Update #11: Advisory on COVID-19

Wednesday, April 8, 2020
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SPORT MEDICINE ADVISORY COMMITTEE UPDATE:

Within Canada the number of cases continues to rise across the country, but the rate of new cases appears to be slowing in most regions although at different rates. Despite this, areas or clusters of sustained infections and rising hospitalisations are still occurring. In Canada the overall “doubling time” is now between 4 and 5 days. This is in large part due to the efforts of everyone to stay at home and of the social distancing since 12 March. Interesting, of the present confirmed cases 79% have no known contact which reinforces the previous recommendations of “Act as if you are infected and treat anyone you come into contact with as if they are infected”. It is also important to understand that 63% of all confirmed cases in Canada are between the ages of 20 and 59 (28% of all cases between 20 – 39) no one is immune!

There is increasing evidence that people who are infected will transmit the virus even before they show any symptoms. (This is one of the reasons for Dr. Tam suggesting that masks be worn when social distancing cannot be guaranteed - to minimize asymptomatic spread.) If you do wear masks it is very important that you are fully versed in how to put them on and take them off to stop contaminating your own hands (Link to Canada govt website). https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks.html

Although certain countries in Europe and Asia are considering relaxing isolation restrictions in the near future, it is still far too early in Canada for us to start to follow suit. We need to keep on with the social isolation, hygiene and distancing measures to ensure the gains made so far are effective and sustained. It is still not safe to look for loopholes to restart group training. It remains essential for everyone for all of us to avoid training in teams/crews/ pools etc, using shared equipment of public facilities as per the previous statements.

Training
As per the previous updates we strongly encourage athletes to take this enforced self-isolation period to work with their Coaches, HPDs, IST and CMOs to address any known biomechanical and physical deficiencies that are easily addressed with home training and NOT to be attempting to reach peak performance this year. (Rationale has been addressed in earlier releases.) If you do have symptoms you should not train until you have contacted your Team Physician, CMO, CSI physician or Family physician to avoid any potential complications etc.

Anti-Doping
As noted previously in the CCES advisory, the CCES has suspended testing at this time. There may, however, still be independent agencies that are doing testing on behalf of IFs or leagues. It is important to keep your whereabouts current. Links to useful information re CCES, their contacts and useful Q&As in case you are approached for testing are included below.
 
The CCES’ Notice:  https://cces.ca/news/cces-testing-program-hold
The CCES will advise when the suspension is lifted. The timeline obviously is dependent on how the situation unfolds.

WADA published a helpful Q&A for athletes: https://www.wada-ama.org/sites/default/files/resources/files/covid-19_qaforathletes_en_0.pdf

Athletes can keep reaching out to us for any questions or support they need. Depending on how much info you want/can provide, you can either provide  info@cces.ca  as the general contact, but here are some more specific contacts. All are monitored during this time:

Whereabouts support: whereabouts@cces.ca
Report Doping: intelligence@cces.ca
E-learning support: onlinelearning@cces.ca
Substance inquiries: substances@cces.ca
TUE questions and applications: tue-aut@cces.ca

Nutrition
Scientific evidence currently shows  no indication that COVID-19 is a foodborne illness . Evidence does, however, show that the virus can be transmitted via contact (with an infected person, surface or object) or droplets (from and infected individual coughing, sneezing or talking). 

According to the  Centers for Disease Control and Prevention (CDC), the transmission of the virus is far more likely to spread through  respiratory droplets  from an infected person and much  less  likely via surfaces or food.
       
TIPS FOR SAFE GROCERY SHOPPING                                                                                          
While grocery chains have  ramped  up cleaning and sanitation measures to keep customers safe, it is essential that we also maintain proper hygiene when grocery shopping. 

When at the store, touching surfaces and objects such as shopping carts, freezer door handles, and grocery items are inevitable.

Use disinfecting wipes to wipe down baskets and shopping carts, freezer door handles. (Discard used wipes immediately after use and wash your hands when possible.)  Health Canada has published a list of hard surface disinfectants that are likely to be effective for use against COVID-19.

Keep your distance (2 m)! Follow the one-way signs in the aisles. 

Opt OUT OF RECEIPTS!

Latex gloves are not durable and designed for everyday activities, like grocery shopping. They can rip easily and making them ineffective to protect you. Gloves require proper discarding and frequent changing after use. They should be reserved for our front-line workers. You can use your own gloves (and wash after use) or simply practice good hand hygiene and use a hand sanitizer (with 70% alcohol) as you leave the store and wash your hands immediately when you get home after your grocery trip.

Visit stores during less busy hours. 

Bag your groceries yourself to minimize touching by the store clerk or use the self checkout.
It is advised NOT to use your own re-usable bags. Use single use bags and discard after use and wash hands thoroughly after touching.

AT HOME
Currently, there are no documented cases of COVID-19 that were infected by viral transmission through food . However, the New England Journal of Medicine states that the virus can remain viable on hard surfaces, such as:

Plastic and steel, for up to 3 days 
Cardboard, for 24 hours
Copper, for four hours

This makes food packaging potentially a risk particularly if that packaging has the virus on it then one touches their own mouth, nose, or possibly their eyes. This is not thought to be the main way the virus spreads because of poor survivability of these corona viruses on surfaces. There is likely very low risk of spread from food products or packaging.

BEST PRACTICE RECOMMENDATIONS

Set aside non-perishable groceries in a place in your point of entry in your home (i.e garage) for 72 hrs. before using them to allow for the virus to become inactive. 
Set up a cleaning station to avoid contaminating your food or other surfaces in the house. 
Consider disinfecting packaging with common EPA-registered household disinfectants OR discard the packaging and re-package in your own clean bags or containers.

HOW SHOULD I CLEAN MY FRESH PRODUCE?
YOU DO NOT need to sanitize your fruits and vegetables! Simply washing under running water for 20 seconds is sufficient. The US Food and Drug Administration (FDA) doesn’t recommend using soap and water when cleaning because these are  not approved or labelled  by the FDA for use on foods due to the risk of soap residues remaining and causing gastrointestinal discomfort.
You may consider using a scrub brush to cleanse your produce better. Don’t forget to  clean  the scrub brush thoroughly with soap and water after each use. 

FOOD SAFETY                                                                                                                           
Food safety, personal hygiene and equipment cleaning should always be a priority when handling food. This is particularly true in the case of fresh fruits and vegetables. Corona viruses are killed by  common cleaning and disinfection methods  and by cooking food to  safe internal temperatures . Check out the Canada.ca/Public-health site to learn more about  food safety .

AN UPDATE WILL BE PROVIDED EVERY WEDNESDAY AT 4:00 PM EDT OR AS REQUIRED.

