What precautions should you take?

Antonio Spataro, Medical Officer to the Italian Rowing Association, gives his opinion

by Stefano Lo Cicero Vaina (source translated by Gillian Shaw)

Clubs are closing, training sessions suspended and races are at risk. Even the rowing world is suffering the effects of the coronavirus emergency that’s forcing Italy and other countries to organise themselves so as to contain the virus that’s troubling organisations and the population at large. For normal, everyday life it’s enough to follow the directions issued by the Italian Ministry for Health to reduce the risk of infection, but for sports people, they’re wondering if physical activity will put their health at risk during this period. To get some clarity on this, we asked Antonio Spataro, President of the Medical Commission for the Italian Rowing Association.

Mr Spataro, what’s your opinion of Covid-19? Does it cause a simple influenza, as some virologists have said, or is it a particularly dangerous virus?

“Coronavirus is a broad grouping of viruses, which attack the respiratory system. We have known about them for years and have caused illnesses like Sars in the past.  Now, this new respiratory disease is spreading, caused by Covid-19. In 85-90% of cases, this virus develops into a minor or moderate illness and people recover of their own accord. Only 5% of people with the infection develop a serious respiratory condition, and 1-4% may die. So, in the vast majority of cases, we can define it as a benign disease. You just need to think of it as the flu, which causes many more fatalities over the course of a season.”

Why then is there so much concern if we don’t usually become so panicked over the flu?

“It’s because we know so little about this virus and because it’s so highly infectious. And usually we have vaccines for seasonal flu which means that people can defend themselves. But this is not the case here, so this virus is finding fertile ground in the human body. Additionally, if too many people become ill and the number of serious cases were to increase, the Italian National Health System would be at risk of being overwhelmed because of the limited number of intensive care beds.”

So how can we protect ourselves?

“The only two safeguards we have are to diagnose and isolate infected patients. We have no other weapons to combat it. The government has done well to take good preventive measures.”

In the beginning, it was said that people at highest risk were those who had pre-existing conditions or who had suppressed immune systems, and particularly older people. But it appears that cases amongst healthy, relatively young people who end up in intensive care are growing.

“There are a small number. WHO says that mortality decreases for those under 60 years old. There may be a few young people but it would be wrong to say that this disease is developing amongst young people.”

Yet the famous ‘patient number 1’ from Codogno, Lombardy is 38 and an athlete, who ran two half marathons before falling ill. He became ill and ended up in a bad state, in resus. How would you explain this case?

“This case can be explained simply. When someone does intense physical activity, during the 24-72 hours following it there is a drop in the immune defences which sport medicine calls the ‘open window’. It’s a window of time when the immune system is depressed. And it brings with it a slight increase in the risk of infection in the upper respiratory tract.”

In the light of this case and what you have just explained, what should a rower or sports person do to remain healthy? Are people who practice sport, with intense training sessions, more exposed to the coronavirus?

“In general, rowing is not risky because it takes place outdoors and not in enclosed spaces. Practiced regularly this sport reduces the risk of catching viruses because it improves the immune system. Above all, this is valid for people who are amateur rowers and don’t follow a heavy training schedule. On the other hand, élite rowers undergo huge respiratory strain, shown by studies carried out by our own rowers – 30% of them catch upper respiratory system illnesses during the winter, but they recover in a few days. As they are currently continuously monitored, there is no risk for them for coronavirus.”

In other words, can we train without worrying?

“Competitive rowers can train as usual. Although, Master rowers should not train too much and should limit themselves to light or moderate sessions. It’s best to avoid high-intensity training and stay within 60-70% of your maximum heart rate, which changes with age.”

Some clubs in Northern Italy have suspended all activity, including boat outings. Who can still train and what precautions should they take?

“As I said before, when you are in a boat there is little risk as you are training outside. The problem is in gyms, as they are confined spaces and are often crowded. It’s best not to use ergometers or weights at high intensities. The other place to avoid is the changing room – it’s best to have a shower at home. And again, there’s no need to change your drinking water bottle, you just need to give it a good wash. That way you’ll keep the places you go to really clean. And remember to wash your hands often.”

Finally, do you have any other advice for our rower friends?

“Don’t stop, continue rowing, but do take the appropriate precautions as indicated by the Italian Ministry for Health.”

5 Responses

  1. Great summary completely in line with my own opinions as an experienced rowing and sculling coach and the author of How to Win – the Sports Competitors Guide to Success. Best to avoid the gatherings after head races too, awaiting results. Just load your boat on the trailer, go home and get the results on the internet. I’m sure the organisers will post your medal to you if you’ve won.

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