UPDATE #14 | 29 April 2020
Advisory on COVID-19
Disease Update
The number of confirmed cases of COVID-19 is over 3.1 million with 975,000 recovered and 219,287 deaths. There are documented cases in over 213 countries or territories.  While some countries have slowed the doubling rate of new cases and deaths, other areas in the world are seeing these rates continue to accelerate. We are continuing to see prolonged second waves in countries that had relaxed their restrictions and are monitoring this closely as this will have an impact on how other countries including Canada manage restrictions and relaxations in the future. 

In Canada we have over 50,000 cases, 2859 deaths and 19,000 (38%) recovered. Of the 28,000 presently active cases in Canada 97% are classified as mild. At present our doubling time has prolonged to every 16 days. Although the curve continues to flatten in Canada there remains a lot of risk involved in relaxing restrictions too early and we can only reemphasize that in Canada there are limited resources available and asymptomatic spread is occurring. Continue to assume all others you may encounter may have COVID and act with that in mind and continue to maintain physical distancing vigilance. Many provinces are starting to prepare plans for staged relaxation of restrictions as is considered safe in their specific area. This progressive relaxation of restrictions will have an impact on training and access to facilities, but timing will differ across regions and across different sports and is yet to be finalised or confirmed.

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 summer (the rationale has been addressed in earlier releases). In addition we would recommend taking this opportunity to also work on mental training.

Institutes and Training Facilities
At this stage all Canadians remain under national and provincial public health guidance and as such all institutes and public training facilities remain closed at this time. As information changes it will be updated.

Return to Training in Groups
At a Town Hall call involving NSOs and national sport partners on 27 April a Risk Assessment Tool for Sport that will allow groups and teams to assess risk and mitigation of this risk was presented in a draft form. The SMAC group, in concert with COC, CPC and OTP are finalising this tool (to be made available on 1 May 2020) and will continue to collect information from WHO and other countries to create the best path forward for returning to training.

Despite a number of nations returning to group training this week, in Canada physical distancing measures remain in force and we are thus not able to start group training at this point in time. Any decisions regarding return to group training would ultimately be in conjunction with provincial / local health authorities, provincial / local government bodies, your sports associations as well as OTP, CPC and COC.

It cannot be emphasized enough that groups, teams or sports should go through this risk assessment process carefully in planning for the safety of their athletes, coaches and the larger population in general when the return is possible. Ultimately local health officials will need to be on board as different provinces, regions and cities are affected differently with COVID-19 and as a result may have unique policies regarding gatherings of individuals that will determine when and how group training may resume in different regions.

Mental Health Update
Leading mental health authorities and advocacy groups are calling for an increase in mental health resources to cope with the threat of an “echo pandemic”, the significant rise in mental health issues in those significantly affected by COVID-19. The Canadian Sport community is not immune to this echo pandemic, and to help flatten the mental health spike, a preventative and proactive approach must be taken. To help mitigate the ill-effects of stress, protect mental health and promote mental fitness, it is recommended that we practice psychological hygiene as part of the daily routine. The following are some activities to be considered.

Emotional Tolerance
We must remember that emotions are an integral part of the human experience; they are there to protect us, guide us and help us recognize what we need. We should accept that our emotions are real and valid responses to this abnormal event. By understanding our emotions and core needs, we are able to increase our emotional tolerance. Valuable steps in this process include:
  • Naming the emotion we are experiencing (e.g., I feel anxious and overwhelmed) and recognizing it as normal and valid (e.g., just my emotions doing their job in these times of uncertainty)
  • Accepting the emotion as a normal aspect of our experience (e.g., It’s understandable that I have heightened level of anxiety given the current situation)
  • Identifying needs by exploring what the emotion is revealing or why it is important (e.g., I want to be safe and need to take necessary precautions) 

Stress Management
COVID-19 is an unprecedented event. As such, there is no rule book to follow and it is inevitable that stress and anxiety levels rise given the uncertainty and unpredictability of the situation we are facing. However, it is important to remember that not all stress is bad; it depends on our perspective, competencies, and support. Adversity is part of high performance sport, therefore, athletes, coaches, and IST members can use existing skills to manage challenges and the unknown. COVID-related stress management tips include:

Protective physical and psychological factors 
  • Engaging in physical distancing 
  • Washing hands and wearing a mask and gloves when out in public
  • Staying home, especially if sick
  • Reducing information by taking breaks from watching or listening to news
  • Maintaining a sense of balance by pairing intense information processing with light activities (e.g., watching or reading something amusing, playing a game). 
Stress management 
  • Identifying stressors and focusing on the knowledge and skills we have to manage them – keeping our confidence greater than our fears
  • Connecting with others and expressing worries and concerns to feel supported
  • Taking care of our body by exercising, eating and sleeping well, and limiting our alcohol intake
  • Spending time outdoors to benefit from mother nature’s healing effects
  • Doing breathing / relaxation exercises 
  • Having fun and staying stimulated by trying out new activities / hobbies

Mindfulness is deep awareness of the present moment. It reflects our ability to BE.HERE.NOW with an accepting, nonjudgmental attitude. Mindfulness helps us to embrace all human experiences, regulate emotions, improve focus and sleep, and boost immunity. A daily dose of mindfulness training can make a world of difference.  
  • Try the mindfulness app “Calm” for free for one month by clicking here

Gratitude and Growth
To help balance the part of the brain that becomes activated when exposed to perceived threat and danger (the amygdala), we can even out the input by focusing on what is good. This can be done by scanning the world around us for three good things and writing those things down at the end of each day. This activity has shown to improve levels of optimism, happiness and subjective well-being. 

We can also mitigate the stress response by adopting a “challenger” mindset and looking for opportunities for growth and learning that comes with the challenge we are facing. For example, this quarantine is a great opportunity to build mental fitness and resilience skills, which can help enhance sport performance when back to training and competition.

Take a proactive and preventative approach and practice psychological hygiene on a daily basis. 

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.