_________________________________________________________________________________________

SPORT MEDICINE ADVISORY COMMITTEE UPDATE:

WHO/Public Health
Presently we have over 8,600 confirmed cases with > 100 deaths or 3 per 1 million population in Canada which continues to rise. Canada’s death rate is at approximately 1% of confirmed cases.
Canada is still in the early phase of the rapidly rising epidemic curve, as is the USA where the peak is expected to be approximately mid April. Although the peak in Canada is likely to be less severe than US our peak may be delayed by a few weeks. This may be due to the early effect of our isolation efforts which we will not see for another week or two or the viral strain. This means that social isolation efforts will likely need to continue at least through sometime in May (this is all theoretical mathematical modeling at present). On a positive front there are some very early indications that the social distancing and other measures in Canada may be working.

Worldwide there appear to be 3 or 4 different strains of the COVID-19 virus with varying severity that have yet to be confirmed. Italy has an 11% mortality rate and similar to Spain, with a Strain that appears to have originated from Wuhan. In Germany the mortality rate is closer to 0.8% and this strain likely originated from Shanghai. Which strain has infected Canada is yet to be determined and may be different from cluster to cluster, but we still need to make every effort across Canada to restrict transmission no matter which strain we have in our region.

We are presently observing a low but steady trend of local transmission cases from China, Japan, Singapore as restrictions are relaxed. This second “wave” is a concern and will also determine how long we need to enforce self-isolation measures.

IOC/IPC
We are grateful to have confirmed dates from the IOC/ IPC and Tokyo 2020 for the Games. This now enables everyone to begin focused planning and fill any “gaps” in training / acclimatisation plans that became evident for this year. IOC and IPC are working closely with the IFs regarding re scheduled seasons and new qualifying events etc. We encourage all NSFs to work closely with your coaches, ISTs and CMOs to make any adjustments to any plans that were in place for 2020 as needed and to follow your IFs re any new qualification processes etc.

Training
As per the previous updates we strongly encourage athletes to take this enforced self-isolation period to work with their Coaches, HPDs, IST and CMOs to address any known biomechanical and physical deficiencies that are easily addressed with home training and NOT to be attempting to reach peak performance this year (the rationale has been addressed in earlier releases).

It is probable that athletes may not be able to resume “normal” training for 2-3 months given the epidemic predictions and this will need to be integrated into any YTP planning etc (remember China is now only 3 months post initial isolation measures) but this does not mean that we cannot take full advantage of this opportunity to address any performance gaps or biomechanical deficiencies etc.

Canadian Centre for Ethics in Sport (CCES)
CCES has discontinued in-person testing at this stage but whereabouts are still required as before. This is fully explained in the CCES link HERE.

AN UPDATE WILL BE PROVIDED EVERY WEDNESDAY AT 4:00 PM EDT OR AS REQUIRED.

_________________________________________________________________________________________

SPORT MEDICINE ADVISORY COMMITTEE UPDATE:

Yesterday the IOC and Tokyo 2020 made the official announcement that the Games would now be postponed to 2021 which will allow athletes to have some certainty and reduce their training.
 
 
Hygiene and Social Precautions:

  • All Canadians should stay at home, work from home, and exercise at home to the extent this is possible. The actual regulations may be different from Province to Province but the essential principle is the same.
  • Maintain a distance of 2 metres from other people.
  • There is a preferred hierarchy for handling coughs and sneezes.
  • Best practice is to expel respiratory droplets into disposable tissue, dispose of it safely, then immediately wash or sanitize hands.
  • Expelling respiratory droplets onto a flexed elbow is better than no protection or an unprotected hand but it is non-optimal, as virus then remains on either the clothing or skin of the elbow depending on attire, either of which then need to be washed.
  • For protection of others – assume you are infected and behave as such.
  • For your protection – assume all others are infected and behave as such. 

 
 
Updated Government of Canada Recommendations:

  • All Canadians are being urged to stay at home where at all possible.
  • 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). 

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

 
 
Exercise and Daily Training Environment:

At this time, all athletes (Summer and Winter sports) are strongly recommended to reduce training regimens, and instead exercise moderately in isolation from others to maintain general health, work on stability, core strength, fundamental movement quality, and so on.

 
Under the guidance of their NSO coaches, athletes should seek out specific support services to manage transitions in exercise, nutrition, and health needs. The first recommended contacts for physical and mental health issues should be NSO Physicians and NSO Mental Performance / Sport Psychology providers. Athletes who do not have access to NSO health professionals can obtain advice from relevant professionals at COPSIN Institutes and Centres as listed in the link below.

Canadian Centre for Ethics in Sport (CCES) Update:

  • The CCES has significantly reduced operations, testing only where necessary and possible. (Read our updated advisory note here: https://cces.ca/news/updated-cces-statement-regarding-covid-19).
  • CCES is following guidance from public health officials and any decision to test is being taken with full consideration for the health of athletes, sample collection personnel and public health.
  • During this time athletes are still subject to the CADP.
  • Athletes who are part of the CCES’ or their international federation’s Registered Testing Pool should complete their whereabouts as best they can before the deadlines.
  • Athletes are reminded to verify the status of medications using the Global DRO (www.globaldro.com) and to submit an application for a Therapeutic Use Exemption if prescribed a prohibited substance.
  • The CCES’ athlete services team are also available to provide support for online learning.

AN UPDATE WILL BE PROVIDED EVERY WEDNESDAY AT 4:00 PM EDT OR AS REQUIRED.

_________________________________________________________________________________________

SPORT MEDICINE ADVISORY COMMITTEE UPDATE:

The number of confirmed cases of COVID-19 is over 350,000 globally, with approximately 100,000 recovered and over 15,000 deaths. The number of new cases continues to increase rapidly. Over 32,000 new cases were reported in the world yesterday, with the largest surges seen in USA, Italy, and Germany. 

In Canada, the numbers continue to rise quickly, with nearly 1,500 confirmed cases, 20 deaths. The Public Health Agency of Canada still states that the overall risk of infection in Canada is low, but the caseload has risen dramatically in the last week. There were 142 new cases reported on March 22, after two days of having had nearly 250 new cases per day. Continuing to slow the spread of this disease must be our current national and global priority.

Yesterday the COC and CPC made the difficult decision not to send a team to Tokyo in 2020 to minimize the risk to athletes who feel they need to continue training for July 2020 and to minimize the risk to their families and community.

