UPDATE #27 | 30 March 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.
As we move into April of 2021 the number of confirmed cases of COVID-19 world-wide is over 126 million with over 101 million recovered and 2,766,000 deaths. A number of new variants originating in the UK, South Africa and Brazil have recently been identified. In Canada we have over 952,000 cases, 22,700 deaths and 890,000 (93%) recovered. Mortality rate in Canada is 2.3%. A number of provinces are experiencing record numbers of cases and hospitalizations indicating the third wave appears to be upon us. 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.
COVID-19 Asymptomatic Screening in Canadian Sport Institutes Across Canada
Please check the following links for the latest information on options for testing for screening in each of the CSIs across Canada.
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)
Please contact Dr. Andy Van Neutegem, OTP Director of Performance Sciences, Research & Innovation, firstname.lastname@example.org or a Canadian Sport Institute should you wish to have further information or discuss your POCT options.
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 rollout of the vaccine is well underway and supply chains are ramping up the vaccination process.
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 4 vaccines approved by Health Canada for use in Canada;
- Moderna COVID-19 vaccine
- Pfizer-BioNTech COVID-19 vaccine
- AstraZeneca COVID-19 Vaccine
- Janssen COVID-19 Vaccine (Johnson & Johnson)
Moderna and Pfizer Vaccines are newer technology mRNA Vaccines, require specific cold chain management prior to administration and require 2 doses between 21 days (Pfizer) and 30 days (Moderna) apart. In several provinces the interval has been extended as much as 4 months between injections to enable maximisation of 1st dose administration with the limited supply available. 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.
AstraZeneca is viral vector vaccine which uses adenovirus (same as common cold virus) to deliver a COVID-19 spike protein that is on the surface of virus to induce the immune response. It is also a 2 injection vaccine with the time interval 4-12 weeks between injections.
Janssen is another viral vector vaccine which is a single dose vaccine and takes 2 weeks to develop significant protection against COVID-19. It has been found to be 66% effective in preventing symptomatic COVID-19 disease.
All 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 continue to require proof of a negative COVID-19 PCR test (and some an added rapid antigen test) prior to boarding a flight or entering a competition / 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.
Canadian High Performance COVID-19 Database
Thanks to those sports that have reported to the COVID-19 Testing database. We are still receiving information and if you are a CMO of a sport or IST Lead that has not received the email and links please contact Dr. Andrew Marshall (email@example.com). Requests can be made to OTP should you require specific data for a specific purpose such as an application or presentation to public health authorities.
Within Canada some provinces are placing restrictions on travel for sport within or across provincial lines. If camps or competition 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 outside the Atlantic bubble.
- In Quebec there is no official isolation requirement for people arriving from other Canadian provinces. For the INS recommendation is 7 days of isolation and negative testing before having access to the INS. Individual evaluation is done for each circumstance.
- Ontario has a stay at home order and strongly advises self-isolation for 14 days if arriving or returning to Ontario from another province. CSIO will require a 5 day self-isolation and negative COVID-19 test (rapid antigen test is acceptable) to access to our spaces and services following interprovincial travel using public transportation (plane, train, or bus). Persons travelling independently via private vehicle will be exempt from this requirement.
- In Alberta local health authorities may subject travellers to or from other provinces to restrictions but there is no provincial ruling. Athletes and Coaches returning to CSI Calgary from within Canada must complete a negative COVID-19 test upon arrival in Calgary followed by a Telehealth call before entry to the CSI Calgary. Cost to be borne by the NSO/athlete.
- In BC, a request to avoid any non-essential travel within and outside the province exists but there are no specific inter provincial travel isolation requirements at this time. CSIP is requiring that athletes and staff self-isolate for 14 days, or until after Day 5 COVID test is reported, before accessing the facility or working directly with the staff.
SMAC strongly recommends that NSOs travelling to another province without a travel restriction or isolation requirements, consider PCR asymptomatic screening tests 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 screening comes back positive, isolate and follow all mandatory public health authority restrictions and requirements including PCR testing.
The travel ban across the Canada-US border has been extended and there is no date of ending this in the near future.
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 with PCR testing on entry to Canada and again on day 10 in addition to proof of a negative nasal PCR test prior to boarding the returning flight.
Additional domestic and international travel precautions are as follows:
- 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. There is some evidence emerging that double masking is more effective.
- 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.
- Using 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.
Updated links from the Government of Canada and WHO
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: firstname.lastname@example.org
Dr. Andy Marshall Canadian, Paralympic Committee: email@example.com
Dr. Suzanne Leclerc, Institut National du Sport du Québec: firstname.lastname@example.org
Dr. Steven Dilkas, Canadian Sport Institute Ontario: email@example.com
Dr. Brian Benson, Canadian Sport Institute Calgary: firstname.lastname@example.org
Dr. Paddy McCluskey, Canadian Sport Institute Pacific: email@example.com