Ramesh Kanjilimadhom (Photo: courtesy Ramesh)

Amidst continuing lockdown due to COVID-19, there has been relaxation of rules. Runners and cyclists have reappeared in some cities and towns, albeit in small numbers. It is a beginning although the new normal with mask, physical distancing and no races on the horizon, won’t be easy for all to embrace. Yet, signs of life – that it is.

For well over a month Ramesh Kanjilimadhom was confined to being indoors. In that while, the IT professional and amateur runner worked out to keep himself physically fit. Then, to stay connected to his chosen sport, he began jogging within the compound of his apartment complex. “ It was to keep myself going. By no yardstick can that be a replacement for running outdoors like before,’’ he said.

Contacted on May 22, five days into the fourth phase of the nationwide lockdown, he said that following relaxation in the severity of lockdown in Kerala, some runners have resumed their early morning run. Ramesh is among founders of Soles of Cochin, the state’s best known running group. It is a very sociable, outgoing group; the outfit’s social media presence reflects that spirit. The new normal has two important aspects, which are a departure from the sociable past – the use of masks and physical distancing. Ramesh described the outings amid the fourth phase of lockdown. Given the group is active on social media and well networked, a few of them still assemble at a predetermined place but with none of the clustering of before. They maintain physical distancing and wear masks. When the running commences, they don’t run as a group; they maintain separation. Post run, there is none of the old visits to café for breakfast either. According to Ramesh, it is not easy transitioning from an environment where people ran close together and chatted as they went along, to one where they are distanced from each other and consciously staying in a protected personal ecosystem. You have to acquire that habit. From among those venturing out in the new normal, the majority – including Ramesh – runs solo.

It is tempting to assume that the discomfort felt is less for those pushing longer distances like the marathon and the ultramarathon as they are used to being in a personal cocoon.  Ramesh thinks that assumption is too simplistic. “ Even distance runners used to find a few others of their league and proceed as a small group. So it is more a case of managing individual character, whether you liked sociability and proximity or could do without it. Overall, the current experience is a bit monastic compared to how sociable running used to be earlier,’’ he said. Ramesh said that runners from the group, who are doctors, had discussed the recent media report of a Chinese runner who used to run wearing a mask and eventually suffered a collapsed lung. Based on details available, they were not convinced that the collapsed lung was a direct consequence of wearing a mask; it seemed more due to existing comorbidity. However, Ramesh conceded that although people wear a mask when running in the new normal, it is not a pleasant experience. “ First of all, it is uncomfortable. Second, in places like Kochi, the humidity is quite high. It takes no time for the mask to get wet,’’ he said.

It was in September 1987 that Pink Floyd released their thirteenth studio album: A Momentary Lapse of Reason. For cover, it had a picture showing hundreds of hospital beds. Its opening song was the instrumental ` Signs of Life.’ The name of that song could be apt description for recreational sport right now in India. Things came to an abject standstill when lockdown commenced from the midnight of March 24. Now, amidst continuing lockdown due to COVID-19, there has been relaxation of rules. Runners and cyclists have reappeared in some cities and towns, albeit in small numbers. It is a beginning although the new normal with mask, physical distancing and no races on the horizon, won’t be easy for all to embrace. Yet, signs of life – that it is.

Anjali Saraogi (Photo: courtesy Anjali)

Anjali Saraogi and her husband run a health care services company in Kolkata. “ I haven’t run for over ten weeks now. I decided to take this lockdown positively and focused on yoga and flexibility,’’ she said. Anjali represents India in international ultra-running events. She holds the national best among women in the 100 km run. At the 2019 IAU 100 km Asia & Oceania Championships, held at Aqaba, Jordan, Anjali set a new national best of 9:22 hours, breaking her own previous record.

According to her, running with a mask on is very challenging. Getting back to races will take a long time. “ The running community will have to figure out how to organize races, which have huge crowds, especially at the big events. Also, the expo of the event, the holding area, the start line, the finish line and volunteering – all these are usually so crowded and involves physical contact,’’ she said. For some time ahead, the focus of running will be purely on fitness. She believes the new normal will definitely dilute the fun element, the bonding and camaraderie that training runs and races used to offer.

