DAN recommendations for a safe return to scuba diving
- Because scuba diving relies so heavily on safe and efficient lung function, special recommendations are being released for divers who have contracted COVID-19. Keep in mind that scientists are still learning about the virus, how it spreads, and its potential effects on the human body - so this information will likely change in the future. And, no two cases of COVID are identical, so it's essential to speak with a doctor before diving, even if you were asymptomatic! Also, keep in mind that DAN's "fit to dive clearance exam" should be performed by a diving medicine specialist, not a general practitioner or family doctor.
- If you need to speak with a diving doctor but aren't sure where to start, don't worry. DAN Europe members are currently eligible to receive a medical consultation with a diving medical specialist from DAN Europe's diving support network as part of their membership benefits.
The current recommendations from DAN are as follows:
- Divers who have tested positive for COVID-19 but were completely asymptomatic should wait at least 30 days from their first negative test before applying for fit-to-dive clearance.
- Divers who have had symptomatic COVID-19 should wait at least 30 days from their first negative test, followed by an additional 30 days without symptoms (for a total of two months at minimum) before applying for fit-to-dive clearance.
- Divers who have been hospitalised with or because of pulmonary symptoms in relation to COVID-19 should wait at least three months before applying for fit-to-dive clearance. This should include complete pulmonary function testing (at least FVC, FEV1, PEF25-50-75, RV and FEV1/FVC), an exercise test with peripheral oxygen saturation measurement, and a high resolution CT scan of the lungs to verify a return to normal functionality.
- Divers who have been hospitalised with or because of cardiac problems in relation to COVID-19 should wait at least three months before applying for fit-to-dive clearance. This should include a complete cardiac evaluation with echocardiography and an exercise test (exercise electrocardiography) to test for normal cardiac function.
Understanding other risk factors
Researchers are still studying the potential hazards for divers who have had the COVID-19 infection, and the best way to determine if you might be subject to higher risk is through a thorough diving medical exam. During your medical consultation with a diving doctor, you might discuss potential health concerns such as pulmonary barotrauma, lung bubble shunting, and cardiac problems.
DAN has released the following considerations for high risk divers:
- Pulmonary overpressure syndrome or lung barotrauma may be a risk for divers who experienced severe pulmonary symptoms. In some cases, prolonged or even permanent pulmonary damage may be present, even if lung function has returned to nearly normal. This type of damage may lead to a higher risk for lung barotrauma, even after dives without a rapid or uncontrolled ascent.
- At this time, little is known about a possible increased sensitivity of the pulmonary tissue to the toxic effects of oxygen at depth, known as pulmonary oxygen toxicity. Therefore, technical diving with prolonged breathing of hyperoxic gas, with a PO2 of 1.3 ATA or higher, including rebreather diving, should be avoided. Nitrox diving, with a maximum PO2 of 1.4 ATA that is only breathed for short periods, should not present any problem.
- Even less is known about the possible alteration of the lungs' bubble filtering function post-COVID-19 pulmonary infection. This may imply that the risk for decompression illness and injury could increase significantly. For this reason, divers who have suffered from pulmonary symptoms of COVID-19 should limit their dives to well within the no decompression limits (NDL) of their computer.
Stop the spread
While more and more people are already getting vaccinated, COVID-19 may persist in the community. This could lead to a continued risk of transmission between people in direct proximity or sharing common personal scuba equipment. To protect yourself, ensure that your dive centre or team is following DAN's published recommendations for minimising the risk of COVID transmission.
DAN additionally suggests that:
- Divers should continue the social distancing measures recommended by local authorities during diving operations by wearing masks and maintaining a safe social distance, specifically before and after dives and during surface intervals.
- Private and rental equipment, including emergency oxygen units, should be thoroughly sanitised with approved disinfectants covering a broad spectrum of germs, fungi, bacteria, spores and viruses.
- The exchange of scuba regulators or personal breathing systems should be avoided, except in real emergencies. And, any planned "breathing systems sharing" exercises, for example, during dive courses, should be conducted in a way that ensures personal protection.
- Following these guidelines can help slow the spread of COVID and other infections and ensure that all divers resume their participation in the sport safely.
Avoid disappointment, download and review the Diver Medical Form to ensure you won’t need a physician’s approval to dive before enrolling in a scuba course. Instructors, divemasters and dive shop staff are not physicians and should not be asked for medical advice; only medical professionals can give medical clearance to dive.
If you (or your physician) have questions about medical fitness to dive, contact the experts at Divers Alert Network (DAN).