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.
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:
|
|
NO |
YES |
Q1 |
Since January 2020
have you had any symptoms suggestive of Covid-19 infection? (See below for
symptoms) |
□Go to Q2 |
□Go to Q3 |
Q2 |
Have you had a
positive test for Covid-19? |
□Go to A |
□Go to Q3 |
Q3 |
Have you been
admitted to hospital or been treated with supplemental
oxygen? |
□Go to B |
□Go to Q4 |
Q4 |
Have you needed
respiratory support e.g. ventilation? |
□Go to C |
□Go to D |
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 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.