COVID-19 : Recommendations from FISA's Sports Medicine Commission

The follow-up of the disease progression and the increase in infected persons in many countries demonstrate that the virus called Sars-CoV-2 and the resulting disease Covid-19 cannot be successfully contained with rare exception. The virus is apparently easily transmissible via infected individuals with and without obvious symptoms. Covid-19 can be transmitted by healthy-appearing carriers.

National Health authorities provide recommendations on how to prevent spread of new infections. FISA strongly encourages each NF to guide their athletes on how to avoid exposure to Covid-19 and such guidance should follow recommendations expected to be promoted by official health authorities, such as WHO and local authorities. Simple actions may be effective to limit spread of virus as is known from a common influenza infection. The virus is a global pandemic and will require significant effort by all to control.

With the Olympics now postponed, we, along with all National Federations, will try our best to contain the disease and to learn for the future of a safe and healthy sport.

The basic rules to stay safe are:

– Wash your hands frequently for a minimum of thirty seconds with soap and hot water.

– Don’t touch your mouth or nose with your hands.

– Stay at least 1.5 m away from infected people

– Do not go to mass gatherings

The basic rules for those who are infected or do feel not well:

– Typical symptoms are fever, dry cough, disturbed smell and taste, inflammation of the eyes – conjunctivitis, mild diarrhea, but also tiredness or shortness of breath can be felt.

– You should stay in self-quarantine at home and communicate with your doctor.

– Avoid sports practice in groups.

– Do not get close to your partner, family members or to other people, keeping a minimum distance of 2 meters.

– Eat separately and use a separate toilet.

– Wash your hands regularly with soap.

– Contact your medical doctor and others by phone.

– Only when cleared by your doctor can you return to your normal routine.

General recommendations:

Prevention:

1. Each person should adopt the same preventive measures used against the transmission of viral influenza, as Covid-19 follows classical dissemination via respiratory droplets and may survive on contaminated surfaces up to a few days.
2. Hands should be regularly washed with soap and water (30 sec), then disinfected with alcoholic disinfectant after drying them.
3. Food should not be served in buffet style.
4. Rooms should be ventilated regularly.
5. Some NFs may still be in training camps. If this is the case daily cleaning of all facilities and maintaining hygiene is mandatory. Washrooms, toilets and door handles should be disinfected daily. Laundry services should be available.
6. As far as travel is necessary in the current situation, face masks and eye protection should be used, but will not fully protect against infection.  In the plane, disinfection of the seat tray is recommended. Personal containers of hand sanitizer alcoholic disinfectant should be carried and used regularly.
7. A varied, vitamin-rich diet with sufficient vegetables and fruit helps prevent infections or reduce symptoms by improving immunity. Fruit containing vitamin C, such as oranges or grapefruits, are particularly important. Team members should also drink enough to keep mucous membranes moist. In cold weather, the immune function of the mucous membranes is particularly disturbed, so keep the respiratory tract as warm as possible.

Boat house use and rowing in teams in the current pandemic situation :

1. Many rowing clubs and national training centers have already been closed. FISA SMC recommends to strictly limit the use boat houses, particularly dressing-rooms, showers and training-facilities.
2. The use of ergometer training and resistance training at home is advised.
3. When rowing outdoors, an individual has a low risk to be infected, the risk may be increased secondary to close proximity to boat partners and crews. Therefore, rowing a single is of lower risk, bigger boats like fours and eights are not recommended (if not in strict self-quarantine).
4. If possible, rowers should change and shower at home rather than at boat house facilities.

If athletes feel sick :

1. With the above typical symptoms, athletes and entourage should take a break from training and call their team or family doctor and follow their instructions. They should inform team members and other recent contacts.
2. Such athletes and entourage should be separated from the rest of the team, self-isolate and should carefully disinfect their hands. They should wear a face mask during acute symptoms, but ensure that the mask is used correctly. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks
3. The separation should be 2-3 days more than the actual signs of infection and should be decided by the attending doctor. It is wise to have separated toilets for such athletes to break the transmission of virus on hard surfaces.

How can I exclude Coronavirus (Sars-CoV-2 / COVID-19) infection?

1. Fever is uncommon with most colds and upper respiratory infections but is ubiquitous with COVID19 and the flu.
2. The probability of infection with the coronavirus (Sars-CoV-2 / COVID – 19) is very high in regions where the infection is widespread (community infection). Caution in the current situation: not only are travelers potentially infectious who return from risk areas, but caution is generally required for any contact outside the family.
3. Most infections with Coronavirus (Sars-CoV-2 / COVID 19) are mild, but more severe complications may arise, particularly in older and immunocompromised people.
4. Coronavirus (Sars-CoV-2 / COVID 19) infection should be considered a possible cause of infection in acute respiratory illness by the medical doctor.
5. Athletes and entourage who are ill and had contact with an infected individual or someone who traveled to affected regions should seek medical advice in a public health office where Coronavirus (Sars-CoV-2 / COVID-19) testing can be performed (following and according to local health instructions). In such persons, a 14-day-quarantine might be required, but it is important to follow local public health or WHO recommendations regarding further testing and isolation.
6. Transmission time appears to be 14 days; during that time an infected person may transmit the virus to others, even if there are no clinical signs of infection (during this asymptomatic period the virus may not be detectable by the test).

Is there a role for vaccination?

1. There is no vaccination presently available for Coronavirus (Sars-CoV-2 / COVID-19).
2. FISA recommends vaccination with quadrivalent flu vaccines against viral influenza for athletes and their entourage. COVID-19 is not an influenza strain and is not prevented by this vaccine. Flu vaccination is most effective in the northern hemisphere in November and in the southern hemisphere in June. 

Where is information available?

FISA and IOC are regularly assessing all information available. The following webpages allow the most recent international information:
https://www.ecdc.europa.eu/en/novel-coronavirus-china
https://www.who.int/emergencies/diseases/novel-coronavirus-2019

Updates in treatment
https://emcrit.org/ibcc/covid19/

On behalf of the FISA Sports Medicine Commission:
Juergen M Steinacker, Chair, Ulm (GER),
Jo Hannafin, New York (USA),
Mikio Hiura, Amori (JPN),
Mike Wilkinson, Vancouver (CAN),
Donia Koubaa, Tunis (TUN),
Piero Poli (ITA),
Petra Zupet, Ljubljana (SLO),
Tomislav Smoljanovic, Zagreb (CRO),
Henning Bay Nielsen, Copenhagen (DEN),
Co-opted members: Kathryn Ackerman, Boston (USA),
Fiona Wilson, Dublin (IRL)

 Spanish version here

[DOC src=”142141″ name=”Spanish version – Update from FISA Sports Medicine Commission”]

______________________________________________________________________________________________

[DOC src=”142035″ name=”IOC Letter to IF Med Chairs – re Novel Coronavirus – 20.02.2020″]

[DOC src=”142036″ name=”IPC Coronavirus Advisory Update – 21.02.2020″]

[DOC src=”142037″ name=”WHO – 2019 – nCoV – POEmassgathering – 2020″]

[DOC src=”142044″ name=”Recommendations from the FISA Sports Medicine Commission – Coronavirus – 27.02.2020″]