Pervin Batliwala (Photo: courtesy Pervin)

As COVID-19 plays out in India, one of the clearest trends yet is that of positive cases being most in a handful of major towns and cities. And of this unfortunate lot, Mumbai is the worst hit. In the domestic world of running, Mumbai is among cities most active in the sport; it hosts India’s biggest annual event in running – Tata Mumbai Marathon (TMM) – and it is home to a large number of amateur runners. Transposed onto running, Mumbai’s lockdown story becomes one of a city of runners caged by the misfortune of being a red zone. It is a predicament they must weather. “ I miss running on the road and meeting my runner friends in the process,” Pervin Batliwala, Mumbai-based amateur runner who has been an age category podium finisher in many races, said. She does not miss the gym, though. “ Through the lockdown period, I have been doing workouts at home at least three times a week,” she said around the time the fourth phase of India’s nationwide lockdown was due to commence. Recently she started jogging in the compound of her colony, which is quite large by Mumbai standards.

Although she misses running on the road, Pervin enjoys the fact that she does not have to wake up at unearthly hours to commence her run. “ Running in the new normal would mean we have to keep a distance between runners. But running with the mask on is not in the least comfortable. It is suffocating,” she said. A gregarious individual, Pervin loves running with big groups and enjoys chatting while on the run. However, as of mid-May, she was already reconciled to the new normal. “ We have to take the whole process of resuming running gradually. Anyway, there is no goal or race to focus on, anytime in the future,” she said. For 2020, Pervin had enrolled for the Tokyo Marathon and the Chicago Marathon. The Tokyo Marathon, held in March this year, was confined to elite runners and the organizers allowed amateur runners to defer their participation to 2021. “ Tokyo Marathon may allow runners to defer further to 2022. If so, I will opt for 2022,” she said. Chicago Marathon has already announced the option for deferring participation to 2021.

Chitra Nadkarni (Photo: courtesy Chitra)

Given the pandemic, most major running events and similar mass participation events in the field of endurance sport have been getting postponed or cancelled. Hope at large is no more centered on return of races; it is centered on simply getting back to doing the things we love, something as simple as the morning run for instance. The new normal will get some time getting used to. Maintaining adequate physical distancing from other runners won’t be easy in training and particularly so at running events, Chitra Nadkarni, said. A Mumbai-based amateur runner and frequent podium finisher in her age category, she was all set to shift her focus to the triathlon after the 2020 Tokyo Marathon. Following COVID-19 outbreak, the marathon in Japan was eventually held restricted to elite runners. But her triathlon plans are on. With the aim of attempting an Ironman event, she has been focusing on cycling. “ I have put my cycle on a trainer and have been training regularly,” she said.

Endurance sport at the training level and at the event level will not be the same, says Chitra. “ It is going to be a sad scenario. I will miss meeting, training and bonding with people,” she said. Things are not very clear at this juncture and will take quite some time to evolve into a new normal, she said.

Anuradha Chari (Photo: courtesy Anuradha)

Mid-May when lockdown eased in Bengaluru, Anuradha Chari, recreational runner and triathlete, was able to go for a long bicycle ride covering a distance of about 45 kilometers. Prior to lockdown, Anuradha was doing 60-70 km. After being confined to limited space, a bike ride of said distance was liberating experience for her. “ It felt good to get out and breathe some fresh air. I went slower than my usual pace and also covered lower distance compared to my normal mileage,” she said. While there was personal relief in being out, the altered reality outside wasn’t a pretty sight. The ride was exhilarating but the sight of migrants walking along the road to destinations they wished to reach was distressing. Also, the deserted roads did not feel entirely safe, Anuradha said. All through the lockdown, she hadn’t been able to focus on a fitness regime to the level desired for want of time. “ With work from home, cooking and cleaning, I could not spare time for workouts,” she said. She did step out early morning for a short run around her housing complex. Going forward, the need for physical distancing will remove some of the fun from both training and racing, she said.

