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Maccabiah 21/22 and COVID 19

This update is predominantly about Long COVID but before we launch on that topic, I have been asked to comment on Vitamin D and COVID 19.

It has been postulated theories that Vitamin D might help prevent COVID 19 infection, reduce the virulence of the infection and aid the effectiveness of the vaccinations.

There have been papers published from a group in Barcelona where subsequent review of the methods used were found to be below the standard expected and the paper was withdrawn from the Lancet.

All these papers have been retrospective observational studies. In other words when you measure the levels vitamin D in people those with lower levels are likely to have a worse outcome from a COVID 19 infection. In order to prove that the reverse is true i.e., that high levels of Vitamin D protect against COVID 19, we need prospective double blind controlled studies. There is a small study from Germany which did do this however their findings did not support the theory that Vitamin D would improve the protection against SARS-CoV-2.

Increasing your level of Vitamin D is unlikely to cause harm whether it will help protect you from COVID 19 – the jury is still out. Despite this it seems that the NHS in the UK (equivalent to our Medicare) has been encouraging people to take Vitamin D.

Let’s talk about ‘Long COVID’ or what the medical community are terming PASC - Post-acute Sequelae of SARS-CoV-2 Infection. This has now been defined as a continuation of symptoms beyond 3-4 weeks from the onset of acute infection.

Anecdotally many of our athletes, management team members, coaches etc. will have had COVID infection before we leave for Israel. Recovery from COVID 19 infection can be total i.e., a swift recovery to normal function. For some, however, this is not the case and some of you or your families will unfortunately develop long COVID. This manifests itself by affecting any of the following: the nervous system, the respiratory system, the cardiac system, the musculoskeletal system with aches + pains of muscles and joints, the gastrointestinal system and endocrine system. Many people feel more fatigued, suffer difficulty with concentration and can lose their sense of smell or taste. Others can suffer depressive symptoms and PTSD. This can hit young super fit people just like you, on testing 20% of people post COVID infection have performances on the 6-minute walk test below the lower limit of normal.

Although we are all vaccinated, we can still catch COVID. The vaccines we currently are using are preventative against the initial COVID 19 virus the Wuhan or alpha variant. It is probable that later this year hopefully by May we will have boosters available that will include vaccination for the Delta and Omicron strains. The ones we currently have still work but as we all know they do not protect us indefinitely and not 100%.

If we’ve had a COVID infection, we might go on to develop long COVID. We do not know how to prevent this. It is less likely if you are fully vaccinated, and this now means having had 3 shots of vaccine if your last one was 3+ months ago.

What can you do to manage it?

  1. Listen to your body – you will need to rest more

  2. Stay hydrated if you have sweats replace fluids with water and a well-balanced electrolyte solution like Hydrolyte (not Gatorade).

  3. Do not stay in bed

  4. You can work/study or attend school but may well find that you will need shorter hours of work so that you don’t wipe yourself out

  5. Exercise within your limits gently – doing nothing makes it worse doing too much and you’ll be able to do less the next day. If you are able to join a rehab program through your local hospital this would be ideal.

  6. Address the symptoms you have with the appropriate specialists e.g., respiratory cardiac neurological etc.

  7. There is no Grade 1 evidence that vitamin supplements help unless you are deficient in them. This includes Vitamin D. Obviously to find out if you are low in any vitamins minerals or iron you will need to see your local doctor for a blood test.

  8. If you have chest pains, shortness of breath, palpitations etc you must seek individual medical advice.

If anyone feels they cannot access the help and advice they need you can reach out to the Maccabiah team medical staff by emailing me c/o the Maccabiah office. We will do what we can to help.

Stay well everyone … looking forward to seeing you in Israel in July.

Regards Dr Billie


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