Introduction by Croakey: The Paralympic Games have been declared open in Paris after “a glorious ceremony in which competitors were celebrated by joyful volunteers and spectators on a sweet summer night,” reports the ABC.
Capping the event, which was held on the Champs Élysées and the Place de la Concorde, French athletes lit the Paralympic cauldron, which then rose into the evening.
Meanwhile, some health experts are raising concerns about COVID-19 measures at these Games, in the wake of similar questions about the Olympics.
Alison Barrett writes:
Following concerns about elite athletes competing with COVID-19 at the Paris Olympics, public health experts have called for improved COVID-19 protection measures at the Paralympic Games – not only for the athletes’ own health, but also for the health of coaches, volunteers and spectators.
The Paralympic Games offer an opportunity to rethink COVID-19 management, and to promote prevention and evidence-based policies, according to Professor Linda Slack-Smith, social epidemiologist at The University of Western Australia.
She urged organisers improve on the COVID-related measures taken at the Olympic Games.
The Australian Olympic Committee (AOC) told Croakey more than 1,000 Australians, including athletes and support staff, stayed in AOC accommodation over three weeks for the Olympics. Nineteen athletes in the Paris team tested positive for COVID, and fewer than 20 staff tested positive for a respiratory or gastro illness. However, the AOC did not specify how many staff had COVID.
“The rate of respiratory infections was considered within the normal range. Importantly, infections were contained within teams and not spread from one group to another,” the AOC said.
Health promotion expert Glen Ramos said the “laissez-faire approach to COVID” at the Olympic Games conveys a message that this is a disease of little or no consequence, which “is clearly not the case”.
“Scenes of people with COVID in duress during or after their events, or in many cases withdrawing from events, contradicts this ‘wishful thinking’ message,” said Ramos.
In stark contrast to the Tokyo Olympics, held in 2021, the Paris Games dropped all previous COVID protocols – leaving it to the athletes and teams to “determine for themselves how to respond to infection”, according to an article in Scientific American earlier this month.
Surprising
The International Paralympics Committee (IPC) told Croakey that the same COVID-19 measures that were in place for the Olympic Games would be in place for the Paralympic Games.
Given Paralympic athletes may have conditions or comorbidities that place them at higher risk from severe COVID illness and/or long COVID, this is surprising.
“If this lack of care continues at the Paralympics, which by definition involves disabled competitors who may be at even greater health risks from COVID, then it is even more egregious,” said Professor Deborah Lupton, Centre for Social Research in Health at University of New South Wales.
Adrian Esterman, Professor of Epidemiology at the University of South Australia, told Croakey that while the Paralympics face similar COVID-19 challenges to the Olympics, there were additional concerns as some Paralympians may be at higher risk of severe illness.
While running parallel to each other, the Paralympic and Olympic Games run independently. The Australian Paralympic team doctor told Croakey the International Olympic Committee (IOC) does not govern the Paralympic Games, which is the responsibility of the International Paralympic Committee.
Australian measures
A spokesperson for the AOC told Croakey that, in addition to testing, if any symptom of any respiratory illness was reported, the AOC promoted mask wearing and other simple hygienic procedures for all athletes. These were recommendations and not compulsory, the spokesperson said.
However, “if a positive result was recorded, the athletes were isolated, wore masks, observed hygiene procedures and stayed clear of common areas”.
While several athletes did withdraw from specific events, “depending on how they felt, the athletes could train depending on their sport and equally, could compete”, the AOC spokesperson said.
The AOC told Croakey “this was the most thorough and precise testing the AOC had ever done – we were able to pick up bugs that would not be picked up previously”.
“No athlete was ruled out of the Games due to COVID or other illnesses,” the AOC said.
The Australian Olympic Team said that it “supplied its own antivirals”.
Nuance
As former elite athletes Dr Bronwyn King, a public health expert and Burnet Institute special advisor on clean air, and Marayke Jonkers, retired Paralympic swimmer and current President of People With Disability Australia, have commented, the matter of whether elite athletes should compete at the Olympic and Paralympic Games with COVID is nuanced.
On one hand, elite athletes have trained for many years for an, often, once in a lifetime opportunity to compete at the highest level. They may decide, if they are feeling up to it, to take the risk and compete.
