SUNDAY BYTES: Save Precious Lives! Gyms, Bodybuilding Clubs Must Be Equipped for Life-Saving Response
Dr. Fiaz Maqbool Fazili
A disturbing viral video of a young man collapsing during exercise—and the helpless onlookers around him—should shake us out of our complacency. A life was lost not only to a suspected cardiac event, but also to the absence of immediate, informed response. No one stepped forward with CPR. No one appeared trained. No system was in place. This is not just an isolated tragedy; it is a systemic failure. It demands urgent attention.
Sudden cardiac arrest can strike without warning, even in seemingly healthy individuals. The difference between life and death in such cases is often measured in minutes. Immediate cardiopulmonary resuscitation (CPR) and timely defibrillation can double or even triple survival rates. Yet, in many gyms and fitness centres across our region, there is a glaring absence of even basic emergency preparedness. This is unacceptable.
Every gym, fitness centre, and bodybuilding club must be mandated to have a functioning resuscitation trolley equipped with essential life-saving tools—an Automated External Defibrillator (AED), oxygen supply, and basic airway management devices. More importantly, equipment alone is not enough. Staff must be trained in Basic Life Support (BLS), including CPR and AED usage. Certification should not be a one-time formality but a periodically renewed competency.
We cannot continue to treat gyms merely as commercial spaces focused on aesthetics and performance. These are high-risk environments where individuals push their physical limits, often without proper medical screening or supervision. The rise of intense workout regimens, coupled with the unregulated use of performance-enhancing substances, has added a new layer of risk. There is growing concern that certain supplements, steroids, and chemical enhancers—often used without medical guidance—may predispose users to cardiovascular events, including arrhythmias, myocardial infarction, and sudden death.
This raises an important public health question: are we adequately regulating what goes into the bodies of those who frequent these establishments? Many of these substances are procured over the counter or through informal channels, with little to no quality control. Some may be adulterated, mislabeled, or outright dangerous. There is an urgent need for regulatory bodies to step in, enforce standards, and ensure that what is being sold and consumed is safe.
A simple medical evaluation—history, blood pressure check, and basic cardiac assessment—can go a long way in identifying those at risk. After COVID-19, the pattern of cardiovascular illness has undergone a notable shift. What was initially perceived as primarily a respiratory infection is now widely recognized to significantly involve the vascular system. The virus has the capacity to induce endothelial dysfunction, causing damage to the inner lining of blood vessels, along with persistent inflammation and a pro-thrombotic state that promotes clot formation. In essence, it behaves, at least in part, like a vascular clotting disorder rather than a purely pulmonary disease.
Even after apparent clinical recovery, a subset of individuals may continue to carry a silent burden of low-grade inflammation, microvascular injury, and an increased tendency toward thrombosis. These lingering effects often remain subclinical but can later culminate in serious and sometimes fatal cardiovascular events such as myocardial infarction, sudden cardiac arrest, or pulmonary embolism. What is particularly concerning is the increasing incidence of such events among young, seemingly healthy individuals, many of whom are actively engaged in strenuous physical activities, especially gym workouts.
Intense exercise places significant physiological demand on the cardiovascular system. In the presence of unresolved inflammation, an underlying pro-thrombotic state, or occult myocarditis, this stress can act as a trigger for catastrophic outcomes. This evolving risk profile challenges the long-held assumption that youth and physical fitness inherently confer protection against cardiac events.
In this context, the need for pre-exercise cardiovascular screening, particularly for individuals with a history of COVID-19, becomes critically important. A careful evaluation should include a detailed medical history with attention to the severity of prior infection, assessment of blood pressure and overall cardiovascular risk, and baseline investigations such as an electrocardiogram. Equally important is the need for pre-participation health screening. Individuals with undiagnosed cardiac conditions may unknowingly place themselves at risk during high-intensity workouts. Where clinically indicated, further evaluation with echocardiography and cardiac biomarkers may be warranted. Equally important is the adoption of a gradual and supervised return-to-exercise protocol rather than abrupt resumption of high-intensity workouts.
The broader public health message is clear: it is no longer sufficient to equate youth with safety. The post-COVID era demands a more cautious and structured approach to physical exertion, with an emphasis on early detection, risk stratification, and preventive screening, particularly among gym-going populations.
Gym memberships should ideally require a fitness clearance, especially for high-intensity programs.Alarm bells are ringing , the concerned departments—particularly the Directorate of Health Services and the Directorate of Sports—must step in with urgency and authority. They bear a shared responsibility for ensuring safety and healthcare standards in such high-risk environments. An immediate, comprehensive audit of all gyms and bodybuilding clubs is essential to assess whether standard operating procedures (SOPs) are in place and being followed. This should include verification of substances used for body building and emergency preparedness, availability of resuscitation equipment, CPR kit and certification of staff in Basic Life Support. Regulatory oversight cannot remain passive; it must be visible, enforceable, and continuous to prevent avoidable tragedies.
Public awareness is another critical pillar. CPR is not just a medical skill; it is a life skill. Every citizen should be empowered with the knowledge and confidence to act in an emergency. Schools, colleges, workplaces, and community centres should integrate BLS training into their programs. A culture of readiness must replace the current culture of bystander paralysis.
Policy intervention is now overdue. Health authorities, municipal bodies, sports authority and licensing agencies must collaborate to create enforceable guidelines. No gym should be allowed to operate without certified BLS-trained staff, emergency equipment, and a clearly displayed emergency response protocol. Periodic audits and penalties for non-compliance must be instituted.
We must also address the ethical responsibility of gym owners and trainers. When individuals entrust their health and safety to these establishments, there is an implicit duty of care. Ignoring this responsibility in pursuit of profit is not just negligent—it is dangerous.
The viral video that sparked this conversation is painful to watch, but it must not be forgotten. It should serve as a catalyst for reform. Lives can be saved—not by chance, but by preparation. Not by hope, but by action.
This is a wake-up call. Let us not wait for the next tragedy to act. Let us build a system where every gym is not just a place for physical transformation, but also a space of safety, responsibility, and readiness.
(STRAIGHT TALK COMMUNICATIONS EXCLUSIVE. The author is a medical professional who contributes to the development of healthcare policies, safety protocols, and systemic reforms.)
