cease. (5) For severe cases, the average time between initial infection and hospitalization is 13 days. (1) 

Who Does the Virus Affect and How Does It Affect Them?

The virus can infect anyone; nobody appears to have natural immunity. Age is a major factor in both severe symptoms and death. In Colorado, nobody under the age of 45 has died of the virus. Three percent of the deaths come from people between the ages of 45 and 54; 7.8 percent of deaths have come from people age 55-64; and the remaining 89% of deaths have come from people over the age of 65. (4) People with preexisting medical conditions are most at risk for hospitalization and death, including obesity, high blood pressure, heart disease, lung disease, cancer, and diabetes. (5) 

Based on these two data sets, older people with any of those preexisting conditions OR anyone who has regular, direct contact with these older, high-risk individuals should not be leaving their homes and absolutely should not be engaging in any kind of training regardless of the precautions taken. 

As we discover more about the nature of the virus, we're learning it may attack our circulatory system, which might be the reason we're seeing people die from heart, kidney, and liver failure, and may also explain the strange inflammatory disease we're seeing in children. (10) Right now, we simply don't have enough data to draw conclusions, but this unknown should lead us to be even more cautious with exposing our vulnerable populations to the virus. 

How Can We Protect Ourselves and Others?

As of right now, we have no way to prevent the virus, no way to effectively treat the virus, and no way to know if we've been exposed to the virus without getting tested and having contacts traced. Because of this, we have to rely on indirect methods to slow the spread in order to "thread the needle." Remember, our goal is to keep the number of positive cases for our region below about 1,260 in a two week period. As individuals, we can take steps that have been proven to be effective, or there's some convincing evidence the measures might be effective. 

It's important to note the goal of ALL these measures isn't to eliminate the virus or even prevent the spread. The goal is to SLOW the spread. The slower the virus spreads, the more we can reopen anything and everything and still stay below our local hospital's capacity. These measures include:


  • Social distancing. The farther we are from each other, the less likely the airborne droplets we expel will be inhaled by another person, the less likely we are to spread the virus. (4)
  • Wearing non-surgical masks. This weirdly-controversial measure works by trapping at least some of the droplets we expel. If we're unknowingly infected, wearing a mask in public should slow the spread, at least to some degree. (4)
  • Frequent washing of hands. Soap and water, along with alcohol-based hand sanitizer, is effective at killing the virus. If we touched a surface that has been infected, we can prevent ourselves from getting infected if we wash our hands before touching our eyes, nose, or mouth. (4)
  • Frequent cleaning of "high-touch" surfaces. Common household cleaners are effective at killing the virus, so frequent cleaning of surfaces a lot of different people touch is an effective measure to slow the spread. (5)
  • Stay in your county of residence. The closer we stay to home, the less likely we are to spread the virus to other communities. If there is a sudden spike in positive cases, this measure can assure that outbreak is localized. (4)
If all of us practice these measures as often as humanly possible, we can effectively control the spread. Again, the goal isn't to eliminate the virus (because we can't); the goal is to slow the spread enough to prevent the hospital from being overwhelmed. Practically, that means businesses (like jiu jitus gyms) can reopen sooner than later. 

In other words, if you want to get back to training, wear a damn mask, keep your distance from others in public, and wash your hands! Every person who fails to do so is actively keeping our businesses closed!

Our Current Situation in Colorado in General and Montrose in Particular

As of today, we have about 25,000 positive cases and about 1350 deaths across the state. (2) We're currently processing around 5,000-6,000 tests per day. State health officials estimate this number will need to increase to about 8,500 to effectively manage the peak in cases. Until we get to that point, our data is going to be somewhat unreliable, which means it's going to be difficult to predict spikes in cases. For us business owners, that means future shut-downs may happen without much warning. 

We do know that the state's first phase "Stay at Home" measures worked well; the viral transmission rate (known as R0, pronounced "R naught") was at around six at the peak, meaning one person spread the virus to an average of six people. That number is now less than one, which means the number of new cases is decreasing... that's a GREAT development. 

Unfortunately, we won't get data on the state's second phase of reopening ("Safer at Home") until May 29th. Given people across the state have been more mobile since mid-April and mask-wearing behaviors have decreased, we can logically assume the data will show at least some increase in the state's R0 number. (1) 

Based on the data collected so far, 65% of the state's residents would need to maintain adequate social distancing, mask-wearing, and hand-washing to prevent a spike that will overwhelm local hospitals, including Montrose Memorial. (1) THIS IS WHY IT'S IMPORTANT FOR ALL OF US TO SOCIAL DISTANCE AND WEAR MASKS IN PUBLIC!

If less than 65% of the general public fails to comply, we're expecting to see hospitals being overwhelmed around mid-August. If compliance falls below 45%, this will occur sooner. If local hospitals are overwhelmed, we can expect the state to go back to the phase one "Stay at home" regulations. 

Here in Montrose, our county is currently operating under a variance to the state's "Safer at Home" orders. (8) For gyms, this means we still cannot run group classes, but we can train freely with people from our household (including rolling and sparring) and can do everything else if we maintain social distancing, wear masks if possible (but they're no longer required), check temperatures at the door, clean all high-tough surfaces regularly, and limit the total number of people in the gym to fifty or less. (9)

This variance will be in effect until either the state relaxes standards to the phase three "Protecting Our Neighbors" level, regresses back to the "Stay at Home" order, or we have 42 new, positive COVID cases in the county over a two week period (we're at 19 over the last two weeks as of today) OR there's a 15% positive rate on tests being given (we're currently at 11.7%) (8) If the variance is rescinded, the entire county would go back to the current "Safer at Home" guidelines, which would limit the number of people at the gym from 50 down to 10. 

