Doctors warn athletes with Covid-19 not to run Hong Kong Marathon, even if symptom-free
- Those who recently recovered from infection should have trained for at least two weeks before race, doctor says
- Runners who earlier had the virus should manage their expectations as the infection is likely to affect their fitness levels, sports expert says
Runners who test positive for Covid-19 should not compete in the Hong Kong Marathon next Sunday, even if they are asymptomatic, and those who recently recovered should have trained for at least two weeks before taking part, sports experts and doctors have warned.
Dr Lobo Louie Hung-tak, a senior lecturer at the Education University’s department of health and physical education, warned runners should not “risk their health” for the race.
“If all symptoms of Covid-19 including shortness of breath, chest pain and dizziness have subsided after recovery, it should be fine to go back to training,” he said. “But one should train for at least two to three weeks to assess the physical capacity before joining the race.”
Louie said the American College of Sports Medicine advised those who had severe symptoms such as myocarditis – inflammation of the heart muscle – to avoid exercise in the three to six months after recovery until they obtained medical clearance.
He added mild cases could return to moderate-intensity workouts a week after recovery if all their symptoms had subsided.
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“A person’s physical fitness will normally decline after resting for seven days without moving a lot,” he said. “The most important thing is to listen to your body and to not push yourself too hard.”
Louie added that those who felt ill should perform a rapid antigen test (RAT) before the race to make sure that they did not spread the virus.
Marathon organisers on Monday said runners who fell sick because of Covid-19 or other illnesses should seek advice from doctors.
“If [the doctor said] the health condition is not fit for the marathon, runners should not push themselves to take part in it to protect themselves and others,” Dennis Ng Yu-ho, executive director of the Hong Kong Association of Athletics Affiliates, told a press briefing.
With relatively high humidity on race day, runners had to be cautious with their pace and hydration, he warned, adding they should slow down or stop to rest if they felt unwell. Ng also reminded runners not to carry any political elements on their clothing.
The organisers said participants who felt sick on the day could get a refund of their entry fee if they provided medical proof.
The annual event, originally scheduled for November last year, will feature 37,000 local and international athletes, who were at first told to take a polymerase chain reaction (PCR) test 48 hours before the race and a RAT 24 hours before the start.
But the organisers of the event, sponsored by multinational bank Standard Chartered, later dropped the requirement and announced the return of the cheering zone near the finishing line at Victoria Park in Causeway Bay after the government cancelled mandatory isolation for Covid-19 patients. But runners must keep their masks on before and after the race.
Dr Sam Wong Wing-sum, executive director of the Physical Fitness Association of Hong Kong, China, said all runners who felt ill, whether it was Covid-19 or something else, should not take part in the event.
He warned that those who ignored the advice risked developing life-threatening complications.
Wong said runners who had the virus earlier should manage their expectations as the infection was likely to affect their fitness level.
“Instead of trying to achieve their personal best or reach their pre-Covid fitness levels, they should try finishing the race within a reasonable time,” he said.
Respiratory diseases specialist Dr Leung Chi-chiu agreed that Covid-19 patients should avoid running the marathon as they faced a risk of developing hypoxaemia – low oxygen levels in arterial blood – and cardiac arrest.
“Running a marathon is a huge challenge to your cardiorespiratory system,” he said. “Even if you have no symptoms, your organs could still be affected by the virus and they might not be able to handle a vigorous activity like a marathon.”
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Family doctor Edmund Lam Wing-wo said he advised runners who had recently recovered from the virus to assess their fitness levels using information such as heart rates and running speed as some patients found their heartbeat at rest had increased from 60 to 90 a minute after infection and they suffered more easily from fatigue.
“One should participate in the marathon when their fitness level has returned to at least 80 per cent of pre-infection levels,” he said. “If they are not physically fit for the marathon, they may experience shortness of breath and fatigue easily, or even fall down, so better watch out for these scenarios.”
