Prior to official announcements on the suspension of group activities, we cancelled all formal training programmes. This was because these groups tend to be larger, and the participants run together in compact groups, in close proximity to each other. Taking the evidence and advice provided by the authorities into account, it was clear that to continue to hold these sessions would be entirely inappropriate.
In the light of advice from the Scottish Government that was announced on 23rd March, we also cancelled our normal group runs. This advice was subsequently included in The Health Protection (Coronavirus) (Restrictions) (Scotland) Regulations 2020.
Here is the principal evidence that has been taken into account when designing, monitoring and updating our protocol:The following content is made up of extracts taken directly from official documents. It may have been paraphrased. Content in square brackets is the author’s commentary on the extracts. The content is provided in good faith. While every effort has been made to ensure that the interpretation provided is correct, you should not rely upon it and should make your own judgement, referring to the full official documentation as necessary.
How is the virus spread?
The transmission of COVID-19 is thought to occur mainly through respiratory droplets generated by coughing and sneezing, and through contact with contaminated surfaces.
The predominant modes of transmission are assumed to be droplet and contact.
Contact precautions are used to prevent and control infection transmission via direct contact or indirectly from equipment. This is the most common route of infection transmission.
[In other words, it’s important to keep surfaces clean and to wash hands regularly.]
During a cough or sneeze, there is an increased risk of air-bound spread of infectious agents irrespective of the mode of transmission (contact, droplet, or airborne).
Droplets travel only short distances through the air; a distance of at least 1 metre has been used for deploying droplet precautions. However, this distance should be considered as the minimum rather than an absolute.
[Our protocol recommends maintaining a MINIMUM 2/3 metres separation but, ideally, 10 metres.]
The risk of infection is reduced merely by being out of doors, and further reduced by maintaining separation. Nonetheless, it's now even more important that, if you have been in contact with anyone showing symptoms, you should self-isolate ... even if you show no symptoms yourself.
What does social distancing mean?
Professor Jason Leitch, the National Clinical Director of the Scottish Government explains: “The science requires the virus to be in fluid, to transport in some form to the next person and that person to take it in.
“I would have to cough or spit either at you directly or on to a surface that you then touched and put in your nose, your eyes, or your mouth. The science says that you need to be 2 metres apart for that to be almost impossible. Within a metre it’s difficult; if we’re closer than a metre it’s likely. So keeping that level of social distancing is going to be helpful”Interview with Kaye Adams, Radio Scotland’s Mornings 16th March 2020
[Our protocol recommends maintaining a MINIMUM 2/3 metres separation so, whether running or waiting it’s “almost impossible” to be infected by cough or spit. However, when running in single file, we may be in a position where - due to wind direction or just our own movement towards the cough 'cloud', we need to leave a bigger gap. Thus we recommend a 'single file' spacing of around 10 metres.]
If someone coughs or sneezes, how long does the virus hang in the air?
The rate of clearance of droplets in an enclosed space depends upon the extent of any mechanical/natural ventilation – the greater the number of air changes per hour (ventilation rate), the sooner any droplets will be cleared.
A minimum of 2 air changes in hospital settings is considered pragmatic.
[I can find no information about how long droplets hang in the air out of doors. This would have to take account of wind direction, wind speed, the local environment (i.e. degree of shelter), etc. Thus any guidelines would be meaningless.]
Is the virus spread by exhaled breath?
Droplet precautions are used to prevent and control infection transmission over short distances via droplets (>5μm - 1μm is one thousandth of a millimetre) from one individual to another individual. The maximum distance for cross transmission from droplets has not been definitively determined, although a distance of approximately 1 metre (3 feet) around the infected individual has frequently been reported in the medical literature as the area of risk.
Droplets carried in exhaled breath may carry micro-organisms capable of transmitting disease over both short and long distances. The size distribution of such droplets will influence the type of organisms that may be carried as well as strategies for controlling airborne infection. Tests indicated a preponderance of particles less than 1μm, although larger particles were also found.
[In other words, it is highly unlikely that you will contract the virus by breathing someone else’s exhaled breath. Nonetheless, it’s important that you observe the need to maintain a minimum distance of 1 metre from others.]
Is the virus spread by sweat?
Sources of infections include blood and other body fluids, secretions and excretions (excluding sweat), non-intact skin or mucous membranes.
[In other words, it is highly unlikely that you will contract the virus by being in contact with someone’s sweat. Nonetheless, it’s important that you observe the need to avoid contact with others.]
How do I know if I can catch the virus from someone?
Assessment of the clinical and epidemiological characteristics suggests that patients will not be infectious until the onset of symptoms. In most cases, individuals are usually considered infectious while they have symptoms.
[In other words, if someone is NOT showing any symptoms, it is highly unlikely that they will pass the virus on to others. The following item has more information on asymptomatic infection.]
How infectious individuals are depends on the severity of their symptoms and stage of their illness.
The median time from symptom onset to clinical recovery for mild cases is approximately 2 weeks and is 3-6 weeks for severe or critical cases.
But I’ve heard that someone can be infected but not show any symptioms!
There have been case reports that suggest infectivity during the asymptomatic period, with one patient found to be shedding virus before the onset of symptoms. Further study is required to determine the actual occurrence and impact of asymptomatic transmission
Subsequent information provided at official briefings suggests that a greater number of asymptomatic people are infectious that was thought. As at 3 July 2020, however, official documentation to medical staff (updated 27th March) was that such cases are very rare.
[In other words, very few people have proved to have the virus but NOT show any symptoms.
Research published on 16th March suggested that 10% of infections in a sample came from those with the virus but who showed no symptoms. This is concerning. However, the researchers put significant "buts" on their findings.
Dr Gregor Smith (the Interim Chief Medical Officer for Scotland) explained that cases of asymptomatic infections are more likely to have actually been pre-symptomatic. In most "asymptomatic" cases, the individual went on to show symptoms.
Also, it is possible that individuals reporting contracting an infection from an asymptomatic person may actually have contracted it as a result of contact with a surface contaminated by an unknown symptomatic person.
The number of asymptomatic cases has not been published, but government briefings have not indicated a widespread incidence.]