An integrated approach to monitoring and estimating COVID-19 risk exposure among leisure-time physical activity participants

Background: Leisure time physical activity (LTPA) provides both health benefits and risks, particularly during a pandemic. During the COVID-19 pandemic, significant increases in close-to-home LTPA raised concerns for public health and land managers alike. This project illustrates a novel, integrated monitoring approach to estimating COVID-19 risk exposure during trail-related LTPA, with implications for other public spaces. Methods: COVID-19 risk exposure was conservatively calculated from the integration of in-person observations of LTPA trail groups and automated monitoring of trail traffic volumes in spring 2020. Trained observers tracked 1,477 groups. Traffic volume estimates and observed distance data were integrated, considering occlusion and total trail traffic volume. Results: 70% of groups had one or more encounters. Among individual users, 38.5% were 100% compliant across all events observed but 32.7% were not compliant. Considering trail traffic volumes and annual daily traffic volume, exposure to risk of COVID-19 was conservatively estimated at 61.5% among individual trail users. Conclusions: Monitoring opportunities and challenges of health risk exposure exist. Adjusted exposure measures based on volume counts can approximate numbers of unique individuals exposed, inform management actions, efficacy and policy decisions.