Hygiene and Social Precautions:

  • All Canadians should stay at home, work from home, and exercise at home to the extent this is possible.
  • Maintain a distance of 2 metres from other people.
  • There is a preferred hierarchy for handling coughs and sneezes.
  1. Best practice is to expel respiratory droplets into disposable tissue, dispose of it safely, then immediately wash or sanitize hands.
  2. Expelling respiratory droplets onto a flexed elbow is better than no protection or an unprotected hand but it is non-optimal, as virus then remains on either the clothing or skin of the elbow depending on attire, either of which then need to be washed.
  • For protection of others – assume you are infected and behave as such.
  • For your protection – assume all others are infected and behave as such.

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).

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

Sports and Institutes:

  • COPSIN is fully supportive of the decision made by COC and CPC yesterday not to send athletes to the Tokyo Summer Games if they occur this year.
  • At this time, athletes are strongly recommended to reduce training regimens aimed at peak performance capacity at Tokyo 2020 Summer Games, and instead exercise moderately in isolation from others to maintain general health, work on stability, core strength, fundamental movement quality, and so on.
  • Under the guidance of their NSO coaches, athletes should seek out specific support services to manage transitions in exercise, nutrition, and health needs. The first recommended contacts for physical and mental health issues should be NSO Physicians and NSO Mental Performance / Sport Psychology providers. Athletes who do not have access to NSO health professionals can obtain advice from relevant professionals at COPSIN Institutes and Centres as listed below:

CSI Pacific

CSI Calgary

CSC Saskatchewan

CSC Manitoba

CSI Ontario

INS Québec

CSC Atlantic

  • Athlete Services and Game Plan Manager – Meaghan Donohue (506-453-4500)

 
Training and Training Environments :

  • It is currently recommended that all Canadians should stay at home and exercise at home to the extent that is possible.
  • Canadians who should be self-isolating for reasons of recent travel, any symptoms of illness, or contact with ill persons should NOT exercise in outdoor environments; they must remain at home.
  • Athletes with symptoms of illness are advised not to exercise and seek medical advice.
  • Athletes are strongly recommended to reduce training regimes for the purposes of performance gains related to Tokyo preparation.
  • For a home based program athletes should work specifically with their HPD and team Coaches for your needs.
  1. You should be exercising alone in open spaces or in your house as per current recommendations.
  2. Spacing of 2 metres between people must be maintained.
  3. Do not share equipment; each athlete must use their own equipment.
  4. If training in indoor environments, wash or disinfect your hands before and after touching any equipment or surfaces. Disinfect all touched surfaces with EPA-approved disinfectants (70% alcohol, quaternary ammonium chlorides, 4% hydrogen peroxide).

Mental Health:

Athletes are encouraged to seek out their NSO MPC/Sport Psychologist or speak with a CMO (see below for contact details) to address any mental health needs. Additional mental health support services include:

  1. Referrals can be made online, by email, or by phone:
  2. Online at www.ccmhs-ccsms.ca/refer
  3. By email at INFO@CCMHS-CCSMS.CA
  4. Contact Poppy DesClouds, MPC, CCMHS Care Coordinator at 613-454-1409 ext. 2090

The National Sport Partners have initiated a COVID-19 Mental Health Task Group that will coordinate sharing of best practice within the community of Mental Performance Consultants (MPCs) and Sport Psychologists. National initiatives will be driven by the Task Group, if needed, in response to NSO-driven requests and needs. For more information speak to your NSO or COPSIN MPC/Sport Psychologist or Chief Medical Officer (see below for contact details).

Nutrition for Athletes in Isolation
While athletes may find themselves in isolation during the Covid-19 pandemic, it is important to keep nutrition top of mind.  Work directly with your team or institute nutritionist and follow these quick tips to ensure that you’re tailoring your nutrition to best suit your current needs and to maintain the training gains you’ve had all year long, while keeping your health optimized.

  • KEEP TO A REGULAR EATING SCHEDULE: This will prevent boredom and mindless eating, which can lead to excess unwanted (and needed) calories! Ask yourself Are You Hungry first, if YES, then PLAN what you will have, and listen to satiety cues and stop when you’re full!
  • KEEP THE FIBRE UP!: If you’re moving less overall due to confined spaces, be sure to get adequate amounts of daily soluble and insoluble fiber to keep the bowels moving while also helping you to feel fuller longer; preventing the late night Netflix munchies.
  • STAY HYDRATED: Dehydration can increase levels of stress hormones, something we all don’t need more of right now.  Drink 2-4 L of fluid such as water, carbonated water, tea, coffee, milk, or small amounts of 100% juice. If your first urine after waking up is the colour of lemonade, you’re doing well. Limit Alcohol!
  • REDUCE OVERALL ENERGY INTAKE: Depending on what types of at home training you’re doing, it is most likely that your total volume and intensities will be decreased from normal training loads.  It will be individual but can average a reduction from 500-1000 calories/day, mainly from starchy and simple carbohydrates (Grains and Fruits) and fats. See example below. TIP: reduce your usual plate/bowl size to reduce overall portions and limit snacking.
  • KEEP PROTEIN HIGH!: It is important to continue with your regular protein needs, as this will help to minimize any lean muscle mass loss during reduced strength training. Focus on high quality proteins: Poultry, meat, fish (canned or dried!), eggs, dairy (and lactose free dairy), soy (edamame), and quinoa (good sub when there is no rice!). 
  • CONTINUE WITH YOUR REGULAR NUTRITION SUPPLMENTATION PROTOCOL: This means if you were taking for ex. iron, Vitamin D, B12 etc. for clinical deficiencies, DONT FORGET TO CONTINUE THEM!

Canadian Centre for Ethics in Sport (CCES) Update:

  • The CCES has significantly reduced operations, testing only where necessary and possible. (Read our updated advisory note here: https://cces.ca/news/updated-cces-statement-regarding-covid-19)
  • CCES are following guidance from public health officials and any decision to test is being taken with full consideration for the health of athletes, sample collection personnel and public health.
  • During this time athletes are still subject to the CADP.
  • Athletes who are part of the CCES’ or their international federation’s Registered Testing Pool should complete their whereabouts as best they can before the deadlines.
  • Athletes are reminded to verify the status of medications using the Global DRO (www.globaldro.com) and to submit an application for a Therapeutic Use Exemption if prescribed a prohibited substance.
  • The CCES’ athlete services team are also available to provide support for online learning.

AN UPDATE WILL BE PROVIDED EVERY 48 HOURS AT 4:00 PM EST.

_________________________________________________________________________________________

SPORT MEDICINE ADVISORY COMMITTEE UPDATE:

As of March 21 the number of confirmed cases of COVID-19 is over 285,000 globally, with approximately 91,000 recovered and over 11,800 deaths. The largest surges in cases continue to be in Europe (with Italy, France, Germany and Spain being hardest hit) and Iran. The USA has also reported accelerated numbers of new cases. Of note there have been more cases in Canada than in Japan at this point.

