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Can COVID-19 spread through water while swimming?

 


The pandemic of Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) resulted in several lockdowns announced by government authorities around the world. These blockades were accompanied by a partial or complete suspension of activity in the country to mitigate the pandemic. Resuming after the blockade is essential to maintaining the economic well-being of the country. However, precautions should be taken to prevent SARS-CoV-2 infection.

study: COVID-19 infection during swimming-related activities: rapid systematic review.. Image Credit: Anna K Mueller / Shutterstock.com

Background

After the blockade, public health authorities have various strategies, along with rules and regulations, to reopen public places and carry out activities that may involve social interactions, such as swimming in facilities, lakes, or beaches. Is recommended. Swimming-related activities promote the physical and mental health of individuals. However, during this pandemic, the necessary precautions must be taken and implemented.

Recent systematic reviews published in the journal BMC infection, Scientists explore available evidence at COVID-19 infection It is related to the effectiveness of swimming-related activities and recommended strategies to limit them.

The current review of both strategy relevance and effectiveness was conducted on COVID-19’s Living OVerview of Evidence (LOVE) platform. The platform maps COVID-19-related population, intervention, comparison, and outcome (PICO) questions to the repository built by the Epistemonikos Foundation. The search on the L ・ OVE platform covered the period until April 19, 2021.

Is there a link between swimming-related activities and COVID-19 infection?

Three studies obtained from the L-OVE platform were confirmed to be subject to relevance review after a rigorous screening process.

NS First studyA Danish swimming club was involved in an attempt to investigate the extent of SARS-CoV-2 infection during indoor swimming activities from August to December 2020. Subjects positive for SARS-CoV-2 in swimming activity were considered risk episodes.

A total of 162 risk episodes occurred, eight of which led to SARS-CoV-2 infection and 23 were infected. The study also reported that 23 swimmers who belonged to the same club were affected in the training camp.

In particular, members of other clubs training in the same pool during the same period were not affected, so the transmission could be due to other activities such as eating in a training camp, sleeping in a dorm, or socializing. there is.

This study also evaluated Effectiveness of Safety strategy. For this purpose, no association was observed between the implementation of safety measures and the risk of SARS-CoV-2 infection for indoor swimming. However, the study turned out to be biased, providing no conclusive evidence.

NS Second study It was an epidemiological study investigating the outbreak of COVID-19 in recreational facilities, including public baths. It identified one SARS-CoV-2 infected person who used the public bath for two consecutive days. Individuals were associated with 12 bathing-related infections, 10 of whom used public baths and 2 of whom were workers there.

Secondary transmissions have also been reported, and interestingly, the secondary transmission rate on entertainment sites was low when compared to outside locations, such as suppers with colleagues and friends. This may be because the entertainment site is maintained at high temperatures (18-42 ° C) and humidity (60-80%), which may prevent the virus from transmitting.

NS Third study He was admitted to a hospital in Jiangsu Province, China, and observed nine SARS-CoV-2 positive patients, all using the same bus center. Of the infected, eight used the facilities of the bus center and one was a worker. This study contradicted the second study and concluded that warm (25-41 ° C) and humid conditions (60%) in the bath center did not prevent viral infection.

Researchers who conducted a systematic review concluded that the evidence from the three studies was not conclusive and did not address confounding factors.

Strategies to prevent COVID-19 infection

To carry out a systematic review of the current strategy, 50 guidance documents published in 76 documents by 50 organizations obtained from the LOVE platform were selected after a rigorous screening process. Finally, the recommendations from the guidance document were summarized and 11 topics were identified.

Avoid crowds

All guidance documents are committed to ensuring social distance. In addition, 88% of the guidance documents suggested limiting facility capacity either by implementing a booking system or reducing the number of facilities available.

Distance measurements are also recommended, and most documents suggest a distance of 6 feet between individuals, which includes physical barriers, visual cues, pool and area surveillance, and a limit of one person per pool lane. It can be implemented in several ways, such as.

Personal hygiene

Of the documents reviewed, 90% were ill, including hand washing, avoiding contact with the face and unwashed hands, advocating breathing etiquette, and ensuring the use of facilities with access to hand sanitizers and other hygiene products. We recommend personal hygiene practices to prevent transmission of. Payment procedures that are considered safe during a pandemic.

