Diving post Covid

[sheeper]

medical professional here (paramedic). And recently had COVID after working the frontlines since the start.
with the current variants, fully vaccinated and boosted patients generally have mild(er) symptoms. Both my wife and i had very minor head cold symptoms, all nasal, with extreme fatigue. Wife was sick for 5 days with symptoms and positive tests for 7. Me....sick for 10 days and positive for 16 days!
neither of us had more than minor nasal symptoms. there was no pulmonary involvement, nothing else other than fatigue.
When we started with symptoms and a positive test, we both started a course of Paxlovid. We, and our MD, thinks it helped keep symptoms minor.
That all said I have seen a lot of bad outcomes. Including a dear friend of mine who had minor COVID symptoms (but did not know she had it) who went diving and died due to a cardiac event likely exacerbated by COVID.
We see a lot of long-term issues from COVID especially if there is a pulmonary component. We have also seen cases where there is neurological or circulatory involvement. In moderate to severe cases we have seen patients decompensate rapidly in the hospital. Fortunately, these cases are less common now than they were earlier on.
So, i strongly recommend that unless there are extremely minor symptoms to be sure to get checked out before returning to diving. Even though i am fully recovered for near 2 weeks, i will not return to diving until sometime next week even though i have resumed my normal heavy workout schedule with no ill effects.

better to be smart than sorry.

 

[YSU]

We just had to replan a dive trip due to catching COVID (coughing right now in fact). I was thinking of pushing it just a month or so vs a year, assuming no "long COVID".

Thoughts?

 

[waterone]

We just had to replan a dive trip due to catching COVID (coughing right now in fact). I was thinking of pushing it just a month or so vs a year, assuming no "long COVID".

Thoughts?

It depends on how hard it hits you. I had covid and lost smell, taste and had slight congestion but was otherwise fine in 3 days. I had to cancel my trip only because I was to fly out a day after I caught it. If I could have scheduled the trip for after the 10 days I would have, but instead waited just over a month to work out my schedule.

 

[YSU]

How hard? This utterly sucks, but only like the world's worst flu. Others have had it worse.

We had to tell the dive shop it was a COVID issue in order to get the pre-paid trip delayed w.o penalty, and now they want a refreshed fit-to-dive note before we dive; and my Dr. wants to wait 60 day to be sure I'm not dealing w lingering issues. <sigh> Another few months w.o SCUBA...

 

[Outbound]

We just had to replan a dive trip due to catching COVID (coughing right now in fact). I was thinking of pushing it just a month or so vs a year, assuming no "long COVID".

Thoughts?

How hard? This utterly sucks, but only like the world's worst flu. Others have had it worse.

We had to tell the dive shop it was a COVID issue in order to get the pre-paid trip delayed w.o penalty, and now they want a refreshed fit-to-dive note before we dive; and my Dr. wants to wait 60 day to be sure I'm not dealing w lingering issues. <sigh> Another few months w.o SCUBA...

Sorry to hear that. But it's probably for the best to postpone your trip a while so you can get checked out and cleared to dive once you've recovered. Your description of feeling like you have the world's worst flu means that you have a pretty good case of it. The last time I had the flu (nearly 20 years ago, and I still remember it) I felt like utter crap and was coughing for weeks after I'd cleared the virus. Fortunately, my covid case was incredibly mild and was far less severe than any of the colds I've ever gotten. But I know folks who had average cases who still had lingering coughs for a month or two after. Respiratory diseases can wreak some havoc for sure.

Wishing you a speedy and full recovery.

 

[Wibble]

On the other hand, if you feel up to it, go diving.

 

[waterone]

We had to tell the dive shop it was a COVID issue in order to get the pre-paid trip delayed w.o penalty, and now they want a refreshed fit-to-dive note before we dive; and my Dr. wants to wait 60 day to be sure I'm not dealing w lingering issues. <sigh> Another few months w.o SCUBA...

Sucks that they will only remove penalty due to having covid. I wouldn't want anyone sick to be around for a trip and would hope that they would postpone and get a credit the same.

Since doctors practice medicine, after I was feeling better and only if it was required, I would get a 2nd opinion and a note. To me waiting 60 days no matter what to dive seems extreme unless I was having continued symptoms. Scuba is my yoga and waiting through quarantine while slightly sick was hard enough.

