Medicals in the Covid-19 Era

What are the issues with Covid-19 and having medicals?

The coronavirus pandemic sweeping the world has changed the way we have to function. Although the number of new cases in the UK is curently falling we do not know whether a second wave will occur. Many of those infected do not have symptoms and may spread the virus unknowingly. We also know that sufferers can be contagious for some days before developing symptoms. Therefore, in the absence of rapid testing facilities or antibody tests, which signify immunity to further infection, then everyone should be assumed to be a potential source of infection.

Medical examinations for assessing divers are potentially high risk for transmitting the virus. Close physical contact is required, forced exhalations during lung function testing (spirometry) and the rapid deep breathing stimulated in the exercise test. This all results in the high probability that any infection will be transmitted between the client and doctor. An infected doctor can then easily transmit the infection to other clients.

Protocol for the provision of medicals whilst transmission risk remains high

I currently have no access to rapid antigen testing. I have a duty of care to ensure that as far as reasonably practical I must keep both my clients, myself and family protected from transmission of the coronavirus. This will be done in several stages:
1) Pre medical booking screening
2) Screening on arrival
3) Disinfection of workplace on daily basis
4) Face masks will be need to be worn for most of the consultation
5) Social distancing between doctor and client where possible
6) Easy access to hand sanitising and hand washing
7) Viral filters on spirometer
8) Positioning of exercise test to redirect exhalations away from doctor
9) Disinfection of workplace after consultation
10) Bookings will be made to avoid client to client contact so please arrive on time

Those that have either suffered with coronavirus symptoms or have had a positive test will need to beware of the recommended time before resuming diving and potentially any additional tests that will be needed. Please read this carefully to avoid not being issued with a fit to dive certificate due to presenting prematurely for the medical assessment. If you need further tests then it would be sensible to obtain these first.

Covid-19 screening algorithm:

Possible symptoms of Covid-19:

·         Fever / chills

·         Loss of appetite

·         Fatigue

·         Cough / shortness of breath / sore throat

·         Muscle pain / aches

·         New loss of smell or taste

Advice of when to resume diving and what tests may be needed:

A – Although you are at low risk you may have had an asymptomatic infection. Refrain from diving for 1 month (I recommend July 2020 earliest.)

B – Refrain from diving for 1 month from date of diagnosis. Spirometry and exercise tolerance test with oxygen saturation monitoring recommended.

C – Refrain from diving for at least 3 months after resolution of symptoms. Spirometry, High resolution CT of lungs and exercise tolerance test with oxygen saturation monitoring recommended.

D – Refrain from diving for at least 3 months after full recovery. Advised full assessment by both Respiratory and Cardiology specialists.

Please do not book an appointment for assessment until any period of refraining from diving has expired because I will not issue a fitness to dive certifcate until this has been completed.

Only spirometry was included in the Pre Covid-19 medicals with the addition of the Chester Step Test for HSE diving medicals, all other tests will be at additional cost.

The chart below is from The Oxford Martin School of The University of Oxford's Our World in Data website and reports the incidence of Covid-19 :

The recommencement of this service is not an endorsement that it is safe to dive, you should only resume diving if your risk assessment is satisfactory and acceptable to all concerned.

Updated 23rd April 2021