Mini Nampoothiri (Photo: courtesy Mini)

The new normal may be particularly challenging for those who are new to running or are yet to settle into a solo space. That early phase is when you seek a supportive ecosystem and typically in sport, it means training with others around. It is a symbiotic relationship – you feed off the group’s energy and the group gaining from each one’s contribution has more energy to spread around. “ I was running with others alongside as I was new to running,” Dr Mini Nampoothiri, Navi Mumbai-based gynecologist and amateur runner, said. She has been running for over two years. At the time of writing, she had participated in half marathon races and distances lower than 21.1 kilometers. Functioning under lockdown like everybody else, she is keen to get back to running but knows it may be a different experience in the new normal. “ I am waiting to get back to running,” she said, mid-May. She felt that running with a mask on will be most uncomfortable. Physical distancing while running will make running much less enjoyable for her, Mini said. But she felt she would adapt to the new normal. She avers she should be able to run solo during her training runs in the future.

Naveen John (Photo: courtesy Naveen)

The view is tad different when perspective is that of elite athlete. “ If there is a national competition tomorrow, I will do well,’’ Naveen John said late-May 2020. Among India’s top bicycle racers, he held out the same possibility should he be heading to Belgium to participate in a kermesse, which is usually the norm for him in this time of the year. The observation reflected how well he had trained during the preceding three phases of the nationwide lockdown (by late-May, India was into the fourth phase). “ I am absolutely happy with my fitness,’’ he said. Despite the training and hard work there was a sliver of disillusionment – rather an honest admission of reality – emergent. “ The challenge now is that for the first time in my career in cycling, there is no horizon,’’ he said of India and world sailing on with no real end game in sight for the pandemic. The lockdown itself hadn’t worried Naveen much. He had rationalized that a couple of months spent so, won’t make a dent to the years he had spent so far in cycling and the years ahead. The forecast of a monastic new normal with much less sociability in sport too didn’t upset him because as he put it, athletes chasing high performance are already into the hermit life. Further, all athletes have to cope with episodes of being out of action due to injury and illness. The lockdown could be treated as a slightly longer version of the same. But the important thing is – there is a return to normalcy; a sense of confidence with roadmap alongside for how to get back to normalcy. This roadmap is missing with COVID-19 and to the extent it is absent, athlete misses concrete direction when preparing for the future. “ Previously my plans used to span three to four weeks. Now I am taking it one week at a time,’’ he said.

On the bright side, Naveen is back to cycling outdoors. From the third phase of lockdown, Bengaluru authorities made it possible for cyclists to venture out. He leaves home at 5 AM, when there are very few people out on the road. “ It feels good to be out again,’’ he said. Naveen is currently working on devising a template for the rest of the year. In all likelihood the rest of 2020 will require a change in paradigm for him. A landmark shift in global cycling that happened during the lockdown was the virtual reality version of the annual Tour of Flanders (the actual event was postponed due to pandemic). Unfortunately a similar version is not available for Belgium’s renowned season of kermesse and other races rated below the elite segment. One reason is that outside the professional category of racing (to which elite races belong), the world of virtual reality hasn’t yet got a level playing field in place. Among parameters used to judge outcome in virtual races is the product of power generated on home trainer divided by stated weight of rider. The latter is a case of self-declaration. Systems to monitor such parameters exist in the professional category but not in the rungs below it, where Naveen has so far participated. This inhibits virtual races from catching on in a strange year like 2020, although the practise of cycling using trainers and apps has grown exponentially amid pandemic.  Simply put therefore, there is nothing to fully replace the kermesse season Naveen will miss this year. “ I think this year will be a case of focusing on training self and others,’’ he said. He is working on the details.

Apoorva Chaudhary (Photo: courtesy Sunil Shetty / NEB Sports)

Ultra-runner Apoorva Chaudhary was confined to her apartment in Gurgaon during the lockdown. On May 25, she managed to travel to Bijnor in Uttar Pradesh, where her parents live. “ I resumed my running only after I got here. I don’t do very long runs. There are no Covid-19 cases on the 10 kilometer-route that I run on,’’ Apoorva said. She holds the national best in 24-hour ultra. At the 2019 IAU 24-hour World Championships held at Albi, France, Apoorva clocked 202.212 km during the stipulated period, the highest for a woman runner from India.

