Editors note: General Practitioner and Sports Physician Dr Etti Barsky has compiled some advice for Covid-19 patients that have managed to recover but are wondering how to start exercising again.
Getting back into training after recovering from a Covid-19 infection is not as clear cut as it is after other viral infections. For the past 30 years, we have relied on the “neck check” to decide when an athlete – elite or recreational – can return to sport after a respiratory infection.
This rule would extend to anything from the common cold to complicated pneumonia and is as follows:
If your symptoms are confined to your head and neck, for example, a runny nose, sinus pain or a scratchy throat; and you don’t have a fever or muscle aches, then you are most likely clear to train.
These criteria, however, do not apply in the Covid-19 scenario. There are many reasons for this, but the two that are the most worrying are:
- It is possible for someone with mild novel coronavirus symptoms to deteriorate on around day 7
- Cardiologists are seeing a higher incidence of heart issues in people infected with the virus
There is a 22% higher prevalence of cardiac injury in patients hospitalised with Covid-19 as compared to 1% in patients with other viral infections.
It is currently not known how far-reaching the effects of the virus are on asymptomatic people; on people who have mild-moderate infection and are not hospitalised; and the long term effects on those who have had severe infection either with or without cardiac involvement.
International sporting and cardiology experts, therefore, agree on a stepwise approach to resuming physical activity in the following way:
Covid-19 Positive and Asymptomatic
Wait 2 weeks before resuming training.
Covid-19 Positive and Mild Symptoms
Wait for all symptoms to clear, then rest for a further 14 days before you try a workout.
Covid-19 Positive and Severe Symptoms/Hospitalised without heart issues
Wait for all symptoms to clear, rest for 2 weeks then be evaluated by your doctor.
Covid-19 Positive and Severe Symptoms/Hospitalised with heart issue
Evaluation and clearance from a cardiologist once the 2 week rest period has been completed, is necessary.
The more high-level athlete you are, the more it is advised to go for a formal check-up which would include an ECG and cardiac enzyme level checks.
Knowing that the virus can cause complications in many systems of the body, the best practice is to resume training in a slow and steady way. You need to pay attention to both the physical and psychological effects of a workout.
Things to look out for during or after your workout would be: -
- A higher than usual resting and exercise heart rate, as well as a longer time to recover.
- Excessive fatigue – this includes knowing that you had a low-intensity workout and feeling completely exhausted afterwards (as if you’d done a much harder workout).
- Shortness of breath – more so than you normally would be during or after a training session.
- Dizziness, Chest pain, Muscle pain and Palpitations.
The best way to go about getting going again is to start with a very low-intensity session and gradually build yourself up over a 3 - 4 week period.
Meanwhile, Briefly.co.za reported that the South African Revenue Service is probing 300 businesses that managed to secure R2 billion in tenders.
Listed among the companies that were awarded contracts to provide the government with personal protective equipment are a car wash, a pub and a bakery.
In addition to having close to no experience in the field less than 30% of the companies are tax compliant, a major red flag that the usual procurement processes were flouted during bidding.
R1.2 Billion in tenders is being investigated by SARS for being awarded to companies with political connections.
Commenting on the situation, SARS Commissioner Edward Kieswetter says there is no length enterprising crooks weren't willing to go to:
“It’s all kinds of shenanigans that they play. Not declaring income from PPE even though they get it from the government, they still choose to cheat the government. They have outstanding tax returns, they file fraudulent or incorrect returns. They obtain tax certificates by fiddling the system, and they are not registered for VAT."
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