In Canada, the numbers are rising at an accelerated rate, with over 1,000 confirmed cases, and 12 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 minimising spread is key.

Hygiene and Social Precautions:

  • All Canadians should stay at home, work from home, and exercise at home to the extent this is possible.
  • Maintain a distance of 2 metres from other people.
  • There is a preferred hierarchy for handling coughs and sneezes.
  1. Best practice is to expel respiratory droplets into disposable tissue, dispose of it safely, then immediately wash or sanitize hands.
  2. Expelling respiratory droplets onto a flexed elbow is better than no protection or an unprotected hand but it is non-optimal, as virus then remains on either the clothing or skin of the elbow depending on attire, either of which then need to be washed.
  • For protection of others – assume you are infected and behave as such.
  • For your protection – assume all others are infected and behave as such.

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).

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. These are left here for rapid access.
  • If you as an athlete are not formally affiliated with an institution then your first choice of medical contact should be your personal or family physician, your sport’s team physician or IST lead. If they are not available or you do not have any of these then you may seek advice from the CMO of your region’s closest Canadian Sport Institute (see contact information below).
  • Services currently available at Canadian Sport Institutes and Centres:

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 Strength and conditioning lead.
  • If you would like a Physiology consult, please consult your sports physiology lead.

CSI Calgary

  • Physicians are available for in-person clinical appointments by contacting our Medical Coordinator at 587-830-2240 or mcosh@csicalgary.ca. General advice and/or follow-up appointments can also be arranged remotely via telephone pending each athlete’s unique situation.
  • Athletes in need of sport therapy services should contact their team therapist directly by email or telephone to schedule in-person or virtual rehabilitation. Athletes needing to hear from a therapist should contact the Medical Coordinator at the number / email address above.
  • Strength and conditioning staff are also available for in-person or remote consultation, please contact your coach directly by email or phone. 

CSC Saskatchewan

  • Nutrition and mental training, and strength and conditioning contact your service provider via email, or Travis Laycock at travis.laycock@sasktel.net or the Athlete Services Manager Kia Schollar at kschollar@sasksport.ca
  • Game Plan and mental health services contact Lisa Hoffart (Game Plan Advisor) lhoffart@mygameplan.ca
  • CSCS/Sask Sport offices are closed to the public, but can be reached via email at mdezell@sasksport.ca or cell phone at 306-281-5814. 

CSC Manitoba

  • Nutrition and Sport Psychology services continue as usual. Please contact your service provider or the Athlete Services Manager, Scott Sywy (scott@cscm.ca) for access.
  • Strength & Conditioning services are being provided over video link. National Team and NSO identified athletes are being provided with equipment for home use following an assessment of needs and space constraints. Please contact your service provider or the Athlete Services Manager, Scott Sywy (scott@cscm.ca) for more information.
  • Lab/Physiological testing is available to athletes on a 1-to-1 basis, provided they have adhered to any quarantine or self-isolation protocols following travel or potential exposure. To discuss specific circumstances, please contact our Physiologist, Jeremie Chase (jeremie@cscm.ca).

CSIO – switchboard 416-596-1240

  • Physicians are available for remote consultation by contacting our Medical Coordinator at 647-725-4105 or sportmedicine@csiontario.ca. We are actively contacting everyone who had an existing physician appointment when we closed.
  • Therapy staff are checking in with athletes in their caseload on a regular basis by remote means to check their exercise programs, progressions, and how they are doing. Athletes needing to hear from a therapist should contact the Medical Coordinator at the number or email address above.
  • Strength and conditioning staff at CSIO also remotely communicating with the athletes they normally train, are available for remote consultation, and can be contacted directly by email or phone.

INS Québec

  • Physicians are available for remote consultation either by contacting them directly or through our medical secretary who is working remotely too 514-255-1000 ext 301 or email: medical@insquebec.org. All athletes who had an appointment were contacted either by phone or email.
  • Therapy staff are checking in with athletes in their caseload on a regular basis by remote means to check their exercise programs, progressions, and how they are doing. Athletes needing to hear from a therapist should contact the medical secretary at the number / e-address above.
  • Strength and conditioning staff are also available for remote consultation. They are working on developing home programs, implementing web sessions (for small groups) and we are exploring equipment loan programs.

CSC Atlantic

  • CSCA staff is all working remotely. All performance services experts are prepared to assist athletes and coaches as required.  
  • All Game Plan services are available as well as inquiries regarding specific challenges that athletes are facing through this period of uncertainty. 

Additional Information

  • As noted before athletes should not seek on-site medical attention for respiratory conditions (cough, fever, runny nose, sore throat) at CSI 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:

  • There have been some suggestions published in recent medical literature that 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.
  • While some authorities including WHO are questioning the evidence on this issue, we believe it is presently prudent to avoid NSAIDs, and recommend that if symptomatic relief of fever or aches and pains is required, you should use acetaminophen (e.g. Tylenol or other brands thereof), not NSAIDs.

Training Environments:

  • It is currently recommended that all Canadians should stay at home and exercise at home to the extent that is possible.
  • Canadians who should be self-isolating for reasons of recent travel, any symptoms of illness, or contact with will ill should NOT train in outdoor environments; they must remain at home.
  • Athletes with symptoms of illness are advised not to exercise and seek medical advice.
  • If it is not possible to train at home, then training in outdoor or indoor fitness facility environments must follow practices that maintain distance and hygiene:
  1. Avoid crowded spaces; no spaces should contain more than 50 people.
  2. Avoid public transit if possible. Walk, ride a bike, or use a private vehicle if possible.
  3. Spacing of 2 metres between people (equivalent to 4 m2 of space per person in indoor environments) must be maintained.
  4. Do not share equipment; each athlete must use their own equipment.
  5. If training in indoor environments, wash or disinfect your hands before and after touching any equipment or surfaces. Disinfect all touched surfaces with EPA-approved disinfectants (70% alcohol, quaternary ammonium chlorides, 4% hydrogen peroxide).

Mental Health:

  • The National Sport Partners have initiated a COVID-19 Mental Health Task Group that will coordinate sharing of best practice within the community of Mental Performance Consultants (MPCs) and Sport Psychologists. National initiatives will be driven by the Task Group, if needed, in response to NSO-driven requests and needs. For more information speak to your NSO or COPSIN MPC/Sport Psychologist or Chief Medical Officer (see below for contact details).
  • Athletes can reach out to mental health professionals or mental performance consultants through their NSO or at regional institutes by email.

AN UPDATE WILL BE PROVIDED EVERY 48 HOURS AT 4:00 PM EST.