On the other hand, while the COVID situation has changed since the locked down Tokyo Games, the risk of infecting others, and the potential for long-term health complications also need to be considered.
Dr Diego S Silva, Senior Lecturer in Bioethics at Sydney Health Ethics and the University of Sydney School of Public Health, agreed athletes had multiple factors to consider when participating in elite sports.
“Athletes take on a host of risks to self all the time by going to competitions, for example, obviously and most notably, but not trivially, the risk of injury from the sport they’re competing in itself,” he said.
He argues that it should be the athlete’s choice to decide whether to compete with COVID-19, acknowledging they may be a “diminished version of their self – though perhaps not – but will want to compete and complete a dream they’ve worked hard toward that is valued by many persons in most societies throughout history”.
However, he added, it is important that athletes are encouraged and facilitated to protect themselves and others.
Given that COVID can cause both acute and long-term morbidity in self and others, Silva said it makes sense to implement systems to mitigate the spread of infection in places like the Olympic Village, including through air filtration systems and encouraging mask-wearing.
Lupton told Croakey it is risky for athletes to compete at the Olympics with COVID, for their own health, and for other athletes, staff and potentially to audiences, particularly in poorly ventilated spaces inside.
She said this approach sends the wrong message that COVID is “mild” and that people should “soldier on” through it.
Not without risk
While elite athletes are generally healthier than the general population, and therefore at a lesser risk of severe illness and/or long COVID, they are not without risk.
A retrospective study, based on self-reported questionnaire, of elite aquatic athletes who performed at World Championship in Hungary in 2022 found that half had had COVID at least once since the beginning of the pandemic.
Ninety-four percent of the athletes had received at least one dose of a COVID-19 vaccine, 92 percent a second dose.
Of these, 54 percent reported mild symptoms, 27 percent moderate and 17 percent no symptoms. Only two percent required hospitalisation with severe COVID-19 symptoms.
Ten percent of the athletes who had had COVID reported long COVID symptoms, with fatigue, shortness of breath and cough being the most common.
Australian Olympian sailor Matt Wearn, who won gold at both Tokyo and Paris Games, has spoken about the impact long COVID had on his training following the Tokyo Olympics – although it is unclear when he acquired COVID.
For most of the first year after he won Olympic gold [in Tokyo], Wearn struggled to get out of bed or off the couch. He tried to sail a few times, and couldn’t figure out why his body felt so horrible, reported The Sydney Morning Herald last month.
“His mind stayed relatively sharp, but he needed to rest. It was a struggle walking down to the local shops.”
The lack of COVID-19 protection measures in Paris also sends a message that COVID-19 is a personal, rather than public, health concern to manage.
“I’m not being critical of anyone – leaving athletes and coaches to navigate these tricky decisions themselves isn’t fair – but there has been a disappointing lack of leadership on this issue,” Dr Bronwyn King said.
Professor Adrian Esterman echoed these sentiments. “By not imposing strict protocols, the message emphasises personal responsibility. Athletes and visitors are advised to practise good hygiene and wear masks if symptomatic, but there is no overarching mandate,” he said.
“This approach also sends the message that COVID is now just another respiratory disease,” he said. It is the same message being sent by many governments and health organisations around the world, when in reality, COVID continues to cause major issues, he added.
Assistant Professor Saskia Popescu, infectious disease epidemiologist at University of Maryland, also said that the approach taken at Paris Olympics is the “wrong approach”.
“While COVID is now something we live with, that does not mean the risks of serious health outcomes and long COVID have disappeared, nor does it mean that others are comfortable with people exposing them and thus potentially acquiring the disease themselves,” she said.
Improved infection prevention efforts need to be implemented at the Paralympic Games, according to Popescu.
The spokesperson for the Australian Olympic Team told Croakey it will conduct a review of all its operations in Paris as part of its usual post-Games brief.
When asked to comment for this story, the Australian Paralympic Team doctor told Croakey they did not attend the Olympic Games and were “not in a position to comment on the COVID-19 measures that were put in place by the IOC or Paris 2024”.
They did not respond to further questioning about what COVID-19 measures would be in place, if any, for the Australian Paralympic team.
Previously at Croakey
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