What is COVID-19? Where did it come from?
COVID-19 is a newly discovered, novel Coronavirus. Coronaviruses are a large family of viruses that circulate widely and are commonly found in humans and many mammals such as cows, camels, cats, pigs and bats. Normally, Coronavirus infection causes a mild respiratory illness that we think of as a ‘common cold.’
Occasionally, Coronaviruses that infect animals jump to infect humans. When this happens the disease is often more serious. Past instances of this include the Coronaviruses responsible for Severe Acute Respiratory Syndrome (SARS) and Middle Eastern Respiratory Syndrome (MERS.) Scientists believe the former originated in bats, while the latter came from camels. SARS virus is not very contagious and has a mortality of around 10% while MERS is quite contagious and has a mortality of around 35%. Like SARS, COVID-19 likely originated in bats but unlike SARS or MERS, COVID-19 is more contagious but with significantly lower mortality.
How bad is COVID-19 infection?
To date, COVID-19 is much more dangerous than a common cold or even the flu, but the actual mortality rate remains unclear. As of this writing (3/7/2020), just under 102,000 cases of COVID-19 infection have been diagnosed worldwide and 3,486 deaths have been directly attributed to the infection. This would suggest a mortality rate of 3.5%.
Compare this to the annual influenza epidemic that has a mortality rate of 0.1%. Also, consider the 1918 Spanish Flu–the last major pandemic that had a mortality rate of just over 2% and resulted in more than 18 million deaths worldwide. In the case of COVID-19, the 3.5% number is likely very misleading. The reason for this is that the vast majority of COVID-19 infections are minor or even asymptomatic and as a result may not get diagnosed.
For this reason, the actual number of cases may be much higher than 102,000. If so, this would drive the mortality rate down, though by how much is a matter of considerable speculation. Still, the high infectivity, and the fact that a considerable number of infected will die, is enough for public health officials to be appropriately alarmed.
My athlete has cold symptoms, should they get tested for Covid-19?
The current guidelines for testing for COVID-19 depend on individuals suffering from several key symptoms of a respiratory illness. These include experiencing a cough and/or shortness of breath,) with a fever and a high risk of exposure to an infected person, either as a result of travel to an endemic area (e.g. China or Italy,) or exposure to a person known to have tested positive.
At this juncture, it is still exceedingly unlikely that any athlete with a cold will have COVID-19 as opposed to any other usual source of upper respiratory tract infection. So the best course of action is to simply assume that the infection is COVID-19 and do everything possible to make sure that it is not passed to anyone else.
This includes:
- Working from home if possible.
- Wearing a mask to prevent spreading viral particles.
- Rigorous hand washing.
- Self-quarantine (up to 14 days).
If these things can only be accomplished after a positive test has been obtained, athletes should know that current guidelines do not allow for testing for anyone who wants it, but rather just for individuals who meet the thresholds listed above.
How will COVID-19 affect my athlete’s racing season?
The main ways public health agencies are controlling the spread of this outbreak are monitoring those who have the infection, decreasing the spread by the use of quarantine, educating the public on handwashing and finally, keeping people from gathering in large groups.
This last strategy poses the biggest threat to upcoming triathlons. Because large gatherings of people present an opportunity for the virus to spread rapidly, it’s vital to prevent or reduce the number of such gatherings to preserve vital public health. However, a couple of things are in favor of triathlons not being canceled.
First, these are dispersed, outdoor events. As opposed to concerts or large spectator events where large groups of people are concentrated indoors or close together, triathlons disperse participants along a lengthy course and this keeps the likelihood of disease spread lower. Second, triathlons tend to attract younger, healthier individuals less likely to arrive with COVID-19 and less vulnerable to its effects, were they to be infected.
How will warmer weather affect the spread of illness?
Another as yet to be determined factor is how warmer weather will affect the COVID-19 outbreak. As respiratory viruses all have a seasonality to their frequency, it is safe to assume that COVID-19 may regress as the temperature rises and people spend less time indoors in close quarters with each other. If this comes to pass, then discussions about race cancellations may become moot. When athletes ask if their events are going to be canceled, the safest answer is to plan and train as though events will occur, but to prepare for the eventuality that they will not. As with everything related to training and racing in the sport, it is wisest to concentrate on the things within one’s control and let everything else just take care of itself.
One thing for all athletes to consider is that travel costs are likely not going to be refundable nor covered by any travel insurance if an event is canceled because of fears around COVID-19. For this reason, it may be prudent to delay purchasing expensive flights or paying for accommodation until as close to a race as possible.
What are the key take-home points for all of this?
There is no question that this virus represents a possible major public health threat. Triathletes should do their best to mitigate their risks of contracting Covid-19 by maintaining good hand hygiene, refraining from shaking hands, sharing water bottles and avoiding close contact with those who are ill with respiratory symptoms. They should continue to train for events as though they were going to take place but mentally prepare for the eventuality that they may not happen, in the service of the greater good of public health. Train hard, train healthy.
References
https://www.cdc.gov/coronavirus/2019-nCoV/summary.html
https://www.cdc.gov/coronavirus/2019-ncov/php/guidance-evaluating-pui.html
https://www.who.int/news-room/q-a-detail/q-a-on-infection-prevention-and-control-for-health-care-workers-caring-for-patients-with-suspected-or-confirmed-2019-ncov
https://www.worldometers.info/coronavirus/coronavirus-death-rate/