________________________________________________________________________________________

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.

CSI Calgary

  • Physicians are available for in-person clinical appointments by contacting our Medical Coordinator at 587-830-2240 or mcosh@csicalgary.ca. General advice and/or follow-up appointments can also be arranged remotely via telephone pending each athlete’s unique situation.
  • Athletes in need of sport therapy services should contact their team therapist directly by email or telephone to schedule in-person or virtual rehabilitation. Athletes needing to hear from a therapist should contact the Medical Coordinator at the number / email address above.
  • Strength and conditioning staff are also available for in-person or remote consultation, please contact your coach directly by email or phone. 

CSC Saskatchewan

  • Nutrition and mental training, and strength and conditioning contact your service provider via email, or Travis Laycock at travis.laycock@sasktel.net or the Athlete Services Manager Kia Schollar at kschollar@sasksport.ca
  • Game Plan and mental health services contact Lisa Hoffart (Game Plan Advisor) lhoffart@mygameplan.ca
  • CSCS/Sask Sport offices are closed to the public, but can be reached via email at mdezell@sasksport.ca or cell phone at 306-281-5814. 

 

CSC Manitoba

  • Nutrition and Sport Psychology services continue as usual. Please contact your service provider or the Athlete Services Manager, Scott Sywy (scott@cscm.ca) for access.
  • Strength & Conditioning services are being provided over video link. National Team and NSO identified athletes are being provided with equipment for home use following an assessment of needs and space constraints. Please contact your service provider or the Athlete Services Manager, Scott Sywy (scott@cscm.ca) for more information.
  • Lab/Physiological testing is available to athletes on a 1-to-1 basis, provided they have adhered to any quarantine or self-isolation protocols following travel or potential exposure. To discuss specific circumstances, please contact our Physiologist, Jeremie Chase (jeremie@cscm.ca).

CSIO – switchboard 416-596-1240

  • Physicians are available for remote consultation by contacting our Medical Coordinator at 647-725-4105 or sportmedicine@csiontario.ca. We are actively contacting everyone who had an existing physician appointment when we closed.
  • Therapy staff are checking in with athletes in their caseload on a regular basis by remote means to check their exercise programs, progressions, and how they are doing. Athletes needing to hear from a therapist should contact the Medical Coordinator at the number or email address above.
  • Strength and conditioning staff at CSIO also remotely communicating with the athletes they normally train, are available for remote consultation, and can be contacted directly by email or phone.

INS Québec

  • Physicians are available for remote consultation either by contacting them directly or through our medical secretary who is working remotely 514-255-1000 ext 301 or email: medical@insquebec.org. All athletes who had an appointment were contacted either by phone or email.
  • Therapy staff are checking in with athletes in their caseload on a regular basis by remote means to check their exercise programs, progressions, and how they are doing. Athletes needing to hear from a therapist should contact the medical secretary at the number / email address above.
  • Strength and conditioning staff are also available for remote consultation. They are working on developing home programs, implementing web sessions (for small groups) and we are exploring equipment loan programs.​

CSC Atlantic

  • CSCA staff is all working remotely. All performance services experts are prepared to assist athletes and coaches as required. 
  • All Game Plan services are available as well as inquiries regarding specific challenges that athletes are facing through this period of uncertainty. 

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

 

AN UPDATE WILL BE PROVIDED EVERY 48 HOURS AT 4:00 PM EST.

 

_______________________________________________________________________________________

SPORT MEDICINE ADVISORY COMMITTEE UPDATE:

As of March 17 the number of confirmed cases of COVID-19 is over 183,000 globally, with approximately 80,000 recovered and over 7,100 deaths. The largest surges in cases continue to be in Europe with Italy, France, Germany and Spain being hardest hit. There are 161 countries reporting cases. The WHO has declared COVID-19 as a pandemic.

In Canada, the numbers are rising, with over 440 confirmed cases, with 4 deaths in a nursing home in BC and 1 death in ON. 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” (slow the rate of transmission so that at its peak, the case load will not overwhelm our health care system’s capacity).

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.
  • All Canadians currently abroad are urged to return to Canada ASAP.
  • All travellers returning from any destination including USA 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).
  • Canadian borders are now closed except to Canadian citizens, permanent residents, and USA citizens.
  • 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 link below) 
  • All Canadians are requested to stay home and work from home, practice social distancing (2m distance) if at all possible.

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

Sports and Institutes:

  • The IOC remains committed to the Games in Tokyo going ahead on time and is addressing the qualification system through the International Sport Federations.
  • See the IOC communiqué
  • Tokyo 2020 Qualifying and test events continue to be cancelled.
  • The IOC and IPC are working with International Sport Federations to develop fair alternate qualifying processes.
  • INS, CSIO, CSIC, CSIP, CSCS, CSCM and CSCA are all closed. Many staff are working from home. Contact your regional institute or centre by email for details.
  • Athletics Canada closed both its East and West Hubs on 16 March 2020.
  • There was one confirmed positive case at the Cross Country World Cup event in Québec City. It was a foreign national who immediately isolated on arrival, but the Canadian team members have been advised to undergo 14 days of self-isolation after leaving Québec City.
  • As noted before athletes should not seek on-site medical attention for respiratory conditions (cough, fever, runny nose, sore throat) at CSI clinics. 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.

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

 

AN UPDATE WILL BE PROVIDED EVERY 48 HOURS AT 4:00 PM EST.

 

Updated links from the Government of Canada and WHO

https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19.html#faq
https://www.who.int/emergencies/diseases/novel-coronavirus-2019
Provincial Information

 

Travel Advisories

All countries recommend no travel and require 14 day self-isolation upon return.

 

Further Questions:

Further information about COVID-19 may be obtained from your NSO Chief Medical Officer or Team Physician, or the Chief Medical Officers of the Sport Medicine Advisory Committee.

Dr. Mike Wilkinson, Canadian Olympic Committee: mwilkinson@olympic.ca
Dr. Andy Marshall Canadian, Paralympic Committee: amarshall@paralympic.ca
Dr. Suzanne Leclerc, Institut National du Sport du Québec: sleclerc@insquebec.org
Dr. Doug Richards, Canadian Sport Institute Ontario: drichards@csiontario.ca
Dr. Brian Benson, Canadian Sport Institute Calgary: bbenson@csicalgary.ca
Dr. Paddy McCluskey, Canadian Sport Institute Pacific: pmccluskey@csipacific.ca

_______________________________________________________________________________________

March 15th, 2020

SPORT MEDICINE ADVISORY COMMITTEE UPDATE:

There are over 162,410 cases worldwide, 5,985 deaths and over 75,000 recovered. The largest surges in cases continue to be in Europe with Italy, France, Germany and Spain being hardest hit. There are 141 countries reporting cases. The WHO has declared COVID-19 as a pandemic.

