UPDATE #22 | 12 August 2020
Advisory on COVID-19
SPORT MEDICINE ADVISORY COMMITTEE UPDATE:
Please Note: The SMAC COVID-19 Advisory will no longer be released bi-weekly and will be issued ‘as required’. Please continue to request information via the SMAC CMOs and/or members of the COVID-19 Return to Sport Task Force.


Disease Update
The number of confirmed cases of COVID-19 is over 20 million with over 13.5 million recovered and 746,000 deaths. Mortality rate in Canada is 7.4 %. In Canada we have over 120,000 cases, 8,900 deaths and 106,000 (89%) recovered. There are 4,685 presently active cases in Canada of which 97% are classified as mild. In some countries the numbers of cases are at all-time highs and this reinforces the need to remain careful and follow recommendations on hand washing, physical distancing and use of masks which is now mandatory in some provinces in Canada and many countries in the world.

Despite the present number of new cases, restrictions continue to be lifted gradually across the country. This progressive relaxation of restrictions will have an impact on training and access to facilities, the rate of which will differ across regions and across different sports. Each sport is working on plans and using the guidelines as set out in the RSAT (Return to Sport Assessment Tool) and the recent publication from the High Performance Return to Sport Task Force.


Institutes and Training Facilities
At this stage, all Canadians remain under national and provincial public health guidance. With the recent changes all of the institutes are open. The timing and level of operations possible is dependent on the local restrictions in place and varies from one institute to another. It is recommended that athletes and sports check with their institute for details of services available and how to access them.


Return to Competition Assessment Tool (R-CAT)
As training continues to progress and teams and sports look ahead to returning to competition, SMAC and OTP have collaborated to create a tool to assist NSOs in assessing a return to competition environment. The Return to Competition Assessment Tool (R-CAT) provides an assessment of a potential domestic as well as international competition environment and has an event or camp checklist to assist sport/teams planning for a return to competition or camps. Assistance with assessment of a competition environment is available through CSIs and CMOs from the Canadian Olympic and Paralympic Committees. 
(R-CAT)


Training Node vs Bubble and Testing Protocol
There has been some confusion as well as some reassessment of the definition of a training node vs development of a training bubble. As such the link below is a clear statement on nodes vs bubbles as they pertain to sport as well as recommendations on testing in those environments.


Guidelines on Return to Training Post COVID-19 Infection
As medical information emerges on athletes that have recovered from COVID-19 infections as well as research groups analyze data from patients post infection, SMAC has reviewed the current literature and developed Guidelines for Return to Performance post COVID-19 Infection. This is not intended to provide guidance in how to treat the disease but rather, it is intended to assist health care professionals in returning athletes to training. As more evidence is gathered and research is published these guidelines will be updated. The Guidelines will be provided through expert provider groups including CASEM, Sport Physio Canada and CATA as well as any other group that requests it. NSOs are encouraged to consult with medical staff to review these guidelines.


Travel
The travel ban across the Canada-US border has been extended until late August and will be reassessed every 30 days. As teams start to relocate and gather for group training and airline travel opens up within Canada the following recommendations will assist travellers:
  • Check the local quarantine regulations and disease prevalence rates immediately prior to departure
  • Wear a mask at airport and on flight. Medical grade or N95 masks are not necessary.
  • Wash hands frequently in airport. Once settled in seat use hand sanitizer and wash hands again upon leaving plane and airport.
  • Practice rigorous cough hygiene at all times.
  • Use a wipe to clean the arms of the seat, do not use the seatback table or entertainment system unless necessary and wash it with a wipe before using it.
  • Choose a window seat if possible as this minimizes contacts with others.
  • Wipe down luggage including hand luggage once retrieved and exiting airport and any public transport such as a bus or taxi.


CCES Update
CCES has commenced urine sampling as of 13 July 2020. Athletes in the registered testing pool should have received notification of the restart and protocols involved. The link provides valuable information and a link to their eLearning module.



CCES to Resume Urine Sample Collection
As athletes and sports return to training and provincial health restrictions are lifted, the Canadian Centre for Ethics in Sport (CCES) has developed supplemental doping control procedures to enable the safe resumption of urine sample collection, including sample collection in athletes’ homes, under the Canadian Anti-Doping Program (CADP) effective July 13, 2020.

The CCES has developed a set of supplemental doping control procedures that include the necessary safety enhancements for athletes and doping control staff in order to reduce the risk of transmission of COVID-19. The drafting process involved a complete review and risk assessment of each aspect of the doping control process, factoring in guidance from the World Anti-Doping Agency (WADA) and provincial health authorities. All personnel have been retrained to incorporate the following supplemental procedures:
  • All CCES personnel will complete a COVID-19 self-assessment prior to performing work for the CCES.  
  • All involved in the process will maintain appropriate physical distancing as much as possible. 
  • Only urine sample collection will occur until CCES has developed the appropriate safety enhancements deemed necessary for blood collection. 
  • At the time of notification, athletes will be required to complete a COVID-19 self-assessment as well. 
  • CCES will initially limit the participants in all testing sessions. This will typically mean only one athlete is tested at a time. As restrictions are lifted, testing session sizes may increase.    
  • All participants in the testing session must wear protective masks.
  • Hand sanitizer will be available for the athlete’s use (and their representative, if applicable). 
  • There will be very limited sharing of supplies. 
 
Athletes and stakeholders who have completed True Sport Clean 2020 or the True Sport Clean Review course will receive an email prior to July 13, 2020 inviting them to complete the Return to Testing online learning module. Those who have not yet completed their online learning in 2020 will complete the module on supplemental procedures as part of their course.

Find additional information related to COVID-19, including the CCES’s procedures and links to various WADA and Public Health Agency of Canada resources at cces.ca/covid-19-procedures.

If you have any questions or concerns, please contact the CCES at info@cces.ca
Updated links from the Government of Canada and WHO
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