In Bijnor, she steps out very early for her training run. “ People here don’t go out for walks. Therefore, except farmers getting ready to move to their farmlands, there are very few people out,’’ she said. She tried running with a mask but found it too uncomfortable. “ That’s the reason I go out super early for my run,’’ she said. While at home during the lockdown, Apoorva focused on strength training, something that most endurance athletes ignore to a great extent. She likes running alone and sometimes with one or two runners. “ In the new normal, I will miss the old routine of catching up with runner friends after a training run,’’ she said. Although there are no races on the horizon, as and when they begin, she feels runners may be reluctant to enroll for fear of catching the virus. In the new scenario, runners will run for the joy of running and the competitive approach will take a back seat, she said.

Update: In its order dated May 31, 2020, concerning guidelines for easing restrictions and phased opening of lockdown, the Maharashtra government has permitted the return of outdoor physical activities like cycling, jogging and running in non-containment zones from June 3 onward. No group activity is allowed; only open spaces nearby or in the neighborhood may be used and the activity will have to be between 5AM-7PM. “ People are actively encouraged to use cycling as a form of physical exercise as it automatically ensures social distancing,’’ the order said. All physical exercise and activities must be done with social distancing norms in place. The order said that people are advised to walk or use bicycles when going out for shopping. The above is a condensed version. For a complete overview please refer the actual government order. 

(The authors, Latha Venkatraman and Shyam G Menon, are freelance journalists based in Mumbai.)

Illustration: Shyam G Menon

With COVID-19, the face mask has become part and parcel of our lives. The general feedback from runners who ran wearing a mask is that it is an uncomfortable experience, which you may however get used to. In mid-May 2020, a report appeared in the media (it was circulated on social media as well) of a man in Wuhan, China, who ran wearing a mask and later suffered a collapsed lung. Although health officials believed the culprit was the mask, at least one newspaper reported that a senior doctor at the hospital where the patient was treated had said, the runner was already susceptible to “ spontaneous pneumothorax because of his tall, lanky frame.’’ Aside from speculating, it wasn’t possible to conclude anything from the report. To compound matters, there seems to be no conclusive study available yet on the subject of wearing a mask and running. We spoke to four doctors with strong ties to running, for their take on the subject.

“ There is no real research or study available on the subject yet. It is a new topic,’’ Dr Aashish Contractor, Director, Department of Rehabilitation and Sports Medicine, Sir H. N. Reliance Foundation Hospital, said of the emergent debate around mask and running.

The normal act of running outdoors has to be seen in its full context. It is usually done at an hour before the regular flow of people manifests on roads. There are not many people around and the number of runners among those choosing to be out at that hour is not high. It must also be remembered that runner is neither static nor moving at walking pace. The chances of catching the virus depends on various factors including how crowded an area is, proximity to others, the duration of exposure and the viral load one is exposed to. Against the above outlined outdoor scenario with mask and physical distancing additionally in place, it would appear that the chances of contracting the virus may be further minimized. However it must be borne in mind that exercise – like running – causes heavy breathing. “ I would think you should stay about 20 feet away from another person while running,’’ Dr Contractor – he was Medical Director of the Mumbai Marathon from 2004-2014 – said.

Wearing a mask and running is bound to be difficult. “ Depending on the level of exertion, it will be hard to breathe,’’ he said. One way of overcoming this is to be conscious of how much you are pushing yourself. Rate of Perceived Exertion (RPE) is a good rule of thumb to stay on the safe side. “ If you feel your breathing is becoming hard, slow down. Do that because this is not anyway a time to be proving anything,’’ he said. A simple three ply surgical mask should be adequate for the morning run. Wear it when running and if you are feeling uncomfortable, use your judgement and pull it down a bit for easier breathing. Relief gained; pull it back on. As for the news report about the Wuhan runner who suffered a collapsed lung, Dr Contractor felt available details are inadequate to establish direct link between the condition and use of mask.