In Canada the numbers have started to rise with now over 250 cases. We now have 11 recovered and still only one death of an elderly person in BC

As an update the federal government has recommended that Canadians overseas return to Canada as some countries are closing their borders to international flights. They also recommend to “avoid non essential travel outside Canada until further notice” https://travel.gc.ca/travelling/advisories

Although Olympic & Paralympic travel to training venues is a NSO-based decision (and may be viewed as ‘essential’), it is recommended that consideration be given to being stranded in a foreign country with insurance that may not cover travel or medical expenses. Medical access in the COVID pandemic may also be limited.

Travel for training or competition other than compulsory Paralympic or Olympic qualification in 2020 should not be considered for at least 30 days. Updates will be provided should this time period change.
There are no restrictions or policies about travel within Canada at this time.

In all cases you should contact your team CMO or CSIO CMO/ team physician for advice and coordination.

In terms of self-isolation for anyone returning from outside of Canada, as of March 13, 14-Day self-isolation should be implemented for athletes returning to Canada from all international destinations. Self-monitoring should be emphasized for all athletes returning from international destinations. Please consult with CMOs to discuss travel dates that may be of concern.

Athletes should not seek medical attention for respiratory conditions (cough, fever, runny nose, sore throat) at CSI clinics. Consult with local public health authorities or CMOs by telephone.

Training Environment:

  1. NSOs should withhold athletes/coaches/staff with symptoms from attending training.
  2. 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.
  3. NSOs are recommended to work with CSI/CSCs and/or other training facility owners to determine hygienic training environments inclusive of modified training numbers, enhanced spacing of equipment, increased hand-washing, and increased sanitizing approaches.

NSOs should be mindful of municipal or provincial regulations regarding limits to mass gatherings.
Psychological factors are playing a large role in this pandemic and we encourage those that are concerned to contact their team physician, CMO or mental health team. Link is American but a good reference on social distancing and isolation.

https://www.apa.org/practice/programs/dmhi/research-information/social-distancing

It cannot be emphasized enough to continue to be diligent in self care including hand washing, use of hand sanitizer and cough etiquette.

 

AN UPDATE WILL BE PROVIDED EVERY 48 HOURS AT 4:00 PM EST.

 

Updated links from the Government of Canada and WHO

https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19.html#faq
https://www.who.int/emergencies/diseases/novel-coronavirus-2019
Provincial Information

 

Travel Advisories

All countries recommend no travel and require 14 day self-isolation upon return.

 

Further Questions:

Further information about COVID-19 may be obtained from your NSO Chief Medical Officer or Team Physician, or the Chief Medical Officers of the Sport Medicine Advisory Committee.

Dr. Mike Wilkinson, Canadian Olympic Committee: mwilkinson@olympic.ca
Dr. Andy Marshall Canadian, Paralympic Committee: amarshall@paralympic.ca
Dr. Suzanne Leclerc, Institut National du Sport du Québec: sleclerc@insquebec.org
Dr. Doug Richards, Canadian Sport Institute Ontario: drichards@csiontario.ca
Dr. Brian Benson, Canadian Sport Institute Calgary: bbenson@csicalgary.ca
Dr. Paddy McCluskey, Canadian Sport Institute Pacific: pmccluskey@csipacific.ca

_________________________________________________________________________________________

March 13, 2020

SPORT MEDICINE ADVISORY COMMITTEE UPDATE:

At this point there are over 134,824 cases worldwide, 4,284 deaths and over 70,000 recovered. There are 123 countries reporting cases. The WHO has declared COVID-19 as a pandemic.

In Canada the numbers remain small at 157 cases and one death and now 9 recovered. The risk level remains low and in the last day many provinces have changed or implemented travel restrictions. The table below list the latest info for travelers returning from outside Canada. There are no restrictions or policies about travel within Canada at this time.

People who are currently abroad: The international situation is rapidly evolving and most people are returning to Canada as quickly as possible. Please consult with Chief Medical Officers (CMOs) regarding appropriate self-isolation and/or hygiene practices upon return.

People looking to travel: The current trend is to avoid non-essential travel, and especially international travel. Please consider international or domestic travel carefully and consult with CMOs and investigate regional or provincial travel advisories.

Staging of events:  Numerous organizations are canceling sporting events out of an abundance of caution. We recommend that you contact public health officials if you are considering canceling or postponing upcoming sporting events and/or limit/restrict spectators.  

PROVINCIAL AND TERRITORIAL SELF-ISOLATION POLICIES

In all cases if you have symptoms or have questions you should contact your team CMO or CSIO CMO/ team physician.
For guidance on what self isolation entails please see the attached guidance below. 

HOME ISOLATION FACT SHEET

It can not emphasized enough to continue to be diligent in self care including hand washing, use of hand sanitizer and cough etiquette.

All sports in consultation with their CMO/team physicians need to do a risk assessment of their training facilities for the risk of community transmission and increased facility hygiene and disinfection processes.

INSURANCE: Based on the experience of certain sports, there is a growing risk that, in light of risks due to the COVID-19 virus, personal insurance coverage may no longer cover athletes when traveling abroad. You are therefore strongly encouraged to contact your insurance provider prior to athlete travel to confirm insurance coverage. 

AN UPDATE WILL BE PROVIDED EVERY 48 HOURS AT 4:00 PM EST.

 

Travel Advisories

China, Iran, Italy: Level 3 – Avoid non-essential travel

Do not travel to these areas at this time unless such travel is absolutely required for Olympic or Paralympic qualification. If you must go, use hyper-vigilant hand and face hygiene.

Japan, South Korea: Level 2 – Practice special precautions

In this context, with no available vaccine, this means to be hyper-vigilant about routine hygiene (see Level 1), and restrict travel to venues required for competition, training or accommodation. Avoid busy public places if possible.

France, Germany, Hong Kong, Singapore, Spain: Level 1 – Practice usual precautions

This includes proper hand hygiene (washing with soap for 20 seconds or use of hand disinfectants with >60% alcohol), covering coughs and sneezes with tissue that is then disposed of and hands cleaned, and avoiding contact with face, nose, or eyes with unclean hands, as well as frequent wiping of equipment and objects touched by hands.

 

Further Questions:

Further information about COVID-19 may be obtained from your NSO Chief Medical Officer or Team Physician, or the Chief Medical Officers of the Sport Medicine Advisory Committee.

