Swimming Pools and COVID-19: Precautions for People with Chronic Illness

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Water therapy and swimming may be a big part of your physical activity routine if you’re living with arthritis or a related musculoskeletal condition. However, like many others, you’ve likely thrown in the pool towel during COVID-19 and its consequential closures.

Now that pools are slowly beginning to reopen across the country, you may be wondering: Is it safe to swim again, especially if you may be in a high-risk group for COVID-19 complications?

Here are the risks to consider, and what precautions you can take to swim safely this summer.

The Risk Level of Swimming During the Coronavirus Pandemic

Although every situation is unique, the likelihood of you contracting COVID-19 in a swimming pool is relatively small.

“It’s important to remember that a brief, close encounter like passing someone in a pool [such as while swimming laps] is very low-risk,” says David Aronoff, MD, director of the Division of Infectious Diseases at Vanderbilt University School of Medicine in Nashville, Tennessee. “What we really consider to be a higher-risk encounter is being within six feet of someone for more than 10 to 15 minutes.”

The COVID-19 virus is spread primarily from person to person through respiratory droplets produced when an infected person sneezes or coughs, per the U.S. Centers for Disease Control and Prevention. That spread is more likely when people are within six feet of each other.

That said, you won’t have a mask to protect yourself in the water. The CDC guidelines for public pools advise against wearing face coverings while swimming, because they can be difficult to breathe through when they’re wet.

“You could transiently hold your breath as you pass somebody while swimming, or turn your head to the opposite side,” says Dr. Aronoff. “But swimming in the opposite direction from someone else in a neighboring swim lane is still a really low-risk interaction.”

On the other hand, swimming with others in the same lane or swimming parallel to and in pace with someone else would be a higher-risk scenario, as would taking a water aerobics class for an extended period of time unless all the participants can maintain a distance of six feet or more apart from each other.

In terms of the water itself, the virus will likely be quickly inactivated by a properly chlorinated or brominated pool.

“The virus isn’t super stable, particularly in water that’s specifically treated to kill germs,” says Dr. Aronoff. “And even if someone contaminates the water around them with the virus, it will get diluted very quickly.”

You will likely have a higher risk of contracting the virus in any indoor spaces you visit before or after using the pool, like locker rooms. That said, many public pools are following safety tips recommended by the CDC, which include:

• Cleaning and disinfecting commonly touched surfaces at least daily and shared objects after every use (i.e. handrails, slides, lounge chairs, pool noodles, and kickboards)
• Modifying deck layouts so individuals can stay at least six feet apart from those they don’t live with in standing and seating areas
• Making sure there is enough soap, hand sanitizer, paper towels, tissues, and no-touch trash cans to support hygiene
• Staggering or rotating shifts to limit how many people are at the pool at the same time
• Discouraging swimmers from sharing items that are difficult to clean or disinfect or that come in contact with the face (i.e. goggles and snorkels)

If your local public pool is following these CDC guidelines, and swimming is your go-to form of exercise, avoiding the pool may actually be the riskier option.

“If you go swimming at a pool that has monitoring and regulation, the potential benefits would definitely outweigh the risks in my opinion,” says Robert Keenan, MD, a rheumatologist at Duke Health in Durham, North Carolina. In other words, the mental and physical health benefits of swimming, routine, and socialization are powerful when you have chronic illnesses like arthritis.

Precautions to Take While Swimming During the Coronavirus Pandemic

The the same tips you’ve learned over the past few months to prevent the spread of COVID-19 also apply to pool settings.

“Those basic principles of creating distance, physically blocking transmission, and keeping your hands and environment clean are not any different in a gym, health club, or a swimming pool than they are at a grocery store,” says Dr. Aronoff.

If you are immunocompromised or at high risk for coronavirus complications and are thinking about returning to a public swimming pool, Dr. Aronoff recommends calling or visiting the venue to learn about or observe their hygiene strategies (and how closely they align with CDC guidelines).

Ask the pool staff questions such as:

• How often are surfaces cleaned around the pool?
• What procedures are in place to maintain social distancing?
• Are group exercise classes still taking place in the pool, and if so, how have they been modified to prevent the spread of COVID-19?

Since enclosed spaces like locker rooms may carry a higher risk than the pool itself, also ask the staff if accommodations can be made for your valuables (car keys, wallet, etc.) while you’re swimming.

“You should try your best to make plans to change clothes and shower at home if you have underlying health conditions,” says Dr. Aronoff. “Contained, indoor spaces where people are close together are higher risk, and some venues are even keeping their locker rooms closed during the pandemic.”

Face Masks

On that note, it is important to wear your mask when physical distancing is difficult outside of the water. However, be sure to dry off completely before putting your mask back on, because getting it wet can reduce how effective it is, says Dr. Aronoff.

Towels

You may also consider bringing your own towel from home.

“The biggest benefit of bringing your own towel is you know how it’s been laundered and handled, and that may give you some peace of mind, even though clean towels at the pool are low-risk,” says Dr. Aronoff. “Another advantage is that it marks it as yours, so people are less likely to touch it.”

Hand Sanitizer

While you don’t need to bring hand sanitizer into the pool with you (the treated water will disinfect your hands), it’s a good idea to use it after you’ve returned to your pool chair. This will help protect against germs that may be lurking on the pool ladder, pool chair handles, and other commonly touched surfaces.

If you’re in a high-risk group for COVID-19, it’s particularly important to take these precautions and to mitigate risk by visiting the pool when it’s less likely to be crowded.

The Benefits of Swimming Again

Carefully determine the level of risk swimming may pose to you individually. If you and your doctor are confident you can safely return to your local swimming pool, there are many benefits to your health.

Swimming is often recommended for those with arthritis because it’s a low-impact aerobic exercise that’s easy on your joints. You should try to work your way up to 150 minutes of moderately intense aerobic exercise per week, even if you split that time into 10-minute periods, per the Mayo Clinic.

“Swimming has the dual benefit of being low-impact while still strengthening muscles,” says Dr. Keenan. “Anything that strengthens your muscles will help support the joints better and take stress off of them.”

Just be sure not to dive in too quickly if you haven’t gone swimming since before COVID-19. That may mean starting with 10- to 15-minute swims, even if you normally swim for 30 minutes, to avoid soreness or potential injury.

“You’ll get to where you were before, but not overnight,” says Dr. Keenan. “It may take a good two to four weeks, so the key is to go slow and ramp up over that period of time.”

Of course, always talk to your doctor before adding something new like swimming to your exercise routine. Your doctor can help you determine the best exercise plan — or even the best swim stroke – based on your type of arthritis.

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