Latest Advisory on COVID-19 from the Sport Medicine Advisory Committee

Advisory on COVID-19
​19 March 2020
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SPORT MEDICINE ADVISORY COMMITTEE UPDATE:

As of March 19 the number of confirmed cases of COVID-19 is over 220,000 globally, with approximately 85,000 recovered and over 9,000 deaths. The largest surges in cases continue to be in Europe with Italy, France, Germany and Spain being hardest hit. There are 171 countries reporting cases. Of note significantly, there are NO new local cases reported in China.The WHO has declared COVID-19 as a pandemic.
 
In Canada, the numbers are rising at an accelerated rate, with over 725 confirmed cases, with 9 deaths. The Public Health Agency of Canada still states that the overall risk of infection in Canada is low, but the entire nation needs to work together to “flatten the epidemic curve” through minimizing spread is key. All Canadians are requested to stay home and work from home, practice social distancing (2m distance) if at all possible.
 
The existing strong advice on the importance of hand and facial hygiene and “social distancing” still holds.
 
Updated Government of Canada Recommendations:

• All non-essential travel outside Canada is to be avoided, the US border is closed to non-essential traffic.
• All Canadians currently abroad are urged to return to Canada ASAP.
• All travellers returning from any destination outside of Canada are required to self-isolate for 14 days from the date of return (see the infographic below for specific information on what is involved in self-isolation).
• As the possibility of coming in contact with someone with confirmed COVID 19 increases, we have included this link from the Public Health Agency of Canada (PHAC) on self monitoring and isolation.
• If you have symptoms (fever, cough, runny nose, sore throat) when attempting to board a plane to return to Canada you will not be allowed on the flight.
• Airlines are reducing capacity and flights (e.g. - Air Canada is operating at 50% of normal capacity), such that it may be difficult to return to Canada later.
• As of 18 March, international arrivals by air (excluding USA, Caribbean, and Mexico) will only be through Toronto, Montreal, Calgary or Vancouver.
• There is enhanced screening and advice on self-isolation at all airports (see the infographic below).

 
KNOW THE DIFFERENCE: SELF-MONITORING, SELF-ISOLATION, AND ISOLATION FOR COVID-19
 
Sports and Institutes:

• The IOC and IPC are working daily with International Sport Federations to develop fair alternate qualifying processes. 
• INS, CSIO, CSIC, CSCS, CSCM, CSIP and CSCA are all physically closed but are providing remote services as many staff are working from home. Contact your regional institute or centre as below for details on accessing service.

 
CSI Pacific

• All CSI Pacific staff are working remotely and at present, providing only remote support and services to their sporting partners.
• As the Camosun Athletic and Exercise Therapy Clinic is closed, Medical and Paramedical providers are also only able to provide remote services at this time. If an athlete would like a medical consultation, please contact CSI Pacific CMO Dr. McCluskey at pmccluskey@csipacific.ca.
• If an athlete would like a physiotherapy consultation, please email Sue Lott at suzyqlott@gmail.com
• If you would like a Strength and Conditioning Consult, please contact your sport's CSI Pacific S&C lead
• If you would like a Physiology consult, please consult your sports physiology lead.

Additional Information

• NSOs determine optimal adapted training environments and strategies to support athlete training and overall well-being. NSOs are encouraged to contact CSIs/CSCs to communicate required initiatives or support to meet athlete needs.
• As noted before athletes should not seek on-site medical attention for respiratory conditions (cough, fever, runny nose, sore throat) at CSI/CSC clinics if they are feeling ill. Consult with local public health authorities or CMOs by telephone or email to discuss treatment, isolation or the need for testing.
• Over the last 48 hours there have been multiple closures and restrictions on public gatherings, restaurants, bars, casinos, gyms, libraries, etc. across the country. This varies by region. Check the provincial links here (PROVINCIAL LINKS) or your own city links for details and specifics.

 
Caution re: Anti-Inflammatory Medications / NSAIDS

• As reported by WHO and in the British Medical Journal published 17 Mar, people with suspected COVID-19 should avoid non-steroidal anti-inflammatory drugs (so-called NSAIDs such as: ibuprofen / Advil / Motrin; naproxen / Aleve; diclofenac / Voltaren; ASA / Aspirin; others) for symptoms and use acetaminophen / Tylenol instead. 
• The use of NSAIDs may lead to more serious symptoms of respiratory or septic complications and cardiovascular complications. 
• If symptomatic relief of fever or aches and pains is required, use acetaminophen (e.g. Tylenol or other brands thereof), not NSAIDs.

 
Training Environments:

• NSOs should withhold athletes/coaches/staff with symptoms from attending training.
• Medical advice recommends that self-isolation includes staying at home and avoiding all mass gatherings and public transport. Training outside (e.g. running) is permissible in isolation; avoiding social gatherings or training groups.
• Spacing of 2 metres or greater for exercising athletes (equivalent to 4m2 = 45ft2 floor space per athlete in indoor spaces) is recommended and should be adopted by NSOs in terms of athlete and equipment spacing.
• If training facilities are still accessible NSOs should check with facility cleaning services regarding cleaning fluids and enhanced practices to ensure optimal effectiveness of products, and to ensure that cleaning is directed at surfaces frequently touched by hands rather than floors and walls, etc.
• NSOs should strongly review training in public venues that they cannot control for enhanced hygienic practices or social spacing appropriate to athletes. Consider off-hour use and NSO involvement in monitoring of cleaning.

 
Mental Health:

• It is important to attend to the mental health of athletes whose training or qualification for 2020 Summer Games may have been interrupted by this pandemic.
• Athletes can reach out to mental health professionals or mental performance consultants through their NSO or at regional institutes by email.
• Please see the linked infographic from Game Plan for additional advice below.

 
CANADIAN NATIONAL TEAM ATHLETE MENTAL HEALTH RESOURCE GUIDE