Dr. Mike Wilkinson, Canadian Olympic Committee: mwilkinson@olympic.ca
Dr. Andy Marshall Canadian, Paralympic Committee: amarshall@paralympic.ca
Dr. Suzanne Leclerc, Institut National du Sport du Québec: sleclerc@insquebec.org
Dr. Doug Richards, Canadian Sport Institute Ontario: drichards@csiontario.ca
Dr. Brian Benson, Canadian Sport Institute Calgary: bbenson@csicalgary.ca
Dr. Paddy McCluskey, Canadian Sport Institute Pacific: pmccluskey@csipacific.ca

________________________________________________________________________________________

March 11th, 2020

SPORT MEDICINE ADVISORY COMMITTEE UPDATE:

At this point there are over 121,000 cases worldwide, 4,373 deaths and over 65,000 recovered.

Some European countries and the US have had increased new cases in the last week. The US presently does not have any restrictions. There is a link below to the latest numbers and locations in the US of cases. Many competition and training opportunities are to be evaluated on a case by case basis and in consultation with the CMO’s listed below.

LiveScience: Coronavirus in USA

Cancellation of events are multi factorial and not necessarily related to COVID-19 medical precautions. The WHO will be publishing recommendations for mass events shortly and we will update as this is released.

WHO, IOC and IPC are all emphasizing that the games are still on schedule and they are working with IFs on any affected qualification routes and impacted test events.
In Canada the numbers remain small at 93 cases and one death. The risk level remains low and no specific measures for travel, participation in sporting events or training are in place. While a COVID-19 outbreak is not unexpected in Canada, our public health system is prepared to respond. PHAC, along with provincial, territorial and community partners, continues to reassess the public health risk, based on the best available evidence as the situation evolves.
Air Canada Update

WHO COVID-19 Update#15 10.03.2020
WHO Coronavirus Myth Busters

 

AN UPDATE WILL BE PROVIDED EVERY 48 HOURS AT 4:00 PM EST.

 

Travel Advisories

China, Iran, Italy: Level 3 – Avoid non-essential travel

Do not travel to these areas at this time unless such travel is absolutely required for Olympic or Paralympic qualification. If you must go, use hyper-vigilant hand and face hygiene.

Japan, South Korea: Level 2 – Practice special precautions

In this context, with no available vaccine, this means to be hyper-vigilant about routine hygiene (see Level 1), and restrict travel to venues required for competition, training or accommodation. Avoid busy public places if possible.

Hong Kong, Singapore, France, Germany, Spain: Level 1 – Practice usual precautions

This includes proper hand hygiene (washing with soap for 20 seconds or use of hand disinfectants with >60% alcohol), covering coughs and sneezes with tissue that is then disposed of and hands cleaned, and avoiding contact with face, nose, or eyes with unclean hands, as well as frequent wiping of equipment and objects touched by hands.

 

Further Questions:

Further information about COVID-19 may be obtained from your NSO Chief Medical Officer or Team Physician, or the Chief Medical Officers of the Sport Medicine Advisory Committee.

 

Dr. Mike Wilkinson, Canadian Olympic Committee: mwilkinson@olympic.ca

Dr. Andy Marshall Canadian, Paralympic Committee: amarshall@paralympic.ca

Dr. Suzanne Leclerc, Institut National du Sport du Québec: sleclerc@insquebec.org

Dr. Doug Richards, Canadian Sport Institute Ontario: drichards@csiontario.ca

Dr. Brian Benson, Canadian Sport Institute Calgary: bbenson@csicalgary.ca

Dr. Paddy McCluskey, Canadian Sport Institute Pacific: pmccluskey@csipacific.ca

_______________________________________________________________________________________

March 8th, 2020

SPORT MEDICINE ADVISORY COMMITTEE UPDATE:

The travel advisory remains the same as per below
 
At this point there are over 111,000 cases worldwide, over 80% in Mainland China.
 
Some European countries and the US have had increased new cases in the last week.
 
Japan has enacted a shutdown of schools and workplaces and their numbers have stabilized, now number 10 on the list of countries with most cases. The measures seem to indicate that this approach can be successful.
 
WHO has recommended avoidance of all cruise ship travel at this point.
 
In Canada the numbers remain small at 62 cases and no deaths. The risk level remains low and no specific measures for travel, participation in sporting events or training are in place beyond good hand washing and covering coughs or sneezes.
 
AN UPDATE WILL BE PROVIDED EVERY 48 HOURS AT 4:00 PM EST.

Travel Advisories:

China, Iran, Northern Italy: Level 3 – Avoid non-essential travel

-   Do not travel to these areas at this time unless such travel is absolutely required for Olympic or Paralympic qualification. If you must go, use hyper-vigilant hand and face hygiene.

Japan, South Korea: Level 2 – Practice special precautions

-   In this context, with no available vaccine, this means to be hyper-vigilant about routine hygiene (see Level 1), and restrict travel to venues required for competition, training or accommodation. Avoid busy public places if possible.

Hong Kong, Singapore: Level 1 – Practice usual precautions

-  This includes proper hand hygiene (washing with soap for 20 seconds or use of hand disinfectants with >60% alcohol), covering coughs and sneezes with tissue that is then disposed of and hands cleaned, and avoiding contact with face, nose, or eyes with unclean hands, as well as frequent wiping of equipment and objects touched by hands.

 

Further Questions:

Further information about COVID-19 may be obtained from your NSO Chief Medical Officer or Team Physician, or the Chief Medical Officers of the Sport Medicine Advisory Committee.

 

Dr. Mike Wilkinson, Canadian Olympic Committee: mwilkinson@olympic.ca

Dr. Andy Marshall Canadian, Paralympic Committee: amarshall@paralympic.ca

Dr. Suzanne Leclerc, Institut National du Sport du Québec: sleclerc@insquebec.org

Dr. Doug Richards, Canadian Sport Institute Ontario: drichards@csiontario.ca

Dr. Brian Benson, Canadian Sport Institute Calgary: bbenson@csicalgary.ca

Dr. Paddy McCluskey, Canadian Sport Institute Pacific: pmccluskey@csipacific.ca

 

General Information

This joint message is from the Own the Podium led Sport Medicine Advisory Committee comprised of Chief Medical Officers from the Canadian Olympic Committee, the Canadian Paralympic Committee, and the Canadian Olympic and Paralympic Sport Institute Network (COPSIN). It is meant to guide National Sporting Organizations (NSOs) in decision-making with respect to travel to competitions within and outside Canada. Information has been obtained from the World Health Organization, Government of Canada and Australian Institute of Sports websites. Other references are listed in this document. This advisory will be updated regularly and distributed to NSOs and other high performance sport partners.

