Timeframe for diving post covid +

[Queen Village Diver]

I’ve read that many people are going right back to diving soon after covid.

I plan on 10 dives one month after recovery from Omicron with minor cold like symptoms, no cough or pain - full vaxx and boost; in a prior bout of covid cleared to dive after x-ray and spirometry 2 mos by a hyperbaric med group.

My confusion assuming no additional health issues - per DAN.org go see a doc, new UCSD no work up, DAN Europe wait 7 days no work up. So what’s to believe? I’ll call DAN about insurance. After potential harm my second concern is coverage? I’ve also seen materials suggesting wait a month before diving and two or three months if symptomatic I won’t likely have time for x-ray, spirometry and follow up before my trip. I believe I’ve represented current policy correctly (links current Dec 2022).

DAN guidance:
COVID-19 and Diving: March 2021 Update

DAN links to this UCSD guidance: https://dan.org/wp-content/uploads/...uation-of-divers-during-covid-19-pandemic.pdf

Meanwhile, UCSD guidance from 2020 was updated - no wait time. Diving after COVID-19: an update to fitness to dive assessment and medical guidance

PREVIOUS GUIDELINES WITH REGARDS TO ASYMPTOMATIC OR MILD DISEASE:

Category 0: No history of COVID or asymptomatic positive testing. Work up: No additional work up required

Category 1: Mild illness, defined as outpatient treatment only without hypoxia or abnormal imaging. Work up: Spirometry and two view chest X-ray

AMENDED GUIDELINES:

Category 0: No history of COVID or asymptomatic positive testing. Work up: No additional work up required

Category 0.5: Very mild illness. Those with isolated upper respiratory or systemic symptoms(rhinorrhea/congestion/pharyngitis/loss of taste or smell), fevers, fatigue, or myalgias but WITHOUT lower respiratory or cardiac symptoms. Work up: No additional work up required

Category 1: Mild illness, defined as outpatient treatment only without hypoxia or abnormal imaging. Any lower respiratory or cardiac symptoms, including chest pain, palpitations, significant* cough, shortness of breath with exertion or at rest. Work up: Spirometry and two view chest X-ray*for example, a cough that is productive, prevents sleeping, or requires medication, ultimately defined at the discretion of the evaluating physician.

Newer DAN Europe guidance:

Group A

• Asymptomatic, paucisymptomatic (nasal congestion and/or sore throat, in the absence of fever, cough, malaise, headache and/or myalgia) with transitory clinical manifestations.
  • In such cases, returning to diving is not recommended before 7 days after recovery.
  • A medical check-up with your treating doctor is recommended if you do not feel you have regained normal physical and mental capacity.

Group B

• Mild illness (See Table #1) where no hospitalisation and/or antiviral, antibiotic, cortisone or heparin treatment has been required.
• In these cases, we recommend a clinical assessment by the family doctor or a Diving Medicine specialist after 10 days since recovery. The assessment should take into account the age of the diver, any condition identified as diving risk factors, vaccination status.

https://www.daneurope.org/en/-/ftd-after-covid-update

Groups C And D go see a Dr. Understood.

 

[FabletheRaven]

Common sense would dictate waiting at least two weeks after initial infection... just because you give the body time to heal. This would be the case even for other viral infections tbh, you don't want to get back to vigorous activity too quickly. For Covid a doctor workup would be a good idea even for a mild case imo because increasingly 'long covid' is an issue even in cases of very mild disease, vaxed etc. Guidelines are every changing and confusing because there is no real data backing it up.

 

[Boarderguy]

Treat it like any other respiratory illness. Once you can breathe without issue ie full breath without coughing, no shortness of breath, no flem, etc then give it a go on a nice easy dive. Only you can determine if you're ready. Do you also schedule doc visits and tests to be cleared after a cold or the flu? My bouts with covid were nothing compared to the flu that kicked my ass the week before Thanksgiving and I went diving about 1 week after I had cleared those symptoms 90%. Residual cough stuck around for 3 weeks.

 

[tursiops]

The updated UCSD guidance is what is used by the aquarium in which I volunteer. My covid bout was in October. Post recovery (I had minor symptoms) I had to wait a month, then do a 6-minute Walk Test and hve my PCP sign me off. He adDed a full-up exercise test (Inclined treadmill), Bruce Protocol, took me to 10 METS, and signed all my papers.

 

[kinoons]

Common sense would dictate waiting at least two weeks after initial infection... just because you give the body time to heal. This would be the case even for other viral infections tbh, you don't want to get back to vigorous activity too quickly. For Covid a doctor workup would be a good idea even for a mild case imo because increasingly 'long covid' is an issue even in cases of very mild disease, vaxed etc. Guidelines are every changing and confusing because there is no real data backing it up.

It is difficult to say how long anyone should refrain from physical activity after an illness. The general rule of if you feel okay, you’re likely okay, is as good as any other rule out there.

