The threat of Covid-19, the vaccine and the underwater activity. The vaccination campaign and how to behave after the administration. Guidelines for those affected by the virus and advice that is always valid for our integrity.
At the beginning of this new year, in which, as we all expected, but certainly not at this rate, the infections related to the Omicron variant are exponentially increasing, I would like to wish everyone for 2022, a year way better than the previous two and studded with many dives into the blue.
I spent this Christmas break spent with my family in both Sicily and France. And therefore I needed to digest twice as much as normally, it was necessary after all the lunches and dinners. With the hope of being able to wear my diving suit without looking like a sausage… In light of the Gimbe Foundation Covid-19 case bulletins, I thought it might be appropriate to make a brief review of the guidelines in relation to practicing our sport. For those who have been diagnosed positive for the virus and those who followed the recommendations of the health authorities by choosing to get vaccinated.
The French Federation of Underwater Studies and Sports (FFESSM)
I was in my hometown, Marseille, venue of the FFESSM (French Federation of Underwater Studies and Sports). And to do this I decided to browse the page of the Medical and Prevention Commission (CMPN) of the Federation.
This Commission, a service body of the FFESSM, was established to safeguard the health and safety of members of federal activities. Through prevention measures, study of medical records and generic but also personalized recommendations. It consists of sanitary professions and federal doctors, subject to the Code of Deontology and formed by the federation itself. They are professionals in the diving field and, therefore, they represent indispensable contacts.
In such a period like the Covid-19 pandemic, vaccines appear to be an essential weapon in the fight against this disease. It is therefore the most effective solution in order to end the restrictions in activities and freedom!
After the evaluation of the Medicines Agency, the vaccines marketed in France as well as in Italy appear to be effective with a good level of safety. Offering a benefit-risk ratio largely favorable to vaccination.
These vaccines are effective in preventing the disease, as well as reducing the transport of the virus.
As is well known, vaccination is the presentation to the human body of a part of the microbe or virus against which it is directed. To prepare the immune system to recognize and fight a given disease. In the event of a subsequent encounter with the virus or microbe against which one has been vaccinated, the organism is ready to activate its own means to destroy the pathogen and therefore not contract the disease or contract it only minimally. The discovery of this type of defense has allowed certain fatal or very disabling diseases to disappear or become very rare.
In France, vaccines against CoViD-19 are subject to enhanced surveillance by regional pharmacovigilance centers, led by ANSM (National Agency for the Safety of Pharmaceuticals and Healthcare Products) which regularly updates its database.
Completion of the vaccination cycle does not preclude compliance with the so-called “barrier gestures”. They must be performed regardless of the injections received. As well as preventive measures relating to the maintenance of equipment and in particular of the respiratory devices used in our activities, as recommended by the CMPN.
Diving after vaccines
The commission reminds us that we should note dive if we are not feeling well. If there is a health problem and in particular if a reaction to a vaccine injection arises.
How a vaccine works
Vaccination, whatever the vaccine used, leads to an inflammatory reaction of different intensity in our body which involves the activation of endothelial cells and platelets. Therefore, there could be an interference with the risk of a decompression accident (PDD). The bubbling phenomenon also generates a reaction in the body with the onset of inflammatory phenomena and platelet activation (decompression sickness). Scientists do not know how long this inflammatory syndrome might last. Probably a few days (varying between 2 and 10 days), and if the intensity of this inflammatory syndrome is related to the severity of the general reaction to the vaccine.
The only way to avoid a decompression accident (PDD) … is to refrain from diving!
Precautions after administration
A period of abstention from diving for a few days after vaccination is recommended. And then you can gradually resume diving within the safety curve, in other words, inside the safety curve at less than 20 meters.
In case of abnormal sensations during the practice of your sport and diving activity (chest pain, disproportionate breathlessness, cough, palpitations, malaise, excessive tiredness), stop and report the problem to your partner or coach with the sign “that there is something wrong”and get out of the water.
After almost two years of viral circulation in France, with containment measures and restrictions that have strongly influenced the practice of our diving activities, we are reminded of the need to gradually resume our activities, whatever they may be, in order to limit the risk of injuries and accidents.
Anyone who had CoViD-19 or who simply tested positive for this disease, but without symptoms, should get checked by their doctor before resuming any diving activity.
Resumption of underwater activity after Covid-19: limiting the risks
Unfortunately, the national lockdown, in the context of the Covid-19 pandemic, had a significant impact on some of the population. The sedentary nature of the lockdown for many of us should have required a gradual resumption of our activities. To limit the risk of cardiovascular injuries or accidents.
