April 22, 2020 - Advisory on COVID-19

Sport Medicine Advisory Committee:

Disease Update

The number of confirmed cases of COVID-19 is over 2.5 million with 690,000 recovered and 177,608 deaths. There are documented cases in over 213 countries or territories.  While some countries have slowed the doubling rate of new cases and deaths (now at approx. 10 days in Canada), other areas in the world are seeing these rates continue to accelerate. We are continuing to see prolonged second waves in countries that relaxed their restrictions. Canada's health officials are monitoring this closely as this will have an impact on how other countries, including Canada, manage restrictions and relaxations in the future. A number of European countries have started to relax movement restrictions (including small group activities) this week, however it remains too early to see what the impact of this is at this stage.

In Canada we have over 38,000 cases, 1,834 deaths and 13,000 (34%) recovered. Of the 23,000 presently active cases in Canada 97% are classified as mild. In Canada the testing rate has increased with approx. 6.4% of tests returned as positive. Of the positive cases 77% have no known contact. Although the curves continue 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. Despite media reports of some sports or leagues discussing June restarts, this is not imminent in Canada. It remains too early for us to start training in groups or shared facilities as the risks of transmission and becoming infected are still very high. It will remain entirely dependent on Local, Provincial and National public health regulations as to when small group in-person training will again be possible. 

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 summer (the 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 severe and long term complications etc.

Institutes and Training Facilities

At this stage all Canadians remain under national and provincial public health guidelines and as such all institutes and public training facilities remain closed for the foreseeable future.

Return to Training in Groups

As weather improves and as a result of physical distancing measures, COVID-19 pandemic infection rates in some parts of t he country are starting to improve. Many athletes and teams are looking forward to restart training in small groups, with the goal of competing foremost in many minds.

In Canada, as physical distancing measures remain in force, we are not currently ready to start group training at this point in time, and all decisions regarding this would ultimately be in conjunction with provincial / local health authorities, provincial / local government bodies, your sports associations as well as OTP, CPC and COC .

To assist with planning a future restart to training, the SMAC COVID Response Group is working on a Risk Assessment Tool to help guide National Sport Organizations, coaches, teams, and athletes. 

Aspects that will be considered in the risk assessment tool for your sport include travel arrangements for athletes to the group training venue, as well as mitigation factors that each team/sport will need to evaluate and plan for including:

• Understanding the current local, provincial, and national COVID-19 situation

• Emergency preparedness and response plan in case of the occurrence of COVID-19 cases in the training group

• Logistical coordination

• Stakeholder coordination and risk communications

• Isolation capacity of the local community in case an outbreak spreads to that community

• Specific measures that need to be in place for training to minimize any risk of COVID-19 in the training group

It cannot be emphasized enough that groups, teams or sports should go through this risk assessment process in planning for the safety of their athletes, coaches and the larger population in general. 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.

The risk assessment tool will be provided next week to NSOs in consultation with CMOs.  A Town Hall will be convened on Monday April 27 th at 11 am Pacific Time / 2 pm Eastern Time to discuss the Risk Assessment Tool. A meeting invitation will be extended by OTP to COPSIN Network representatives, NSO CEO/HPDs COC, CPC and Sport Canada.

Nutrition

Combating the COVID-19 Cravings & How to Manage Stress Eating During the Pandemic

It is without question that we are all dealing with at least some form of stress right now, so it’s no surprise that we may be faced with stress/emotional eating. It IS a real thing and it is NOT your fault! 

In acute times of stress, we release cortisol and during prolonged stress, which is what we are now experiencing, can elevate cortisol levels, which can increase hunger. This coupled with the challenge of being in close proximity to the kitchen: pantry and fridge, can make it even more difficult to stop the endless grazing! People manage stress differently; some like to bake and try new recipes, (which also makes it a challenge to be disciplined enough not to indulge on the sweet new creations!) and some people may eat less. If you are skipping meals, you could be more prone to emotional eating or even binge-eating in the evening.

Here are some other factors that may contribute to mindless (over) eating/snacking:

1.      How you manage stress

2.      Your Surroundings

3.      Schedules! (or lack there-of!)

4.      Food Availability

5.      And…your emotions!

Below are some strategies that will help you ward off the endless grazing and get back to better eating habits.

1. MANAGING STRESS:

• Keep active!!

• Don’t sit longer than 3 hours at a time

• Call an old friend

• Try a new or old skill

2. YOUR SURROUNDINGS:

Get out of the kitchen! Try to set up your workout and space in a designated area AWAY from the pantry and FRIDGE!

3. SCHEDULES:

…Are so important! Try to stick to your daily scheduled/plan just as you would if you were in regular training, with your pre-prepped scheduled meal and snack times! Pack your lunch/snacks and recovery foods the night before as you would have when you were leaving the house! Finding a sense of normalcy will help you keep regular eating habits. Ensure you are still eating every three to four hours to ensure you are getting sufficient nutrients to manage your health.

4. FOOD AVAILABILITY:

What foods are stocked in your home have a significant impact on our food choices. Don’t Stockpile Food! A good rule of thumb: use what you have at home before buying more! Allow yourself to buy ONE of your FAVOURITE treat items each weekly (or every other week) grocery shopping trip.

Planned snacks! Focus on high fiber high protein snacks to help you feel full longer to curb those cravings! STRIVE FOR 20g Protein 4-5 x/Day and a minimum of 25 g fiber!

Quick Basic Snack Ideas:

• Handful of almonds/seeds

• Easy protein balls (https://www.floridacitrus.org/oj/recipes/no-bake-orange-protein-balls/)

• Greek/Skyr yogurt or Cottage cheese (add some canned, dried or fresh fruit!)

• Trail mix: ½ c Chex or Cherrios with ¼ cup almonds and ¼ c dried fruit (stick to 1 cup serving) with some added Easter Treats (smarties) to satisfy the sweet tooth

• Whole grain muffins/crackers/granola/granola bars

• Veggie sticks with Tzatziki or nut/soy butters

Don’t forget to hydrate! It will also help to keep you from excess snacking! Beware of calorie dense fluids such as specialty coffees, alcoholic beverages. Instead try a ½ cup 100% Orange Juice with sparkling water or other homemade smoothies and flavored waters, along with decaf teas and coffee.