Interestingly the common belief that you should see a doctor if you’re sick has never been validated. No randomized control trial has ever been ran with one group seeing a doc for a viral illness, one group just staying home, and comparing outcomes of those two groups.

So my $0.50 worth of general medical, you’re not my patient, advice is if you feel sick, don’t dive. If you feel good, you’re likely okay. If you’re at all unsure don’t dive.

Regarding long Covid - that’s a complete CF. No one can decide what constitutes long Covid, or if long Covid even exist. A well done recent study casts great doubt on long Covid.

Natural course of health and well-being in non-hospitalised children and young people after testing for SARS-CoV-2: a prospective follow-up study over 12 months

In CYP, the prevalence of adverse symptoms reported at the time of a positive PCR-test declined over 12-months. Some test-positives and test-negatives reported adverse symptoms for the first time at six- and 12-months post-test, particularly tiredness, shortness of breath, poor quality of life...

www.thelancet.com

A very good video summary of the above linked study.

 

[Robert H. Diver]

I feel like you’re the only one that can answer your own question…

 

[FabletheRaven]

It is difficult to say how long anyone should refrain from physical activity after an illness. The general rule of if you feel okay, you’re likely okay, is as good as any other rule out there.

Interestingly the common belief that you should see a doctor if you’re sick has never been validated. No randomized control trial has ever been ran with one group seeing a doc for a viral illness, one group just staying home, and comparing outcomes of those two groups.

So my $0.50 worth of general medical, you’re not my patient, advice is if you feel sick, don’t dive. If you feel good, you’re likely okay. If you’re at all unsure don’t dive.

Regarding long Covid - that’s a complete CF. No one can decide what constitutes long Covid, or if long Covid even exist. A well done recent study casts great doubt on long Covid.

Natural course of health and well-being in non-hospitalised children and young people after testing for SARS-CoV-2: a prospective follow-up study over 12 months

In CYP, the prevalence of adverse symptoms reported at the time of a positive PCR-test declined over 12-months. Some test-positives and test-negatives reported adverse symptoms for the first time at six- and 12-months post-test, particularly tiredness, shortness of breath, poor quality of life...

www.thelancet.com

A very good video summary of the above linked study.

I'm a PT that treats people with Post Covid. The accepted criteria are basically continuation of symptoms 1 month after infection. I'm usually treating people with post exertional malaise. Some people develop POTS as well. I'll tell you from some on the people I've seen that the post exertional malaise has ruined their lives. I'm talking about people in their 30-50s who went from running prior to Covid to having difficulty going up a flight of stairs- or more likely will go up a flight of stairs and then require a 2 hour nap. It usually accompanies brain fog as well... So you have people who are struggling to move and people who don't have the energy to do their job. But you're right it's a CF. In the medical world doctors don't know what to do. The best ones are essentially focusing on symptoms management (beta blockers for POTS, medications for anxiety depression, etc.) In the PT world many will receive patients and start an aerobic program and make people MORE sick. I follow a really low intensity exercise program from Mt. Sinai that focuses more on maintaining symptoms and treatment of dysautonomia.

I would agree that the really concerning cases of long covid are waaay rarer then reported. Because if you include everyone with Tachycardia 1 month after infection who are otherwise fine...you end up with over 10% of people infected with covid. However having treated people with serious cases I'm way less cynical then the guy in the video...who seems needlessly agenda driven.

To bring it back to diving...yeah who really knows. I figured why not see a doctor check your vitals, listen to your chest, see if anything weird is going on. But maybe you're right because where do you draw the line; not gonna give a stress test to everyone who wants to return to diving.

 

[Duke Dive Medicine]

Treat it like any other respiratory illness. Once you can breathe without issue ie full breath without coughing, no shortness of breath, no flem, etc then give it a go on a nice easy dive. Only you can determine if you're ready. Do you also schedule doc visits and tests to be cleared after a cold or the flu? My bouts with covid were nothing compared to the flu that kicked my ass the week before Thanksgiving and I went diving about 1 week after I had cleared those symptoms 90%. Residual cough stuck around for 3 weeks.

COVID is not a cold or the flu. It's an airborne respiratory virus, yes, but the range of effects is much broader, which makes return-to-diving guidelines like UCSD's necessary.

Best regards,
DDM

 

[pauldw]

COVID is not a cold or the flu. It's an airborne respiratory virus, yes, but the range of effects is much broader, which makes return-to-diving guidelines like UCSD's necessary.

Kind of you not to observe that people who can't spell "phlegm" shouldn't be giving medical advice.

 

[Boarderguy]

Kind of you not to observe that people who can't spell "phlegm" shouldn't be giving medical advice.

Nice of you to understand what I meant sweetheart. Next time my phone auto corrects to incorrect spelling I'll be sure to send you a DM just to make sure it still makes sense.