I am the President of the Medical Fitness Association. We have worked for the last several months in coordination with NIOSH and the CDC to develop a comprehensive protocol for safely re-opening fitness facilities taking into account ADHS concerns that 6 feet of distancing is not enough in a dynamic exercise environment. Our protocol calls for a phased re-opening starting with those who need it most - populations at risk because of chronic conditions including cancer, Parkinson's, cardiac diagnoses, musculoskeletal issues, respiratory diseases,etc. As you are aware exercise has been shown in multiple studies to improve the immune response of patients with chronic diseases as well as the general population. We are happy to share a copy of our guidelines for your review and consideration (https://www.medicalfitness.org/resources/covid-19-resources/) located on our COVID 19 Resources page. We believe that patients who need exercise to help manage their conditions should be allowed to resume exercise following our published guidelines. So far, more than 20 states have allowed medically based fitness centers to re-open as essential businesses treating patients using our enhanced distancing protocols. Even commercial facilities with the credentialed staff to safely prescribe and oversee an exercise prescription for these special populations should be allowed to partially re-open if they agree to the enhanced distancing guidelines. Many facilities are safely returning to group exercise in outdoor settings with enhanced distancing requirements. I urge you to consider these guidelines and create a path to re-opening of your state's fitness centers. They play a vital role in the prevention and management of chronic diseases. Please feel free to contact us if you would like to discuss further.