Personal Protective Equipment (PPE)

In summary, 76% of the reviewed guidance documents suggested the use of PPE, especially when physical distances could not be tracked. Recommended PPEs included face covers such as masks at the facility, and gloves. Especially when the staff handles towels and cleans the facility. The document also specifies that the mask should not be worn in damp or underwater conditions.

Consume food and water

Of the guidance documents reviewed, 50% work on food and beverage precautions. Some of the recommendations were pre-packaged food service, discouraged sharing of meals between patrons and staff, and social distance in the dining area.

Most of the documents allowed the use of drinking fountains, but some documents recommend suspending or restricting the use of drinking fountains and visitors bring their own water or liquid supply. I requested that.

Facility maintenance

Approximately 67% of guidance documents recommend disinfecting the pool. Chlorine was proposed as a disinfectant by the majority of documents, followed by bromine.

Monitoring the chemistry of the pool and maintaining a record of pol disinfection was proposed by the guidance document as a quality control measure. In addition, ensure that your facility complies with governing body rules and regulations, World Health Organization (WHO) strategies, US Centers for Disease Control and Prevention (CDC) recommendations, and guidelines proposed by manufacturers. Follow.

Frequently touched surfaces

Systematic reviews show that 96% of documents address frequently touched surface issues such as toilets, toilets, changing rooms, waiting rooms, doorknobs, pools and beach areas, decks, equipment, and pool ladders. it was done. Recommended frequency Very variable between documents to clean the surface.

Measures proposed to limit surface contamination include preventing object sharing, restricting access to non-sterilizable facilities, facilitating contactless payments, and providing foot pedals to reduce contact. increase.

Indoor ventilation

Forty-two percent of the documents were found to address ventilation issues in the indoor spaces of swimming facilities. Some recommendations include ensuring the proper functioning of the ventilation system and keeping windows and doors open to facilitate the circulation of outside air.

Screening and management of the sick

Measures for screening and management of suspected or confirmed cases of COVID-19 were proposed in 90% of the guidance documents. The document recommends that patrons and staff stay at home in case of symptoms or when contacting an individual suspected or identified as having COVID-19 infection.

The proposed timeline for the exposed employees to return to work varied from document to document. For high-risk individuals, we recommend that you give them special access time, take special precautions, and ask them to restrict access to the pool if necessary.

Providing first aid

Measures to provide first aid were proposed in 43% of the documents. People in need of first aid were recommended to be treated as COVID-19 positive until confirmed.

Other measures include providing on-site cardiopulmonary resuscitation (CPR) equipment, revising the CPR protocol to meet pandemic needs, and lifeguard PPE. Some documents also suggested that lifeguards should follow social distance measurements and limit physical contact.

Raise awareness

In summary, 72% of the reviewed guidance documents recommended spreading awareness messages and regulations to be followed in swimming facilities that employ postings or broadcasts. For example, you should provide information on social distance, hand washing, and the steps to take if a symptomatic individual is identified. Information should be posted in many places. This will make it understandable to the target audience.

Strategies to prevent SARS-CoV-2 infection during swimming-related activities..

vaccination

Only 6% of the guidance documents dealt with vaccination. Recommendations included continuing COVID-19 precautions regardless of the vaccination status of patrons and staff.

Conclusion

The results of this study confirm the association between swimming-related activities, SARS-CoV-2 infection, and support the safety and effectiveness of recommended strategies to prevent the spread of SARS-CoV-2. It indicates that there is not enough evidence. Use swimming facilities.

The documentation was consistent with recommendations for social distance, PPE use, personal hygiene, and surface cleaning. However, there are contradictions, especially when considering whether food services need to be opened, whether drinking fountains need to be allowed to function, and whether lifeguards need to recommend social distance. I did.

Although there is no conclusive evidence, the current study reveals appropriate strategies that need to be adopted in swimming facilities and swimming-related activities, and integrates information from guidance documents to identify SARS-CoV-2 infection. I’m reducing it. The information discussed in this study may help manage swimming-related activities to plan resumption after the blockade.

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Sources

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2/ https://www.news-medical.net/news/20211101/Can-COVID-19-spread-through-water-while-swimming.aspx

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