Update #26: Advisory on COVID-19

Monday, January 18, 2021

UPDATE #26 | 18 January 2021

Advisory on COVID-19

SPORT MEDICINE ADVISORY COMMITTEE UPDATE:

Please Note: The SMAC COVID-19 Advisory will no longer be released bi-weekly and will be issued ‘as required’. Please continue to request information via the SMAC CMOs and/or members of the COVID-19 Return to Sport Task Force.
 

Disease Update
As we move into 2021 the number of confirmed cases of COVID-19 world-wide is over 93 million with over 66 million recovered and 1,990,000 deaths. A number of new variants originating in the UK, South Africa and Brazil have recently been identified. In Canada we have over 687,000 cases, 17,500 deaths and 591,000 (75%) recovered. Mortality rate in Canada is 2.5%. A number of provinces are experiencing record numbers of cases. In some countries the numbers of cases are at all-time highs and this reinforces the need to remain careful and follow recommendations on hand washing, physical distancing and use of masks which is now mandatory in most provinces in Canada and many countries in the world.

Many provinces are now setting different restrictions on cities or regions rather than just a province wide rule and this often impacts training facilities and sport institutes in different ways. With the surge post holiday season and the expected spikes in the winter, restrictions are being imposed to protect the medical system and health of vulnerable individuals. Please check often with your training facilities for any changes in restrictions.

COVID-19 Asymptomatic Testing in Canadian Sport Institutes Across Canada
Please check the links below for the latest information on options for testing and screening in the Canadian Sport Institutes.

CSI Pacific
CSI Calgary
CSI Ontario
INS Quebec

COVID-19 Screening Testing Requests
In November 2020, National Sports Organizations received Canada’s Olympic and Paralympic COVID-19 Screening and Testing Program Guidelines. A NSO COVID-19 Screening Request Form was provided for the use of the Hyris bCUBE Testing Kits/Units recently purchased by the Canadian Olympic Committee and Canadian Paralympic Committee. OTP is responsible for coordinating requests and invites NSOs to submit an application form for Point of Care Testing (POCT) to occur in February 2021. Deadline to submit applications is Friday, January 22, 2021. 

Please contact Dr. Andy Van Neutegem, OTP Director of Performance Sciences, Research & Innovation, andy.vanneutegem@ownthepodium.org should you wish to have further information or discuss your POCT options.

Vaccinations
Vaccinations in Canada are managed by the Federal and Provincial Vaccination Task Force / National Advisory Committee on Vaccination with specific provincial vaccination schedules, plans and programs in place. The Canadian Vaccination programs specifically target the highest risk populations and communities initially and then rolled out to the less vulnerable and lower at risk individuals. Canadian athletes and teams will fit into the Public Health vaccination program, but we are not able to confirm any specific details at this stage. 

At present there are only 2 vaccines approved by Health Canada for use in Canada;

Both Vaccines are mRNA Vaccines, require specific cold chain management prior to administration and require 2 doses between 21 days (Pfizer) and 30 days (Moderna) apart. In early clinical trials they are between 94% and 95% effective 2 weeks after the second dose although new data will be known as the vaccination program reaches more people. Both Vaccines are WADA compliant.
At this stage it is too early to know definitively how long, and to what level immunity will be maintained post vaccine (or even post infection). For this reason, countries, international sport federations and Canadian Sport Institutes require proof of a negative COVID-19 PCR test prior to boarding a flight or entering a competition and/or training camp bubble rather than a vaccine certificate. The exact timing allowance for COVID-19 PCR tests pre-departure and arrival at destination varies between 48 and 72 hours. We will continue to monitor guidelines and requirements for testing, but teams will need to confirm the specific testing requirements for their destinations and competitions prior to departure.
The availability of and process for asymptomatic screening is covered in greater detail elsewhere in this Advisory.
 
Canadian High Performance COVID-19 Database
Thanks to those sports that have reported to the COVID-19 Testing database. Recently the third data request was released, and we are creating a dashboard of information. This will be released to CMO/IST Leads as well as HPDs of sports in a secure password protected manner in the near future. If you are a CMO of a sport or IST Lead that has not received the email and links please contact Dr. Andrew Marshall (amarshall@paralympic.ca).
 
Inter-Provincial Travel
Within Canada some provinces are placing restrictions on travel for sport within or across provincial lines. If camps or competitions are planned, please check for the latest restrictions.