The outbreak of severe respiratory illness related to the new coronavirus (COVID-19) continues to have an expanding impact internationally. The World Health Organization (WHO) provides regular updates which guide our recommendations. The latest WHO statements can be found at WHO website on Coronavirus disease (COVID-19) outbreak.

COVID-19 is a virus in the coronavirus family. Coronaviruses in this family are responsible for illnesses that range from the common cold to more serious illnesses such as Severe Acute Respiratory Syndrome (SARS-CoV) and Middle Eastern Respiratory Syndrome (MERS-CoV). COVID-19 is a new virus and so health officials are still learning about its impact and severity. At this time, it appears to cause an illness similar to the flu with the most common signs of infection being fever, cough and shortness of breath. In severe cases patients can develop pneumonia, severe respiratory distress, kidney failure and death.

 

Epidemiology: The numbers

The reports from China suggest that with COVID-19:

  • 1% have no symptoms
  • 81% have mild symptoms
  • 14% have severe symptoms that cause them to miss work or go to the hospital
  • 5% have severe symptoms that lead to ICU admission, including a fatality rate of 2.3%
  • The fatality rate is highest in those that are elderly and have other medical conditions
  • The estimate of risk to athletes (i.e., younger and healthier) is thought to be similar to the risk of health care workers; 0.3% fatality rate

Wu and McGoogan JAMA 2020-02-24 Characteristics of and Lessons from COVID-19 in China

The number of cases in Canada is small. At this time the risk of contracting COVID-19 in Canada is very low.

 

Clinical Course

It appears that COVID-19 is more contagious than the typical influenza virus.

The virus is transmitted primarily through respiratory droplets. Those that are experiencing symptoms are more likely to spread the illness than those that have the illness but do not have symptoms. There is ongoing research to determine if there are other possible modes of transmission such as fecal or air.

The estimated incubation period (time from initial expose to onset of symptoms) is between 1-14 days but is about five days on average. Symptoms can persist for longer than three weeks, although the duration of illness will be highly variable.

 

Prevention

Recommendations for protecting yourself and preventing spread of this illness include frequent hand washing and covering both your nose and mouth when coughing. Try to cough or sneeze into your arm, away from others, or into tissue paper (to be disposed in toilet). Wash your hands immediately afterwards. You should avoid close contact with anyone showing symptoms of respiratory illness.

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

 

What to do if you think you have COVID-19

Because the early symptoms of COVID-19 are similar to other respiratory illnesses, if you have any of the common symptoms (fever, cough and shortness of breath) you should contact your doctor’s office and arrange to have a consultation.

 

Treatment:

At this time, there is no specific treatment for COVID-19. The goals 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.

There are efforts internationally to produce a vaccine and to identify if any of the currently available antiviral medications are effective and safe. An update is expected to be released in mid-2020. A vaccine will likely take longer as it will have to go through longer clinical trials to confirm safety and efficacy.

 

Travelling to sporting events

We recommend that you check for up-to-date travel advisories from the Government of Canada at: Government of Canada COVID-19 Travel Advice.

 

On Airplanes:

Vigilant hand and face hygiene should be practiced. Stay hydrated.

The European Centre for Disease Control (EDCD) has published research into the risk of contracting Infectious Diseases on Aircraft. While there are currently no data available on the transmission risk for COVID-19 during airline travel, we look to the risk related to similar diseases, such as influenza and SARS. The ECDC concluded that the quality of evidence to assess the risk of transmission of influenza onboard an aircraft is not adequate. SARS transmission has been documented from airline travel with transmission most likely from those who are severely ill or those experiencing rapid deterioration, usually in the second week of their illness.

 

On Return from Travel:

The Government of Canada advises that any travelers from the above countries should be vigilant for symptoms that may indicate a respiratory illness consistent with COVID-19 (fever, cough, shortness of breath) and report these symptoms immediately to their physician and avoid contact with others until they have been cleared to do so. What this means for sports is, if team members returning to Canada from the countries listed become unwell in the two weeks after return to Canada, they may need to be quarantined and tested for COVID-19. This should be taken into account when planning training camps and competition preparation.

Athletes and coaches who are currently unwell with fever, cough or shortness of breath should delay their flight and seek medical review. If you become unwell during your flight you should notify the flight attendants, place a P2 or N95 face mask on and seek medical review as soon as practical on arrival.

 

Face Masks:

Face masks are most effective in preventing transmission when worn by people who are unwell. If you are well, masks only need to be worn by those who have close contact with those who are unwell (i.e., recommended for health care workers). Correct fitting of face masks is most important to their effectiveness. A good resource is the Australian New South Wales Health web site (How to Fit a Face Mask).

 

Considerations for Athletes, Coaches, Sport Organizations & Event Producers:

Athletes and Coaches:

Prior to travelling overseas for training camps and competitions

  • The risks associated with travel and competitions vary with multiple factors including location, age and origin of participants, indoor vs outdoor venues, and contact vs non-contact sports, among others. Check with your team physician, NSO CMO, or SMAC CMO for detailed consideration of these issues.

 

  • Make an appointment with your team physician or regular doctor prior to departure to ensure that your vaccinations are up-to-date and that you will have enough of your regular medications, with the appropriate documentation, for your entire trip and at least an additional week. Vaccinations need to be administered well in advance of travel to be effective.

 

 

  • It is best to have contingency travel plans in place with the ability to change flights if needed.

 

  • There is no need to alter your exercise or training if you are feeling well, nor do you need to wear a mask in public.

 

National Sporting Organizations (NSOs):

  • Where travelling to places with an elevated risk, NSOs are urged to have a team doctor travel with the team. Other health professionals should not be expected to coordinate or provide medical care.

 

  •  Having appropriate travel insurance for your team that can be relied upon in the event a medical evacuation is necessary.

 

  •  When planning training camps, consider factors such as ease of access to medical resources and the prevalence of infection rates in neighbouring countries.

Sporting Events in Canada:

  •  There have been very few cases of COVID-19 diagnosed in Canada. There is currently no indication for event organizers to delay or postpone sporting events in Canada.

 

  •  For international athletes travelling to compete in Canada, only the Government of Canada should provide details the current travel restrictions in place. At present, the Government of Canada is asking only those that have returned from the Hubei province in the last 14 days should self-isolate for 14 days and contact your local health authority within 24 hours of arriving in Canada. There are no other recommendations. Event organizers should not impose additional restrictions on international athletes. All travelers that have symptoms of fever, cough and shortness of breath should be advised to have a physician assessment.

 

  •  Mass gathering and sporting events can pose additional infection control challenges in general. If there is concern regarding your event, please discuss with your Chief Medical Officer who can help put in place risk mitigation strategies in conjunction with your local public health unit if required.

 

Other Resources:

 

 

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