Timeframe for diving post covid +

[duke dive medicine]

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

You'd be surprised at how many medical professionals misspell things like that. @Boarderguy 's thoughts echo those of many lay people; I think the most important callout there might be the mental model of a respiratory illness. If one experiences a mild case of COVID, one may well place it into the category of "cold" or "flu" because it acts according to one's mental model of mild respiratory illnesses. However, if one walks through an ICU full of people on ventilators and occasionally ECMO because of COVID, one would probably recognize that it has the potential to be much more severe.

For general readership, the study cited by @kinoons above is a long way from "destroying the narrative" of long COVID. It is a real phenomenon that is currently under investigation.

Best regards,
DDM

 

[Boarderguy]

You'd be surprised at how many medical professionals misspell things like that. @Boarderguy 's thoughts echo those of many lay people; I think the most important callout there might be the mental model of a respiratory illness. If one experiences a mild case of COVID, one may well place it into the category of "cold" or "flu" because it acts according to one's mental model of mild respiratory illnesses. However, if one walks through an ICU full of people on ventilators and occasionally ECMO because of COVID, one would probably recognize that it has the potential to be much more severe.

For general readership, the study cited by @kinoons above is a long way from "destroying the narrative" of long COVID. It is a real phenomenon that is currently under investigation.

Best regards,
DDM

I don't disagree with you at all @Duke Dive Medicine. I do however disagree that it is something affecting the masses. Hospitalization is a fraction of a percent of covid now. The majority have symptoms equal to or less than a common cold because that is how this virus has progressed over 3+ years. How many don't even bother to test for covid now? I know I don't (except now my critical illness insurance gives me $ for a pos test). Saying we should go look at the ICU to better understand the affects of covid ate like saying we should go to the dialysis wing to better understand alcohol's affect on the body. Small percentages don't and shouldn't drive majority policies. I stand by mine and my friend's/families experiences (multiple ER/ICU during Alpha and Beta strains, 1 death) and say go based on how you feel. Full breath and not feeling crappy, big stride in.

 

[duke dive medicine]

I don't disagree with you at all @Duke Dive Medicine. I do however disagree that it is something affecting the masses. Hospitalization is a fraction of a percent of covid now. The majority have symptoms equal to or less than a common cold because that is how this virus has progressed over 3+ years. How many don't even bother to test for covid now? I know I don't (except now my critical illness insurance gives me $ for a pos test). Saying we should go look at the ICU to better understand the affects of covid ate like saying we should go to the dialysis wing to better understand alcohol's affect on the body. Small percentages don't and shouldn't drive majority policies. I stand by mine and my friend's/families experiences (multiple ER/ICU during Alpha and Beta strains, 1 death) and say go based on how you feel. Full breath and not feeling crappy, big stride in.

Omicron drove a huge spike in daily number of positive cases, roughly four times that of Delta, but the number of hospitalizations was roughly similar. Most recently, US hospitals (including ours) saw a huge spike in flu and RSV in pediatric patients, far above the number of COVID patients we had. This does not mean that COVID acts like those other illnesses. In many cases it does, but in enough cases to matter, it does not. I agree that it doesn't impact "the masses", so to speak, but lung damage from COVID, even in relatively mild cases, is well-documented. This lung damage can lead to air trapping, which can lead to pulmonary barotrauma in diving. You and anyone else may feel free to follow your recommendations, but they are contrary to those of the highly-regarded UCSD diving medicine specialists, reproduced here for continuity (basically a chest x-ray series and pulmonary function testing for mild illness):

Category 1 Asymptomatic Diver who had a mild COVID-19-suspected illness
We define a mild illness as any patient who:
● Did not seek health care or received outpatient treatment only without evidence of hypoxemia.
● Did not require supplemental oxygen
● Imaging was normal or not required
● They have returned to their baseline exercise tolerance.

Commercial Divers/Scientific Divers/Recreational
● Initial/annual exam per ADCI/AAUS/NOAA/RSTC guidelines (DDM addition: for commercial or scientific divers only)
● Spirometry
● Chest radiograph (PA & Lateral)
● If chest radiograph is abnormal, obtain Chest CT scan
● If unknown (or unsatisfactory) exercise tolerance, perform exercise tolerance test with oxygen saturation

Best regards,
DDM

 

[Boarderguy]

@Duke Dive Medicine Are the documented cases of mild / asymptomatic covid from omicron or from delta and earlier variants? Omicron has evolved a few times and is causing fewer and lesser symptoms so that leads one to believe it is also causing less damage does it not? Also, if these mild cases are not seeking medical attention how are these studies being sourced? I would think that the mild case being studied are those who seek care and not the common "ugh" feeling and low grade fever. Curious thoughts, nothing malicious or detracting if you will.

