During this pandemic period, many divers are asking themselves numerous questions regarding whether or not to resume their underwater activities after being infected by Covid-19 or after receiving their vaccine. Dan Europe has listed all the recommendations to help you see things more clearly.
Have you had Covid-19?
Note that the recommendations for divers who tested positive for the Covid-19 virus but remained completely asymptomatic or were not hospitalized have been updated since spring 2020. The advice and recommendations may vary between European countries.
You tested positive for the Covid-19 virus but remained completely asymptomatic: you must wait at least 30 days after the first negative test before requesting a medical fitness certificate for diving and returning to the water.You had symptoms of Covid-19:you must wait at least 30 days after the first negative test, then an additional 30 days without symptoms (a total of two months) before requesting a medical fitness certificate for diving performed by a diving medicine specialist.You were hospitalized due to pulmonary symptoms related to Covid-19:You must wait at least three months before requesting a medical fitness certificate for diving issued or coordinated by a diving medicine specialist. The authorization must include comprehensive pulmonary function tests (at a minimum FVC, FEV1, PEF25-50-75, RV, and FEV1/FVC), an exercise test with a measurement of peripheral oxygen saturation, as well as a high-resolution CT scan of the lungs to verify a return to normal.You were hospitalized due to heart problems related to Covid-19 : you must wait at least three months before requesting a medical fitness certificate for diving issued or coordinated by a diving medicine specialist. The authorization must include a cardiac assessment, including a cardiac ultrasound and an exercise test (exercise ECG) to ensure that cardiac functions are normal.
Other risk factors to consider
There may be additional potential risks for divers who have contracted Covid-19. The best way to determine if you are at risk is to undergo a recommended medical examination for diving practice with a specialist.Pulmonary overpressure syndrome (pulmonary barotrauma) : Divers who have had severe pulmonary symptoms may suffer from persistent, even permanent, sequelae, even if lung functions appear to have returned to (almost) normal. These sequelae may result in a higher risk of pulmonary barotrauma, even after dives without rapid or uncontrolled ascent.Oxygen toxicity to the lungs: Currently, very little is known about potential increased sensitivity of lung tissue to the toxic effects of oxygen; therefore, a prudent approach would be to avoid technical diving involving prolonged breathing of hyperoxic gases, with a PO2 of 1.3 ATA or more, such as rebreather diving. A simple « nitrox dive, » where a maximum PO2 of 1.4 ATA is breathed only for short periods, in the deepest part of the dive, should not pose a problem.Decompression accidents: Even less is known about the potential alteration of the lung’s ability to « filter bubbles » after a viral pulmonary infection with Covid-19. This could result in a significantly increased risk of decompression accidents. Consequently, a prudent approach would be for divers who experienced pulmonary symptoms related to Covid-19 to temporarily (or permanently) limit their dives well below the no-decompression limits (NDL) of their dive computer (so that at no point during the dive, the computer indicates mandatory decompression stops).
Have you been vaccinated?
Have you received one or two doses of your vaccine and do you wonder if it is possible to resume diving immediately? The following recommendations have been compiled based on the data available at the time of publication and may be subject to further modifications. We recommend regularly consulting the dedicated page on the Dan Europe site for the latest version.
– The need to control the Covid-19 pandemic is paramount, and since, at the moment, widespread vaccination seems the only way to achieve this, it is strongly recommended that everyone get vaccinated against Covid-19 according to the availability of the vaccines and the current national vaccination plan.
– A waiting period of at least 7 days is recommended after each dose of the COVID-19 vaccine before resuming compressed gas or free diving.
– It is recommended to extend this period to 14 days for divers who had adverse effects after vaccination lasting more than 48 hours; divers with risk factors such as (non-exhaustive list): overweight, chronic metabolic disease (including diabetes), smoking, medication that can increase thromboembolic risk (including oral contraceptives).
– The same recommendation of a 14-day period is valid for divers wishing to undertake dives requiring specific technical skills or exceeding the limits of recreational diving without mandatory decompression (technical diving, deep diving with decompression).
– In case of symptoms (adverse effects) persisting more than 48 hours after vaccination it is advisable for divers to consult their general practitioner.– If within 7 days after vaccination, possible symptoms of decompression sickness (DCS) appear after dives « at low risk of DCS, » it is strongly advised to consult a diving doctor. We encourage all divers as well as diving federations and local scientific societies to report any such incident to the DAN Europe medical division at medical@daneurope.org
Maintain protective measures
Given that the COVID-19 vaccination does not provide 100% protection against the possibility of transmitting the virus to others, current protective measures should be observed by every diver, whether vaccinated or not.Maintain the social distancing measures required by local authorities, even during dive-related activities (particularly all stages on the surface), including wearing a mask and maintaining appropriate social distance.Disinfect personal and rental equipment, including emergency oxygen equipment, with disinfectant products covering a wide spectrum of germs.Avoid exchanging personal breathing devices, except in a real emergency, and plan any « breathing equipment sharing » exercise in a way that ensures the safety of everyone.