What Does This Look Like For The Gym Today?

Currently, we're hamstrung by the explicit "no group classes" aspect of the state regulations. That, of course, is our bread and butter. We're also hamstrung by the social distancing requirement, which makes rolling, sparring, or partnered drilling impossible. It's worth noting the governor has explicitly stated that the social distancing requirement will last through all three stages of the state's plan, meaning we won't be able to go back to regular training until ALL COVID-19 mitigation regulations are lifted. And we have no idea how long that will be. Realistically, it's going to be AT LEAST several months. In all likelihood, it's going to be years. (1)

As such, our old business model most of us followed is effectively dead. 

However, there is a route to getting back to training before the pandemic ends. Because we can train unfettered with people from our own household, we can start there as long as we carefully control who has access to the gym AND we follow strict guidelines based on current known best practices. 

For example, it's perfectly fine (and not in violation of the mandates) for Shelly and I to roll at the gym. We just have to make sure nobody else is nearby AND thoroughly clean everything afterward. Since we already spend a ton of time in close physical proximity, there's no danger in rolling infecting us any more than our normal interactions as a couple (giggity.) Same deal with our kids.

The inherent danger to our community comes if people from different households start rolling or sparring. Because of the nature of the virus, it's likely impossible to prevent person-to-person transmission when rolling or sparring. If ONE person in a group has the virus at the beginning of a rolling session, EVERYONE will be exposed and likely infected by the end of the session. Those infected people would then likely spread the virus to the people in their household. It's entirely feasible for a single jiu jitsu class held once at one gym to push the number of positive cases in our county beyond that "42 positive cases in two weeks or 15% positive rate of testing" threshold set by the state for our county variance. (8)

In other words, one example of irresponsible behavior can ruin it for the entire county. 

So we have to be hyper-vigilant about our behaviors, which is precisely what we're working on developing for our gym right now. To this end, we're remaining closed to the public and only allowing current members (and only current members... no guests or people waiting or loitering) to train independently, and only after taking ample precautions like temperate checks, frequent cleaning, etc. 

What Does This Look Like For Gyms In The Future?

The pandemic is going to require us as gym owners to take an active role in assuring the most vulnerable members of our community remain safe, and the way we're going to accomplish this is taking the responsibility to stay informed and act independently. We need to keep an eye on the local situation. We need to know how many active cases we have in our community and how our local healthcare systems are faring. If the numbers shoot up, we need to tighten our restrictions regardless of what we're "allowed" to do. 

This also means we have to be hyper-vigilant about limiting access to our facilities. The fewer people we have walking through our doors, the safer we'll be. 

Finally, this means we have to closely monitor our students and push everyone to self-police. If they're showing symptoms (fever, cough, shortness of breath, headache, nausea, diarrhea, etc.), they need to avoid any contact with the gym or other members for 72 hours AFTER the symptoms disappear. If one or two people from our gym tests positive, we need to close for 48 hours (which is actually one of our regulations.) (4)

There is hope for the future, however. If we discover an effective treatment OR a vaccine, all of these regulations could end. Baring that, if we develop a cheap, effective serologic test (antibody test) that could determine if someone has had the virus and, presumably, developed at least short-term immunity, we could go back to some degree of normal training. Unfortunately, those tests are extremely unreliable to the point of uselessness. (6)

Until any of that happens, we'll be stuck in this weird limbo where we have to "thread the needle." This requires us gym owners to step up and become leaders in our community. Hopefully this post will start discussions on HOW that can happen and WHAT that leadership looks like. 

Gym owners - if you want to discuss these matters in more detail, feel free to drop me a line at eldiablobjj@gmail.com. 

Good luck, folks, and stay safe.

~Jason


***



Sources

    1. Colorado modeling report – 5/26/2020: https://covid19.colorado.gov/sites/covid19/files/MayModelingReport_20200523_FINAL.pdf
    2. Fatality rate and other data: https://www.9news.com/article/news/health/coronavirus/colorado-coronavirus-latest-may-27/73-3b3a8b7b-e4e2-4f52-a46b-22c29510dfc5
    3. Number of tests - https://www.greeleytribune.com/news/colorado-reports-no-additional-deaths-tied-directly-to-covid-19-as-testing-reaches-new-peak/
    4. Guidelines from the state: https://covid19.colorado.gov/sites/covid19/files/Press%20Availability%20May%2026%20%281%29.pdf
    5. WHO information: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/q-a-coronaviruses
    6. Antibody testing: https://www.cnn.com/2020/05/26/health/antibody-tests-cdc-coronavirus-wrong/index.html
    7. Montrose county: https://www.montrosecountyjic.com/
    8. Variance: https://www.montrosecountyjic.com/news-2/montrose-county-variance-application-approved/
    9. Gym criteria: http://www.montrosecountyjic.com/wp-content/uploads/2020/05/VARIANCE-GYMS-REQUIREMENTS.pdf
 10. Circulatory System: https://www.healthline.com/health-news/how-covid-19-triggers-heart-conditions



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