 

[duke dive medicine]

@Duke Dive Medicine Are the documented cases of mild / asymptomatic covid from omicron or from delta and earlier variants? Omicron has evolved a few times and is causing fewer and lesser symptoms so that leads one to believe it is also causing less damage does it not? Also, if these mild cases are not seeking medical attention how are these studies being sourced? I would think that the mild case being studied are those who seek care and not the common "ugh" feeling and low grade fever. Curious thoughts, nothing malicious or detracting if you will.

You make a great point about those not seeking medical attention. There are probably a lot of people out there like that, and they're hard to capture from a data standpoint.

Omicron spiked (at least for us) in mid-January of last year so it's probably still being looked at. If there's a general message, it's that we're only beginning to understand the long-term effects of the disease, and in the specific population of divers, asymptomatic lung damage can have catastrophic consequences so the recommendation is to rule it out prior to diving. That may evolve over time.

Best regards,
DDM

 

[GreggS]

I, like many others as they reported on SB, came home from the Invasion back in June with what I thought was a summer cold. We had some Covid test kits so I used one and sure enough, it showed positive. My symptoms were never severe. The lower part of my throat was irritated a little more than normal (I had a severe case of laryngitis over 30 years ago and have had a small amount of irritation since) and a little bit of chest congestion. The first test was on Sunday, the day after we got home from Coz. I tested again on Wednesday and was still showing positive. Tested again on the following Sunday and showed negative. What was really strange is, my wife and my sister, who had broken her leg at the ankle a couple of weeks prior to us going to Coz and was staying with us as she recuperated, never tested positive although they were both in near contact with me. I never went to the doctor or sought medical care.

We normally dive every weekend during the summer, but for whatever reason, we did not resume until a month after our last dive in Coz. Can't remember if it was due to weather, other commitments, or a combination of the two. But when we did resume, I did fine. My RMV was no different than it was prior to having Covid.

Now, this is in no way saying to ignore what your body is telling you. My symptoms were very mild. I had been vaccinated and gotten all the boosters available up to that time. I've always had a very strong immune system but have no idea if that played a role or not. As a point of reference, I celebrated my 66th birthday during the month interval between the invasion and my next dive.

But I do take Covid very seriously. I have had family members, neighbors, and friends that are no longer with us due to Covid and others that had severe cases and survived. I consider myself lucky that mine was no more severe than it was. I encourage everyone to get vaccinated. As I said earlier in this missive, don't ignore what your body is telling you.

 

[FabletheRaven]

@Duke Dive Medicine Are the documented cases of mild / asymptomatic covid from omicron or from delta and earlier variants? Omicron has evolved a few times and is causing fewer and lesser symptoms so that leads one to believe it is also causing less damage does it not? Also, if these mild cases are not seeking medical attention how are these studies being sourced? I would think that the mild case being studied are those who seek care and not the common "ugh" feeling and low grade fever. Curious thoughts, nothing malicious or detracting if you will.

Weirdly, I'm seeing two people for post covid syndrome right now had really mild cases of Omicron. I always figured that post-covid and severity of disease go together, but it seems that may not be the case (though anecdotal so take it was a grain of salt)

 

[Boarderguy]

Weirdly, I'm seeing two people for post covid syndrome right now had really mild cases of Omicron. I always figured that post-covid and severity of disease go together, but it seems that may not be the case (though anecdotal so take it was a grain of salt)

And did these anonymous people also have comorbidities that affected them? Often I've seen healthy youth - mid aged folk have no ill affects long term nor bad covid. Those with underlying health issues (obesity, diabetes, cardiac troubles, cancer, etc) have generally had more severe and longer lasting symptoms. My obese in-laws were hospitalized. My in shape Marine friends had a sore throat and mid grade fever last year and now have less than cold symptoms. My non obese family friends with lung problems died. Covid does a number to those who aren't healthy (there are always exceptions). If you don't feel great, don't go. If you do feel overall well then it's your health. You know you.

 

[Whitrzac]

The 2nd time i had covid I went diving 2 days after the fever broke... The warm moist air from my CCR kept coughing at bay. TBH I felt better underwater than on land.

 

[FabletheRaven]

And did these anonymous people also have comorbidities that affected them? Often I've seen healthy youth - mid aged folk have no ill affects long term nor bad covid. Those with underlying health issues (obesity, diabetes, cardiac troubles, cancer, etc) have generally had more severe and longer lasting symptoms. My obese in-laws were hospitalized. My in shape Marine friends had a sore throat and mid grade fever last year and now have less than cold symptoms. My non obese family friends with lung problems died. Covid does a number to those who aren't healthy (there are always exceptions). If you don't feel great, don't go. If you do feel overall well then it's your health. You know you.

Yes, but not in the ways you're thinking at all. They are both young, healthy, and athletic 30s and 40s. One has IBS, and the other has a history of other postviral syndrome that was reinflamed by covid. Both had mild cases of covid.

To be clear: Having severe and long lasting covid symptoms is not the same as PACS. It's not PACS until you're a month out.