During the pandemic, Dr Ross Sayers of DDRC Healthcare has worked in intensive care and respiratory units, the Nightingale Hospital, and one of the Covid vaccine trials. He shares his thoughts on what we know so far about how the virus may affect divers.
Vaccinations have been well underway for a few months and there is finally light at the end of the tunnel! There is a real chance that we will start to see life getting back to normal and those dreamy dive weekends back on the calendar in the not-too-distant future. That being said, the NHS remains under real pressure and it is likely many more people will fall ill before the vaccines show their worth.
As divers, there are many questions running through our minds: have I had Covid, and has it caused any long-lasting effects? Will the vaccine keep me safe? Will it affect my diving in the future? This is a quick update of what we know so far.
Have I had Covid?
A quick reminder, Covid-19 is caused by a virus transmitted in droplets from the mouth, throat, and airways. Some people don’t get any symptoms but if you have had a fever, shortness of breath, lost your sense of smell or taste, and had a cough or a flu-like illness in the past 12 months, there is a good chance you have had the infection.
Since its emergence in November 2019, Covid has spread around the world, impacting people's health and mental wellbeing, global economies, and closing your local dive shop. Our understanding of the disease is still very rudimentary but is gradually advancing. Covid-19: what divers need to understand gave a very thorough overview of the virus and its implications for divers.
If I’ve had Covid, what lasting effects could there be?
It’s been a little over 18 months since Covid was discovered and that isn’t much time to understand a completely new disease. There are no studies as yet as to what happens to your lungs after a mild Covid infection where you did not need to be admitted to the hospital.
The few studies thus far show people who need to go to the hospital and have oxygen are more likely to have serious inflammation and residual scarring in their lungs. There have been previous studies in viruses similar to Covid showing that most recover quickly, but some people have shortness of breath, fatigue, and decreased lung function up to two years after infection.
It is this damage to the lungs that we are most worried about when thinking about your safety when diving as it can lead to trapped gas and risk of pneumothorax or decrease your ability to get gas in and out of your blood while exercising.
There could also be other lasting effects of the virus, such as damage to the heart or fatigue that can be very disabling and is increasingly being called ‘Long Covid’ — a quick internet search will give you some people’s Long Covid stories that may resonate with you. These problems are all much more likely if you needed some time in intensive care.
Can I dive after Covid or after having my Covid vaccination?
It is a real challenge to advise divers what is and isn't safe right now. For those who haven’t had Covid, prevention is better than cure and once we are all vaccinated the hope is we will be able to get back to normal.
Dive boats are cramped environments; personal space and privacy when diving are two things often sacrificed! Dive charters are doing excellent work keeping divers safe and have adapted the way they work to follow new Covid guidance; thorough, comprehensive advice is available on the BSAC website. Despite boat operators' best efforts, the Covid-19 virus can still be accidentally shared without vigilance.
The vaccine studies are really encouraging and suggest they prevent the vast majority who get the virus from having symptoms or needing hospital admission. We don't know yet if the vaccine stops you from transmitting Covid with no symptoms, and until we know how effective the vaccine is in the real world, social distancing and safety measures will have to continue on dive trips.
And what about if you’ve had Covid? The UK Diving Medical Committee, a team of experienced diving doctors, has come up with some guidance for you and your local dive doctor to follow. If you have had Covid and didn’t need to go to the hospital, it’s still a good idea to take some time out of the water while your lungs and body recover — at least one month off diving and if you still don’t feel back to 100%, to give it longer. If you were admitted to the hospital, we currently advise up to a year out of the water.
Once you feel good to go, it’s important to see a diving doctor before getting back to diving, especially if you were symptomatic or admitted to the hospital. If there is any residual scarring in your lungs it could lead to an injury to your lungs during pressure changes underwater. The last thing anyone wants is another trip to A&E instead of the pub after their long-awaited return to the ocean. The dive doctor will likely want to do some exercise tests while checking the oxygen levels in your blood, and spirometry, a test where you blow into a tube that measures how much gas your lungs can hold and how quickly it can be released.
These tests are designed to check if there is any lasting damage to the lungs and to keep you safe underwater. Do remember after a period out of the water it’s worth easing your way back into diving. The other safety aspects of the sport still apply, so try to get back to your baseline fitness after all these months of lockdown before any demanding dives — head to our preparation for a return to diving section for more on that.
Being positive for a moment, the vaccine is here and we could be back to diving by summer. Even though we don’t know a huge amount about the long-lasting effects of the virus, if you haven’t had Covid it’s likely you’ll be able to get back to diving without any issue. If you think you have, see your diving doctor and they will help to get you back in the water.
Interested in diving health and medicine?
This column is produced with DDRC Healthcare, specialists in diving and hyperbaric medicine. You can find out more on their website.
This Anatomy of a diver column was originally published in SCUBA magazine, Issue #113 April 2021. For more membership benefits, visit bsac.com/benefits.