FAQS About COVID-19 and Sport

Evidence-based information on the Coronavirus (COVID-19) and high performance sport (Provided by the Australian Institute of Sport)

What is COVID-19?

 

COVID-19 is the name of the disease that is caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). This is a new virus recently identified in Wuhan, China. Currently there are seven types of Coronavirus that are known to infect humans, four of those commonly circulate in the community and generally result in minor illness such as the common cold. The remaining two are associated with significant illness being Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV) and Severe Acute Respiratory Virus (SARS).

 
How unwell does COVID-19 make you?

 

COVID-19 results in a spectrum of illness ranging from possible asymptomatic carriage, common cold to severe cases requiring hospital admission. In a small minority of cases, COVID-19 can be fatal.

The early epidemiological characteristics published should be interpreted with caution. Patients with milder disease would be less likely to seek medical attention and therefore may not be included in the statistics.

 

Epidemiological reports from patients who received medical attention in China suggest the following breakdown of COVID-19 cases:

  • 1% have no symptoms

  • 81% have mild symptoms like the common cold

  • 14% have severe symptoms that cause them to miss work and/or attend hospital

  • 5% have severe symptoms, often requiring ICU admission (including a fatality rate of about 2.3%)

(Wu & McGoogan, 2020).

 

There were no reports of deaths in people aged nine years or younger and of the 1716 health care workers diagnosed who may be presumed to be younger with less co-morbidities there were five deaths reported giving a fatality rate 0.003%, which may be more representative to athletes and coaches (Wu & McGoogan, 2020).

 
How do I know if I am unwell with COVID-19?

 

The most common symptoms are fever, cough and shortness of breath. It can be difficult to tell the difference between COVID-19 and other common respiratory illness particularly in the early stages of illness. Individuals should consult with their doctor by calling ahead. The doctor can take a thorough history, including travel history, perform a physical exam and make a recommendation regarding testing for COVID-19.

What is currently known about the clinical course of infection?

 

The estimated incubation period is between 1-14 days but is about five days on average. The incubation period is the time from when exposure to the virus occurs until symptoms start. Symptoms can persist for longer than three weeks, although the duration of illness will be highly variable.

The literature has demonstrated older and immune compromised persons are more likely to have worse outcomes from the virus, compared to fit young healthy people. However, it has been observed that even mild cases that can be managed as an outpatient have resulted in viral pneumonia observed on lung imaging. What this means for athletes is that for those athletes who contract the virus the risk of becoming critically unwell is low, however even the course of a mild infection is likely have a significant impact on your ability to train for weeks to months, re-enforcing the need to be diligent with infection prevention measures.

 
How contagious is COVID-19?

Analysis of the number of cases from the Diamond Princess suggests that COVID-19 is more contagious than seasonal influenza.

 

This can change based on the circumstances the outbreak is occurring in and it is expected this will be refined over time as more is known.

 

At this point it is expected that for every case of diagnosed COVID-19, a further 2 to 3 cases will be

diagnosed.

 
How is COVID-19 spread?

The virus is transmitted primarily through respiratory droplets. There is ongoing research to determine if

there are other possible modes of transmission such as faecal or through the air.

Infected individuals who are currently unwell are far more likely to be contagious than infectious individuals who have no symptoms. Australians who have travelled overseas in the last 14 days, or have come into contact with a known case of COVID-19 are considered to be at risk.

 
How do I reduce my risk of getting COVID-19?

Hand hygiene remains the single best action individuals can take to reduce their risk of acquiring any respiratory or gastrointestinal tract infection. While COVID-19 is a global concern the number of cases of influenza globally far outweighs the number of COVID-19 as reported on the Global Influenza Surveillance and Response System (GISRS). Annual influenza vaccination remains an important infection prevention measure.

 

You should be vigilant with frequent hand washing using soap and water or an alcohol-based hand rub. Make sure you adhere to 'illness etiquette'. If you are coughing and sneezing, do so away from people into a tissue, your elbow or hands. If you cough or sneeze into your hands, make sure you wash your hands afterwards. Seek medical review early if you are feeling unwell.

 

Research in respiratory infections in travelling sporting teams suggests that the most likely pattern of spread occurs from within a team, rather than from external sources. When an unwell team member joins the team, due to the regular close physical contact between team members the infections can spread readily within a team (Valtonen et al., 2019).

 

Unwell members of the team should not be permitted to attend training or attend work.

 

Social distancing is an effective measure that can contribute to the reduction of transmission of COVID-19 in the community. The current federal government recommendations for social distancing include;

  • When going into public spaces people should only gather in groups of two, or be with members of their own household

    • If exercising outdoors in groups of two, or in family/household groups, maintain at least 2 m between exercising individuals at all times

  • Avoid any public gathering spaces such as public playgrounds, outdoor gyms and skate parks.

  • Staying at home and only leaving home for the following reasons

    • shopping for what you need, food and other essential supplies that enable you to remain at home and to do that shopping as infrequently as possible

    • for medical care or compassionate needs

    • to exercise in compliance with the public gathering rules

    • for work and education if you cannot work or learn remotely

  • When outside your home keeping a distance of 1.5 m between yourself and other people.

 

Aspects of these recommendations may be enforceable by law depending on the state or territory you are currently in.

 
How is COVID-19 treated?

Currently there is no specific treatment for COVID-19. The aims of medical management are to identify other treatable causes of illness (such as influenza), manage any complications from COVID-19 and provide advice on how to limit the transmission from known cases.

Significant resources are being allocated to the development of a vaccine and to assess the efficacy/safety of currently available antiviral medications. The results of the first wave of randomised control trials are being conducted in China and results will be due to be released in mid-2020. A vaccine will likely take longer to go through clinical trials.

 
Should I restrict my physical activity?

 

Exercise and maintaining your level of fitness remains an important part of physical and mental health for

everyone.

 

For those who are well, they should continue to train, within the current restrictions on public gatherings.

 

At this point athletes should not attend team training, public or outdoor gyms, playgrounds or skate parks.

 

Athletes should discuss with their national sporting organisations and coaching staff methods for continuing to exercise and maintain their fitness through this period.

 
What if I am pregnant or planning to become pregnant?

 

Currently there is not enough available information to provide strong, specific advice regarding any additional risks posed by COVID-19 in pregnancy. The decision for women who are pregnant or are planning to become pregnant to travel with teams to areas that have a higher risk profile is best made on an individual basis after a discussion with a medical practitioner.

NSO and coaching staff should support any decision a woman makes regarding their decision to travel or attend work in these circumstances. NSOs should offer measures to allow women to continue to contribute remotely should this be practical.

The CDC provides a summary of what is currently known regarding additional risks in pregnancy.

 
What specific challenges do athletes and sporting events need to consider when evaluating infection transmission in higher risk environments?

 

Current restrictions in the movement and gathering of people is changing rapidly and varies by State and Territory. Athletes and sporting organisations need to observe both the Federal restrictions and State or

Territory government restrictions that are currently in place with individual and public health taking priority over elite sport needs.

All elite athletes should be working with their national sporting organisations and coaches to adapt their training schedule according to the current social distancing advice, how the athlete is coping with the changes and what resources are available to them in their home to train. The Federal government has indicated that the current situation is likely to be in place until at least September 2020.

 

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