  • In the Atlantic provinces there is a requirement for 14 days self-isolation if entering or returning from other provinces.
  • In Quebec there is no official isolation requirement for people arriving from other Canadian provinces.  
  • As of 14 January 2021, Ontario has a stay at home order and strongly advises self-isolation for 14 days if arriving or returning to Ontario from another province.
  • In Alberta local health authorities may subject travellers to or from other provinces to restrictions but there is no provincial ruling.
  • In BC, a request to avoid non-essential travel outside the province exists but there are no specific inter provincial travel isolation requirements at this time.

SMAC strongly recommends that NSOs travelling to another province without a travel restriction or isolation requirements, consider a PCR asymptomatic screening test prior to departure or upon arrival. If the test is negative, athletes and staff should maintain a quarantined training bubble and re-test on Day 5. During and following quarantine periods, continue to follow all required preventative measures such as wearing a mask, washing hands frequently and avoiding close contact. If any asymptomatic test comes back positive, isolate and follow all mandatory public health authority restrictions and requirements including cooperating with contact tracers to identify close contacts. 

International Travel
The travel ban across the Canada-US border has been extended and infection rates in the US continue to climb. To limit the spread of COVID-19, the Government of Canada advises avoiding non-essential travel outside of Canada. For teams planning to travel for international competitions and camps, a full risk assessment and mitigation strategy process should be undertaken to assess the potential benefit of international competition / qualification (using the RCAT- III) versus the risk of travel and the potential impact of the 14 day quarantine.

For ANY international travel into Canada there is a mandatory 14 day self-isolation requirement in addition to proof of a negative nasal PCR test prior to boarding the returning flight. 
https://travel.gc.ca/travel-covid

For international flights landing at Calgary International Airport there is a voluntary testing pilot project that would allow the quarantine to be reduced to 7 days for certain individuals but does require passengers to remain in Alberta for the full 14 day period. Details of the program may be found HERE.

Additional domestic and international travel precautions are below.

  • Check the local quarantine regulations immediately prior to departure.
  • Wear a mask at airport and on flight. Medical grade masks are preferable but N95 masks are not a requirement.
  • Wash hands frequently in airport. Once settled in seat use hand sanitizer and wash hands again upon leaving plane and airport.
  • Practice rigorous cough hygiene at all times.
  • Use a wipe to clean the arms of the seat. Do not use the seatback table or entertainment system unless necessary and wash it with a wipe before using it.
  • Choose a window seat as this minimizes contacts with others.
  • Wipe down luggage including hand luggage once retrieved and exiting airport and any public transport such as a bus or taxi.

CCES Updates
The CCES has been closely monitoring the ever evolving pandemic situation across the country. While some provincial lockdowns, curfews, and stay at home orders have been put in place, exceptions have also been made in these areas to permit the continuation of high performance athlete training. The CCES, therefore, continues its anti-doping work in all areas of the country, while ensuring that adherence to the enhanced restrictions that are in place in some areas (e.g. the curfew in Quebec) is maintained and that the supplemental anti-doping procedures, created to protect all participants during the process, are strictly followed.
 
The CCES also continues to monitor the vaccine roll-out in Canada. In October, the World Anti-Doping Agency (WADA) issued the following statement regarding the COVID-19 vaccines that have come to market at that time: https://www.wada-ama.org/en/media/news/2020-12/wada-clarifies-position-on-covid-19-vaccines. The CCES remains in close contact with WADA regarding the roll-out of additional vaccines to ensure they do not contravene the anti-doping rules.

Updated links from the Government of Canada and WHO

https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19.html#faq
https://www.who.int/emergencies/diseases/novel-coronavirus-2019

Further Questions:

Further information about COVID-19 may be obtained from your NSO Chief Medical Officer or Team Physician, or the Chief Medical Officers of the Sport Medicine Advisory Committee.

Dr. Mike Wilkinson, Canadian Olympic Committee: mwilkinson@olympic.ca
Dr. Andy Marshall Canadian, Paralympic Committee: amarshall@paralympic.ca
Dr. Suzanne Leclerc, Institut National du Sport du Québec: sleclerc@insquebec.org
Dr. Steven Dilkas, Canadian Sport Institute Ontario: sdilkas@csiontario.ca
Dr. Brian Benson, Canadian Sport Institute Calgary: bbenson@csicalgary.ca
Dr. Paddy McCluskey, Canadian Sport Institute Pacific: pmccluskey@csipacific.ca

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