Given the number of races held under its banner, the 2019 edition of La Ultra The High was spread over five days in Ladakh. At that elevation oxygen content in the atmosphere is lower than at sea level; it is lower still atop the high mountain passes the ultramarathon’s route touches. “ We encourage runners, support crew and officials to use their bandanas; cover their face to protect themselves from the fumes of passing vehicles. In the case of someone who walked-ran all those five days, at least as many hours as in a half-day would have been spent protected by the bandana and breathing through it,’’ Dr Rajat Chauhan, Race & Medical Director of the event, said. Dr Chauhan specializes in sports & exercise medicine and musculo-skeletal medicine. “ It should be fine,’’ he said when asked about the issue of wearing a mask and running.

However, there were caveats to the observation. A pre-existing medical condition can alter the tolerance someone has for prolonged breathing through protective barrier. Further, you have to get used to breathing so. “ In the last two months of lockdown, I would have gone out of my house just twice. On both those occasions I wore a mask and it wasn’t easy doing the things I had to do while breathing through the mask. My suggestion to those who are in zones where they are allowed to venture out for running is that they first wear the mask indoors for about the same duration as they plan to be out. Get used to it,’’ he said, pointing to the heat of summer as another factor to be aware of.

Illustration: Shyam G Menon

Getting used to the mask gradually also makes sense because in Dr Chauhan’s assessment most amateur runners haven’t learnt to use their lungs efficiently. “ The typical amateur runner in India still has shallow, rapid breathing,’’ he said. Next, your intensity of exercise matters. Intense exercise puts commensurate demand on the respiratory system. “ Do workouts at low intensity. Very long and or high intensity workouts are best avoided,’’ he said. Aside from the fact that high intensity training is a period when risk of cardiac problems is higher (before things improve as product of having exercised), immunity also lowers temporarily in this phase. The present characterized by COVID-19 is not times when immunity should be fiddled with. The N95 mask, which is more effective in keeping the virus at bay, is tough to breathe through. The normal surgical mask is easier to breathe through but not as effective a virus-barrier. “ At the end of the day you are in the realm of informed decision-making,’’ Dr Chauhan said of the challenge in framing best practices for a problem yet to merit in-depth study and research.

“ Right now the ideal approach would be to consider everyone a potential carrier of disease and have everyone stick to safety protocols like using a mask or face cover. This is not a phase to be viewed only through the prism of sport. It is a question of humanity,’’ he said of world battered by COVID-19. His advice to runners was – focus on strength training.   “ I have this saying: if you can’t do something sitting down or standing up, how can you hope to do the same while moving? All those boxes have to be ticked before you get down to running or running with a mask on,’’ Dr Chauhan said.

When it comes to air quality, Delhi is among the world’s most polluted cities. Colonel Muthukrishnan Jayaraman is a doctor with the Indian Army. He is a regular runner. He first used a mask while running, in 2018, after he was posted to Delhi. “ It was extremely difficult. If you exert yourself, you need more oxygen and getting that in was a challenge,’’ he recalled. The mask was also prone to becoming wet with the moisture of one’s breath. Eventually he stopped using it. Roughly two years later, the mask has become a regular fixture in life due to COVID-19. “ We wear it at work. For that purpose, it is not a problem. But wearing a mask and running is a challenge,’’ the army doctor said. First, it defeats the very idea of a morning run, which is to do something enjoyable. Second, with the more effective masks meant to keep viruses at bay bound to make breathing hard, you end up using simpler models that are not totally competent as virus barrier; it is a compromise. You wear it only because any protection is better than no protection. Consequently, Col Jayaraman is of the view that choosing less crowded stretches of road to run on and maintaining adequate physical distancing is the best option. However, one aspect needs to be borne in mind, he said. During exercise and for a little while afterwards, there is typically a dip in immunity levels. Given this, other precautionary measures to prevent infection, shouldn’t be trivialized, he said.

“ In healthcare, masks have been used for over 100 years now. They are used mainly during an operative intervention, to prevent transmission of infection to the patient,’’ Dr Pravin Gaikwad, pediatrician based in Navi Mumbai, said. A runner and triathlete, he illustrated the equations at work while using precautionary measures like the mask.

