SPORT MEDICINE ADVISORY COMMITTEE UPDATE – 21 March 2020

Advisory on COVID-19

SPORT MEDICINE ADVISORY COMMITTEE UPDATE

UPDATE #7  –  21 March 2020

 

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

To read the complete advisory, click here

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