Today I still have a job, my family is well, and my boss has accepted telework...at least for now. I am spending my days discussing, arguing, and fact-finding, explaining and teaching about COVID-19. I attend virtual webinars from industry leaders about COVID-19 and the impacts on events. I read about Joe Desena’s Spartan events this past weekend and the efforts to make it safe. I reach out to those smarter than me to inquire about epidemiology, false positives, and rates of infection and ask, “What would you do?” I hear many calling for no large-scale events until we have a vaccine.
I am tired and torn. I am confused about the different state “phases.” I am now reading about the skyrocketing increases in infection rates some states are experiencing as a result restaurants, bars, and other activities re-opening. Then I hear that running a race is no different from going to the grocery store right now.
I worry about our athletes in adaptive sports being pushed to the wayside because they are deemed higher risk. I hear some say it might be more convenient to cancel or postpone the race for adaptive athletes but let others participate. I see some of my elders who are fit and healthy still playing golf and tennis. They are carrying on.
I listened to my good friend who is a respiratory therapist in New York City and the stress she was under in April and May. I was proud to see the USNS COMFORT and MERCY deploy to assist and then disappointed when I saw the low numbers of cases, and maybe how those staffs could have been used to assist in nursing homes across the country.
I look at the vast number of events that have been cancelled and the small race operators who cannot pay their staff or issue refunds; they will not survive this year. I feel for the BQ’ers who will not have the experience of a lifetime in Boston this year. Event after event is cancelled. Some are successfully turning to virtual events and rejoicing in the runners who post their medals and family finish lines.
I miss my volunteers. We are in June and I have not seen any of my loyal medical volunteers since last November. I miss the exhaustion of planning, packing, and rehearsing for the big events. I spend my day working on countless courses of action for hosting an event. We have a small one planned in August, maybe 200 runners. I am worried about heat stroke and breathing issues and of course, the cardiac issues we are seeing associated with post COVID-19 infections.
I plan, check equipment, order some new items, and set up training and meetings. Fire/EMS is too busy to talk and plan right now. COVID-19 and social unrest are their immediate concerns.
Do we change our waivers? Do we require anyone who had COVID-19 to get clearance from a cardiologist? Do we take participants’ temperatures? Should athletes be tested before they come to an event?
I informally reached out to our past marathon medical volunteers to get a sense of what they are thinking. No formal surveys, just asking if they would come and "If yes, did they have any question and if no, why not?" Fifteen percent responded in just a couple of days. The physicians were split 50/50, many saying no because of travel restrictions from their organizations. Most nurses said yes and wanted to know about our Personal Protective Equipment (PPE) standards. Some stated that if our event were to happen, we must deem it safe.
What does safe mean to you? That one is hard to grapple with. Many decisions are before us. Some are in the grey zone while others are based more on ethics and morals. I know others are worried, too. And they are uncertain. I ask that we keep talking and supporting each other and working together to reach decisions and answers that are best for each of our circumstances.
I also ask, "How are you feeling?"
Thursday, June 18, 2020
Wednesday, February 5, 2020
The Medical Impact of Unofficial Runners
There are many reasons participants cheat at races. Most of the time it is unintentional, occasionally it’s about ego or proving prowess or trying to obtain an entry into a prestigious event like the Boston Marathon. In 2015, Runner’s World discussed this phenomenon in an article called “How Common Is Cheating at Marathons?” and analysts like Derek Murphy of Marathon Investigation report on those who cheat.
As the medical lead for the Marine Corps Marathon, I review the data after our events to look for injury trends, heat stroke body temperatures, and other relevant information to improve our support. We often receive runners in the medical tents who are not registered as participants. These are not large numbers; in the last three years we have averaged fifteen medical “bandits.” However, if we were to extrapolate those numbers to the full field, we would be looking at almost 400 bandit participants. Nevertheless, let us focus on the effects these runners can have on medical services.
These bandit athletes may have purchased a bib or swapped with someone. If a runner receives a bib through swapping, once he/she enters the aid station, there is a delay in identifying the athlete because there is no match in the database. If the athlete is conscious, we work to get their demographics with emphasis on age and date of birth and any past medical history. If the athlete is unresponsive, however, trying to obtain personal information or next of kin data is impossible. When this unidentified athlete is transported to a hospital for further care, they must then be listed as a Jane or John Doe. We have no way of contacting family members nor obtaining pertinent past medical history. Additionally, for events like the Marine Corps Marathon which uses a live tracker database, we cannot find the registered runner because we are looking for a person not in the event.
We had a case where a runner was picked up off the course and transported directly to one of our hospitals. There were several runners at this emergency room and we were providing updates to our liaison and the medical team about the participants. The information we sent for one athlete was based on the information in the database but, unfortunately, it was incorrect. She was listed as a 42-year-old female. The medical staff thought they were taking care the female shown in our database, and we reached out to her next of kin. But it was not her; instead, it was her 36-year-old friend. It then took additional time to get in contact with the bandit’s family.
What if bib swapping involves a minor? Most registrations require parental consent for a minor. What if we need to obtain consent from that parent for care? Other considerations might include winning an age group or award—protecting the participant’s own race history and records and insurance claims could be complicated if the runner is using someone else’s bib.
We do not want to discourage athletes from receiving care; the medical team, as always, will care for those in need regardless of who they are. But these types of cases certainly make it more difficult for us to do our job. We all need to work to educate our participants about the risks of bib swapping and running as bandits.
As the medical lead for the Marine Corps Marathon, I review the data after our events to look for injury trends, heat stroke body temperatures, and other relevant information to improve our support. We often receive runners in the medical tents who are not registered as participants. These are not large numbers; in the last three years we have averaged fifteen medical “bandits.” However, if we were to extrapolate those numbers to the full field, we would be looking at almost 400 bandit participants. Nevertheless, let us focus on the effects these runners can have on medical services.
These bandit athletes may have purchased a bib or swapped with someone. If a runner receives a bib through swapping, once he/she enters the aid station, there is a delay in identifying the athlete because there is no match in the database. If the athlete is conscious, we work to get their demographics with emphasis on age and date of birth and any past medical history. If the athlete is unresponsive, however, trying to obtain personal information or next of kin data is impossible. When this unidentified athlete is transported to a hospital for further care, they must then be listed as a Jane or John Doe. We have no way of contacting family members nor obtaining pertinent past medical history. Additionally, for events like the Marine Corps Marathon which uses a live tracker database, we cannot find the registered runner because we are looking for a person not in the event.
We had a case where a runner was picked up off the course and transported directly to one of our hospitals. There were several runners at this emergency room and we were providing updates to our liaison and the medical team about the participants. The information we sent for one athlete was based on the information in the database but, unfortunately, it was incorrect. She was listed as a 42-year-old female. The medical staff thought they were taking care the female shown in our database, and we reached out to her next of kin. But it was not her; instead, it was her 36-year-old friend. It then took additional time to get in contact with the bandit’s family.
What if bib swapping involves a minor? Most registrations require parental consent for a minor. What if we need to obtain consent from that parent for care? Other considerations might include winning an age group or award—protecting the participant’s own race history and records and insurance claims could be complicated if the runner is using someone else’s bib.
We do not want to discourage athletes from receiving care; the medical team, as always, will care for those in need regardless of who they are. But these types of cases certainly make it more difficult for us to do our job. We all need to work to educate our participants about the risks of bib swapping and running as bandits.
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