For instance, the operation theater scenario of doctor wearing a surgical mask is a case of – I protect you. In the present situation of COVID-19, if 60 per cent of the population wears masks which are even 60 per cent effective in blocking the transmission of virus, the epidemic may be stopped. That would be a case of – I protect you, you protect me. In a highly infectious disease scenario like COVID-19, special N95 respirator is used to protect the healthcare professional and others from him. The equation here is – I protect myself and I protect you. In industry like asbestos, N95 with valve (which is more comfortable) is used to protect the worker but not others. This is a case of – I protect myself but I expose you. “ That would be sinister if used in the present situation,’’ he said.

Masks can cause discomfort. “ The N95 which fits snugly certainly causes a bit of discomfort upon prolonged use. Talking and being heard, is also an issue. Surgical masks are relatively more comfortable. Surgeons use them for a long time – even 9-10 hours – in long supra major surgical procedures,’’ Dr Gaikwad said, adding, “ compared to the surgical mask, homemade cloth masks or bandana, I presume, would be less breathable and therefore less comfortable.’’

Illustration: Shyam G Menon

According to him, running in a face mask would be uncomfortable in any weather. If one really wants to use it, one has to gradually introduce it in one’s regime. It would take a few weeks to months getting used to it. “ As the amount of air inhaled becomes limited, breathing becomes more laborious. Pace would obviously reduce and fatigue would set in faster. Mask becoming damp partly due to water vapor in exhaled air and partly from sweat is another issue making it not only uncomfortable but also less effective,’’ he said. He felt that for running, surgical masks would be more comfortable to use. “ Basically, the mask has to be breathable and effective….a homemade mask which has to be removed time and again will defeat the purpose,’’ Dr Gaikwad said.

Breathable masks don’t pose the risk of inhaling one’s own exhalation to a significant extent so as to cause disturbance in oxygenation. The droplet size of the present Corona virus is 125 microns and that of the CO2 molecule is 0.00023 microns, 1000 times smaller. Still, to check discomfort, the best option would be to keep runs shorter and gentler, striking a balance between getting exercise done and not exerting to levels inviting strain while using a mask. Choose to run after checking what zone (red, orange or green) your area is in and how authorities have relaxed lockdown rules therein. Even if you are using a mask, maintaining physical distancing of at least six feet is a must.  “ There shouldn’t be sudden increase in mileage in even indoor runs or those done on local campuses as this would make a runner prone to injury besides reducing his or her immunity temporarily. We can ill afford both these angles at present. Always listen to your body,’’ Dr Gaikwad said.

Author’s note: On May 18, 2020, the Athletics Federation of India (AFI) – it is the apex body for athletics in the country – issued Standard Operating Procedure (SOP) for its national camps in Patiala and Bengaluru (please click on this link for that report: https://shyamgopan.com/2020/05/20/afi-issues-standard-operating-procedure-for-its-athletes-coaches-and-support-staff/). The on-field protocols followed by elite athletes at these camps have not been gone into in detail in this article because the training ambiance of amateurs and elites is totally different. Amid pandemic, amateurs live and train in a world that includes everyone else; elites live and train in sanitized national camps with access strictly monitored. Nobody goes from the outside into the camps, nobody from within comes out (rejoining requires quarantine). It won’t be fair to compare the two worlds or blindly copy what performance driven-elites do while training against backdrop of pandemic because one ecosystem is controlled and sanitized, the other isn’t. Some general protocols laid down at the national camps make sense as meaningful guidelines for amateurs taking to public spaces for exercise. They include: not going for training if you have any flu-like symptoms such as sneezing, coughing, difficulty in breathing, fatigue etc or if you have been in close contact with someone who showed above-mentioned flu-like symptoms or tested positive for COVID-19 in the preceding 14 days; maintaining a safe and isolated distance of minimum two meters from others while walking to the training ground and during the training, and avoiding exercising / training / walking in groups. For an overview of the AFI’s SOP for its national camps, please follow the link mentioned earlier.

(The author, Shyam G Menon, is a freelance journalist based in Mumbai. The above article is presented in the interest of reading and discussion.)