UPDATE #11 | 8 April 2020
Advisory on COVID-19
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 will advise when the suspension is lifted. The timeline obviously is dependent on how the situation unfolds.

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  [email protected]  as the general contact, but here are some more specific contacts. All are monitored during this time:


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.
Disease Update
The number of confirmed cases of COVID-19 is over 1,450,000 with 310,000 recovered and 83,500 deaths. The “hot spots” in the world continue to be USA, Central Europe and emerging centres in Turkey, Russia and South America. Physical distancing and self-isolation are in place in over 50 countries and affect over 2.3 billion people.

In Canada we have over 18,000 cases, 380 deaths and 4,000 recovered. The next two weeks will be very telling and once again we cannot stress enough the need to double down in following the measures already discussed. At this time the medical system is coping, and our challenges include obtaining appropriate PPE and ensuring the health of all essential workers so that we can maintain all services needed. N95 masks are in low supply in Canada and should only be reserved for health care providers when needed.
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.