Cycling in the Era of COVID-19

As a physician I have been getting a lot of questions about training in this strange new world that we bike riders find ourselves in. As of March, 24, 2020 in western Colorado where I live, there are five confirmed cases of Covid-19 in our county. So far, we’re pretty lucky, but I am sure that will not last.

This new virus COVID-19 is highly contagious with an asymptomatic incubation prior of just over five days. Ninety-seven percent of people who develop symptoms will do so within 11 days. The asymptomatic incubation period is what all the social isolation is about. The COVID-19 virus is different from the SARS Coronavirus outbreak in 2002-2003 in that it produces very high levels of virus in respiratory secretions during the early, asymptomatic phase of the disease. Thus, there is much more of the virus around for us to catch even when an infected person has no symptoms.

COVID-19 is also very lethal. Death rates from COVID-19 worldwide vary wildly from 0.5% to >10%. Compare this to our old friend, influenza (the Flu), which has a mortality rate of around 0.1%, or even to the infamous Spanish Flu of 1918 at 2.5%.

This is what all of the concern is about. This is real, take it seriously.

Questions from Cyclists about Training During the Pandemic

• What medicine should I have at home in case I get the corona virus?
  Nothing specific, currently there is no treatment for this virus. For mild cases,  Ibuprofen and Tylenol help people feel better. Make sure you have any prescription medications that you need. Make sure you call your pharmacy early for any needed refills.
• Should I still train while I’m feeling healthy?
  Yes, there is some concern that exercise suppresses an athlete’s immune system. This is true in some unusual cases but the majority of evidence indicates that exercise is good for immune function, including immediately during and after the exercise session.
  Coach Dylan Johnson just did a good YouTube post on this topic:

• Should I still do group rides or runs?
  No, this is not safe at this point. The idea behind social distancing is to slow the spread of the virus as much as possible. As COVID-19 is highly contagious especially when you have no symptoms there is really no way of knowing who may have the illness. To be safe, even if your area still allows group gatherings, avoid them. 
• Should I still do solo rides or runs?
  Depends upon where you live. San Francisco ordered a Stay at Home order effective Tuesday March 17^th and New York City issued a Stay at Home order effective March 22. Both of those areas allow outdoor, solo exercise so long as you stay six feet away from other people, which is much easier in suburban or rural areas than in densely populated cities. Quito, Ecuador has closed all parks, and Italy and Spain have banned MTB riding. In much of the United States, the roads and trails are still open for solo activities, but check with your local health department or news sources for updates as the situation can change daily.  I think that is just a matter of time before some degree of shut down becomes mandatory nationwide. Right now, if you can get out, I would go out and exercise but keep your distance and only do solo rides or runs. This article from Cyclocross Magazine expands more on the question of whether riding outdoors is allowed in an area with a strong Shelter in Place order, but the advice is good even if your area hasn’t yet received an order like this.
• Should I avoid riskier activities?
  We have seen an uptick in injuries in our clinic and at the hospital from all of the people who are off work and with the kids being out of school, similar to the summer time. Yes, I would avoid unnecessary injury risks. Right now, you do not want to end up in the hospital where potential exposure would be greater and the bed you need may also be needed by someone else.
• Should I adjust my training program?
  Yes. Many of our A races for the season were scheduled for May and June. Most if not all of these have been cancelled. My feeling is that this is going to get worse before it gets better. As a racer I am looking to the fall before hopefully things get back to some form of normalcy. Talk to your coach (or get a coach if you don’t have one!) It might be best for some athletes to go back to base training or early build phase training. The thinking for them is that there is no need to peak when there are no races. Others may want to peak simply to take advantage of the base they’ve already built or to set some PRs on local courses. This can also be a good time to work on specific weaknesses with no races to “interfere” with training. 
• What is the best source of accurate information about COVID-19?
  CDC.gov and your local health department website. There is a lot of misinformation out there on social media or regular media.
• What should I do if I think I am infected with COVID-19?
  Do not go to the hospital or your doctor’s office. Stay home and call first. They will have protocols in place to allow for observation and screening.

Dr. Richard Price is an MD and coach in Grand Junction, CO who works with cyclist, triathletes and runners on the road and trail, specializing in helping athletes in endurance events stay strong and consistent through health and training.