 

[Nick_Radov]

The difference is that colds typically don't leave one with permanent disabilities, including serious lung damage, as COVID can.

We don't know that for certain, do we? I'm not aware of any large-scale studies looking for evidence of lung damage in patients who have recovered from other cold viruses. Absence of evidence is not evidence of absence. If we did that research, I suspect you might be surprised by the level of damage caused by some of the 200 or so endemic cold viruses.
In particular it would be interesting to take a closer look at HCoV-OC43. That is a common cold virus which is genetically quite similar to SARS-CoV-2 and can cause similar symptoms. It has a fairly high fatality rate among frail patients and is now suspected to have possibly caused a worldwide pandemic in 1889. So, I'm skeptical that COVID-19 is somehow special from a diving medicine perspective, or that it's necessarily worse than at least some other colds.

 

[duke dive medicine]

We don't know that for certain, do we? I'm not aware of any large-scale studies looking for evidence of lung damage in patients who have recovered from other cold viruses. Absence of evidence is not evidence of absence. If we did that research, I suspect you might be surprised by the level of damage caused by some of the 200 or so endemic cold viruses.
In particular it would be interesting to take a closer look at HCoV-OC43. That is a common cold virus which is genetically quite similar to SARS-CoV-2 and can cause similar symptoms. It has a fairly high fatality rate among frail patients and is now suspected to have possibly caused a worldwide pandemic in 1889. So, I'm skeptical that COVID-19 is somehow special from a diving medicine perspective, or that it's necessarily worse than at least some other colds.

Nick, that's an interesting discussion point. The operative word in my post that you quoted was "typically". I'm not an infectious disease expert so can't speak to the rate of occurrence and of long-term complications of CHoV-OC43 with any authority, but I think that if its rate of occurrence and subsequent long-term complications, especially in previously healthy people, approached that of SARS CoV-2, we'd know. That said, certainly if a diver presented with long-term complications of CHoV-OC43, he or she would be evaluated for fitness to dive/return to diving based on criteria similar to those recommended for COVID.

Best regards,
DDM

 

[Nick_Radov]

Nick, that's an interesting discussion point. The operative word in my post that you quoted was "typically".

What does "typically" mean in this case? Can we put some quantitative bounds on it?

I'm not an infectious disease expert so can't speak to the rate of occurrence and of long-term complications of CHoV-OC43 with any authority, but I think that if its rate of occurrence and subsequent long-term complications, especially in previously healthy people, approached that of SARS CoV-2, we'd know.

How would we know that SARS-CoV-2 causes more long-term complications than HCoV-OC43, since the infectious disease experts have never done a direct before-and-after comparison of the lung damage caused by those two viruses, or other common cold viruses? The entire COVID-19 pandemic has been characterized by shoddy science, flawed assumptions, and a rush to hasty conclusions. A little more skepticism is warranted.

That said, certainly if a diver presented with long-term complications of CHoV-OC43, he or she would be evaluated for fitness to dive/return to diving based on criteria similar to those recommended for COVID.

Really? Since HCoV-OC43 is just one of hundreds of endemic common cold viruses, and the specific virus makes little difference in the treatment protocol, clinicians almost never specifically test for it. I had a bad cold some years ago and was left with a persistent cough during any hard exertion that lasted for months. Was that from an HCoV-OC43 infection? Who knows? Did it cause lung damage? My doctor never ordered any respiratory tests or any imaging studies, and I didn't have previous baselines to compare against anyway. So also unknown and unknowable. In any case after the cough went away I resumed diving and sports training. So far my lungs haven't exploded.

The implicit null hypothesis here is that SARS-CoV-2 (COVID-19) is no more likely to cause lung damage (or other sequelae relevant to diving) than at least some other endemic common cold viruses. That null hypothesis could be false but I haven't seen sufficient evidence to reject it yet. So why are we treating this one virus as something special? Or conversely, have we been too casual about upper respiratory infections in general? Should we treat all such viruses the same and get evaluated for fitness to dive after every infection? Not a bad idea in principle, but I'm skeptical whether that would be a good use of scarce medical resources.