Timeframe for diving post covid +

[wetb4igetinthewater]

Probably so, and I definitely concur that we shouldn't stop at "expert opinion" and have that be the sole guidance.

Best regards,
DDM

DDM,

Is my understanding correct in that a person infected with covid may have a compromised respiratory system in which their ability to exchange oxygen/CO2 in the lungs is reduced and while at the surface this isn't apparent, it may be at depth?

If this is correct, are there any guidelines or suggestions for prudently reentering the water post covid recovery? Such as shallow dives first (1 ATA, then 1.5 ATA, increasing by .5 ATA and monitoring oneself). Or does this put the person making the recommendations at risk for liability? As we don't know, but if someone insists on diving, at least don't dive to 60 meters their first time back in the water.

 

[DiveProKoko]

Listen to the experts, I guess. But I (unknowingly) dove multiple days with COVID. I also dove several times in the month following my positive test result and recovery, and many months since then. No issues, but everyone is different as well. I think it's case by case...

 

[Duke Dive Medicine]

DDM,

Is my understanding correct in that a person infected with covid may have a compromised respiratory system in which their ability to exchange oxygen/CO2 in the lungs is reduced and while at the surface this isn't apparent, it may be at depth?

If this is correct, are there any guidelines or suggestions for prudently reentering the water post covid recovery? Such as shallow dives first (1 ATA, then 1.5 ATA, increasing by .5 ATA and monitoring oneself). Or does this put the person making the recommendations at risk for liability? As we don't know, but if someone insists on diving, at least don't dive to 60 meters their first time back in the water.

I think the question is more one of air trapping, which makes depth limitations somewhat less relevant. UCSD published a set of guidelines in 2020 and amended them in March 2022, linked here. I'd actually copied and pasted the 2020 version a my previous post (#13). The original guidelines are linked on DAN's page here.

Best regards,
DDM

 

[pauldw]

Are y'all a little too confident that your understanding of medicine in this marvelous 21st century finally rests on scientific certainty?

 

[kinoons]

I think the question is more one of air trapping, which makes depth limitations somewhat less relevant. UCSD published a set of guidelines in 2020 and amended them in March 2022, linked here. I'd actually copied and pasted the 2020 version a my previous post (#13). The original guidelines are linked on DAN's page here.

Best regards,
DDM

It’s good to see that there was at least some reevaluation made to fitness to dive two years later.

No significant cough? Only URI type symptoms? No need for eval.

Have a cough bad enough to take some cough syrup? Yes you need an eval.

Did you take a look at the references on the new recommendations?

None of those references offer any significant insight to the concern regarding mild (or severe) disease and diving risk. If there was enough concern initially to warrant screening none of this evidence should persuade a change in those screening protocols. We still have no idea if air trapping and diving is an issue.

 

[Dr Simon Mitchell]

We still have no idea if air trapping and diving is an issue.

Hello,

Yes we do. There is absolutely no doubt about it.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6704005/pdf/DHMJ-49-141.pdf

There are also multiple published cases of pulmonary barotrauma and arterial gas embolism just by ascending to altitude in an aircraft if you have a gas trapping lesion.

There have been one or two diving cases post-covid which are not yet published. Nevertheless, I do agree the risk seems small which is why there has been a sensible evolution of the UCSD guideline, but the risk is not zero.

Simon M

 

[kinoons]

Hello,

Yes we do. There is absolutely no doubt about it.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6704005/pdf/DHMJ-49-141.pdf

There are also multiple published cases of pulmonary barotrauma and arterial gas embolism just by ascending to altitude in an aircraft if you have a gas trapping lesion.

There have been one or two diving cases post-covid which are not yet published. Nevertheless, I do agree the risk seems small which is why there has been a sensible evolution of the UCSD guideline, but the risk is not zero.

Simon M

Sorry I should have been specific - we have no idea if air trapping due to sequela associate with Covid is an issue; not can air trapping cause barotrauma or embolism in principal.

 

[WeRtheOcean]

Are y'all a little too confident that your understanding of medicine in this marvelous 21st century finally rests on scientific certainty?

I'm not confident of that at all. Especially in matters of public health fearmongering.

 

[Lorenzoid]

I'm not confident of that at all. Especially in matters of public health fearmongering.

I'm not a doctor or a scientist in any relevant field, so I really can't say what is "fearmongering" and what is current (or current enough) guidance. I'll leave it to the experts, and I have gotten a lot out of the experts hashing out the issue in this thread. Thank you, DDM, kinoons and Dr. Simon Mitchell.

 

[PirateFoxy]

Sorry I should have been specific - we have no idea if air trapping due to sequela associate with Covid is an issue; not can air trapping cause barotrauma or embolism in principal.

If Covid is causing damage that can lead to air trapping, like lung scarring, which it is in some people which does not seem to map perfectly to severity of illness, then by what mechanism would the scarring caused by Covid somehow not increase risk of air trapping when similar scarring caused by other things does? The physics involved don't care what induced the scarring, just if the scarring is trapping the air sufficiently to cause a problem.

Also, the more research is done on Covid, the more it's clear it's *not* an URI, it's a multi-system disease that happens to frequently produce URI symptoms in addition to the other things it's doing where the symptoms may be subclinical. Therefore comparing it to diseases that *are* limited to the upper respiratory system is not valid. That means that the safest behavior with Covid could be quite different from the safest behavior with other diseases even though the observable symptoms are very similar. (For that matter, we may well re-examine other diseases that were in the past thought to be inconsequential using approaches developed/honed with Covid and discover that our past practices were lacking and we *should* have been doing something different but we didn't know any better at the time. Like people keep saying "we didn't mask when the flu was going around!" as if that's proof we shouldn't mask for Covid when maybe it just means that we actually should have been masking for flu the whole time. Past behavior may have been wrong, you can't assume that just because it's what we were doing it's the correct thing to do.)

(And this is completely ignoring the potential for extended issues due to Covid infection, which we're realistically only at the very early stages of figuring out, since we have no practical Covid-related data since it hasn't been around long enough and our understanding of the role of infections in general in things like autoimmune diseases is also fairly 'young' as these things go. I'm not talking about long Covid but rather Covid-infection-induced issues like autoimmune diseases and the potential for things that turn up much later on in the way of post-Polio syndrome and Shingles and that sort of thing.)