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Massive event at Hong Kong fitness center highlights risk of transmission of Covid-19 in confined spaces with poor ventilation, study released Tuesday by US Centers for Disease Control and Prevention found .

Researchers at the University of Hong Kong studied how a trainer infected with Covid-19 was connected to 101 subsequent cases among gym visitors and 53 close contacts.

On March 10, a 27-year-old trainer at a fitness center in Hong Kong without symptoms tested positive for Covid-19, according to the study. As the trainer was giving in-person lessons between February 28 and March 8, the gymnasium was closed to the public and local health officials began tracing contacts.

About 300 people who visited the fitness center between February 25 and March 10 had to be tested, and of these, seven staff members and 94 customers tested positive.

Over 80% of these cases were detected within three days of the trainer’s positive test. The team also reported 53 close contacts of those cases that tested positive for Covid-19, although they had no connection to the fitness center.

Of the 102 cases connected to the gym, 46 had no symptoms when tested – a much higher proportion of asymptomatic cases than in the general population of Hong Kong, the researchers noted. The team said the reason was unclear, although they noted that the 102 cases were on average younger than the general population.

How did it happen: The team used virus sequencing to determine that the event was caused by a “single virus introduction.”

Visitors to the fitness center were not required to wear masks at the time of the outbreak and the gymnasium had poor ventilation, which researchers say may have played a major role in the outbreak.

After the outbreak, new recommendations were put in place to avoid similar outbreaks.

“Our finding highlights the risk of transmitting the virus in confined spaces with poor ventilation and limited public health interventions,” the researchers wrote.

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