To this day, we have no certainty regarding a potential impact of the virus on the risk of sports accidents. In particular cardio-respiratory accidents, decompression accidents for divers or hypoxic syncope for freedivers.
Paucisymptomatic cases (mild symptoms)
Outpatients with mild symptoms did not require CoViD-19 positive screened oxygen therapy. They experienced no episodes of fever above 38 ° C or breathing difficulties that required oxygen treatment. They did not show cough, diarrhea, taste and smell disturbance.
They are contraindicated to practice diving for a few weeks (at least 5 weeks after the alleged contact). Before resuming business, a medical re-evaluation will be required. The latter must be carried out by a federal, sports or hyperbaric doctor. He will perform a clinical evaluation and a self-evaluation of the effort with research of desaturation (<94% at the end of the effort).
Inpatient patients, that is, patients tested positive for CoViD-19, often with lung disease, received oxygen monitoring and specialized follow-up at the end of their hospital stay.
For them, the duration of the contraindication of underwater practice ranges from 2 to 3 months depending on the clinical evolution and the first medical evaluation. This medical evaluation, carried out before resuming activity, includes a clinical examination and self-assessment of effort, measurement of oxygen during exercise (search for saturation <94% at the end of the exercise). If in doubt about the results of the self-assessment, an ECG, specialist analysis based on clinical data and make sure that the ventilatory and cardiac status are normal.
Divers undergoing intensive care
Finally, the diver who was symptomatic and hospitalized in intensive care with ARDS (Acute Respiratory Distress Syndrome), MODS of the visceral type (multiorgan dysfunction syndrome) and thrombo-embolic events, will benefit from a medical rehabilitation and a pneumo-cardiogic. The duration of the contraindication of diving practice is of, at least, 6 months and in some cases, depending on the follow-up data, a reorientation of the activity (snorkeling and freediving) may be contemplated.
In any case, the resumption of sports activities, once the patient’s health allows it, must be very progressive.
Well, as you might have understood from what I mentioned before, it is clear that the days and weeks following the contraction of CoVid-19 as well as vaccination should not be underestimated, especially in relation to diving.
Therefore, and starting from the premise “better safe than sorry”, let me remind you some of the basic principles that every diver should always bear in mind and apply (or at least try to!).
First of all, in order to ensure a safe diving, I need to be healthy and fit!
Our diving activities are demanding in terms of physical effort and reactivity.
Therefore, it is strongly recommended to get enough sleep and to avoid consuming products which might disturb our behaviour and the feelings we get when we are underwater (recreational products, alcohol, medicines, specific kinds of foods, etc.).
In case you undergo a health problem, and / or if you have to do a daily treatment, it is best to consult a specialized doctor.
It is recommended to have an active lifestyle. Practice physical activity regularly (every day) favoring active means of transport (taking the stairs, parking a little further away to walk, getting off a bus / tram / metro first, etc.).
Hydration (I mean by water …!) before and after water activities is essential.
The percentage of water in the human body is on average 70% and dehydration, linked to diving, increases the loss of water in the body.
Since dehydration generates a phenomenon of blood viscosity which hinders the correct perfusion of the organs, the saturation and desaturation of the tissues in inert gases are compromised. In fact, the alteration of the mobility of the micro bubbles and the increase in coagulation around them represent potential risks of decompression sickness.
Therefore, poor hydration during diving increases the risks and decompression accidents.
Furthermore, taking care of dental hygiene is also important. A good oral condition prevents the dental pain that diving can cause. An annual preventive visit to the dentist is recommended, indicating underwater sports practice.
Let’s take care of our back too!
The equipment is often heavy, we should adopt the right postures and let’s not be ashamed of bringing a trolley or a bag on wheels to help us.
Let us think about helping our partner and getting help.
We are not alone when we are underwater! It is important to always report any abnormal, painful or uncomfortable sensation during our activity to the partner / supervisor. Solidarity, empathy and sharing are the essential qualities of a good diver. Taking care of oneself, through small precautions such as those mentioned above, denotes having respect for oneself, which represents the first step towards respecting others.
There is one last thing left to do: I want to wish you a Happy New Year in blue, green or any other color (I think of my beloved “mud” underwater friends!).
I wanna wish a nice time in the sea to those who are lucky enough to have it near and enjoy it all year round, in short, “Have a nice everything”, in safety, health and awareness of the environment.