Earlier this summer, an ICU doctor in the United Kingdom ran nearly 22 miles while wearing a cotton mask and monitoring his oxygen levels.
What Tom Lawton found was his blood oxygen levels -- which should be 95% or higher for healthy individuals -- were consistently at 98%. Lawton used the experiment to prove that face masks, while sometimes uncomfortable, don’t impair oxygen intake.
Lawton’s run has been used by Dr. Matt Axtman, an orthopedic sports medicine doctor for Spectrum Health in West Michigan, as an example of evidence that it’s safe to wear a mask when participating in high-intensity training and competition.
“Some athletes insist that wearing a mask while running decreases their oxygen levels, restricts air flow and/or results in oral infections,” Axtman wrote in a recent article for Spectrum Health. “But there have been no studies or proof that masks decrease oxygen levels in the blood or affect running performance.
“There is no proof that masks increase or put an individual at risk for oral or pulmonary (lung) infections.”
Michigan Gov. Gretchen Whitmer confirmed this week that athletes participating in sports that don’t allow for 6 feet of separation, like football, soccer and volleyball, will be required to wear masks while training, practicing, and competing until further notice. She signed Executive Order 2020-180 on Wednesday evening.
Related: Gov. Whitmer: Football players, other athletes must mask up, even while competing
Masks won’t be required for athletes in cross country, golf and tennis, if they can stay spread out. Swimmers will be exempt from needing a face covering.
A wet mask can leave athletes with the sensation that air flow is decreased, so Axtman recommends having an extra mask or two on hand in case the primary mask gets saturated with sweat. He also recommended trying out different masks to find one that’s breathable and fits well.
But overall, he said wearing a mask “doesn’t reduce performance or have any major functional limitations” on an athlete.
The mask mandate, which also applies to members working out in gyms across the state, has not been received by all with open arms. Some have questioned the safety of the requirement, given that the World Health Organization has recommended people not wear masks when exercising because it may reduce their ability to breathe comfortably.
One Michigan Senator, Lana Theis, R-Brighton, published a letter to the governor on her website Wednesday requesting that the governor allow organized practices and competitions to resume without the face mask requirement.
“To be forced to restrict one’s breathing by order of the government while engaging in an otherwise healthy activity not only makes the activity more difficult, but it also could threaten the health and safety of our athletes, especially for those who may have underlying breathing issues, such as asthma,” Theis wrote.
“Wearing a mask while on the sidelines in close physical contact makes sense and should be encouraged. But to require athletes to “mask up” while competing is a penalty they should not be required to suffer. Please amend your executive order and let our athletes breathe.”
During a press conference Wednesday, Sept. 10, Whitmer and Dr. Joneigh Khauldun were asked about the perceived health risks. The governor noted that women in labor, some of which for 20 hours, have had to wear masks, implying that athletes could safely wear them too.
“That’s some of the hardest work you can do," Whitmer said. “I don’t want to make light of the necessity of mask wearing. It’s really important.”
Khaldun, the state’s chief medical executive, said she hasn’t found any proof that it’s unsafe to exercise with a mask on. Neither has Dr. Axtman, nor Dr. Emily Toth Martin, an epidemiologist and associate professor at the University of Michigan School of Public Health.
“The two things we know more than anything that work to prevent the spread of COVID is social distancing and masking.” Martin said. “To get rid of both of those components means you’re walking into a scenario with no tools to stop the spread.”
Asked about athletes with asthma wearing masks, Dr. Axtman said running with the mask on could trigger an asthma attack. But that athlete could also be more susceptible to a more serious case of coronavirus if infected.
He recommended speaking with your primary care physician or pulmonologist to help weigh the risks and benefits of wearing a mask and/or playing sports at this time.
While athletes and gym members can resume contact sports and indoor workouts in Michigan, Dr. Khaldun doesn’t recommend either as the state continues to see 55 new coronavirus cases per million people per day, and a positive test rate above 3%.
For athletes who don’t feel they can comfortably participate in sports like football, soccer or volleyball with a mask on, Khaldun said "maybe they won’t be able to participate, unfortunately, at this time.”
In addition to washing hands regularly and not touching your face, officials recommend practicing social distancing, assuming anyone may be carrying the virus.
Health officials say you should be staying at least 6 feet away from others and working from home, if possible.
Use disinfecting wipes or disinfecting spray cleaners on frequently-touched surfaces in your home (door handles, faucets, countertops) and carry hand sanitizer with you when you go into places like stores.
Michigan Gov. Gretchen Whitmer has also issued executive orders requiring people to wear face coverings over their mouth and nosewhile in public indoor and crowded outdoor spaces. See an explanation of what that means here.
Additional information is available at Michigan.gov/Coronavirus and CDC.gov/Coronavirus.