FREEDOM

Photo: Shyam G Menon

I don’t know about you, but the one thing I cannot live without is music.

It has been my constant companion through ups and downs in life.

Music complements the other thing I value greatly – freedom.  Increasingly humanity has shrinking respect for freedom. It is being swept aside by the march of money. There have been many songs about freedom. No I am not talking of patriotic songs. I am talking of songs that celebrate freedom as an attribute to be cherished without need for any cause. Freedom does not require a reason to be important; it is important as it is. Why else would the physical universe be so immense? Why else, when we are in chains, do we have the ability to close our eyes and find that same universe within?

Everybody has their favorite song evoking freedom. I don’t dig lyrics much. I am more somebody who identifies with songs because they attract aurally. You find release. For a long time – practically since the first time I heard it in the late 1980s when the album The Joshua Tree was released, U2’s Still Haven’t Found What I’m Looking For stayed with me, an anthem for existence. In later years, Traffic’s Dear Mr Fantasy became a favorite, especially the live version by Steve Winwood and Eric Clapton from their concert at Madison Square Garden with its soaring lead guitar. Amidst pandemic and lockdown, Chris Rea’s Set Me Free emerged another favorite. Hope you like it.

(The author, Shyam G Menon, is a freelance journalist based in Mumbai.)

WFH DAYS

Illustration: Shyam G Menon

Among major shifts accompanying COVID-19 and lockdown was Work from Home (WFH). Initially it was heralded as the digital future. Now, we are worried if it may end up an annoying blend of neither the best of office nor the best of home.

Over the past few months, periodic interactions with friends and relatives threw up concerns about WFH; especially long hours of work given employee is anyway at home and available on call. The boundary between home and office has increasingly blurred. With time we may retract to a more enlightened form of WFH. However, there are challenges. Currently, there is more money in an inch of technology than a mile of human life. In world by money, we just can’t be sure what will eventually triumph. In the meantime, as with many things beyond our control, the best option we have is to laugh at our predicament.

The recent past has for some reason drawn me closer to the music of Chris Rea, the British rock and blues artiste. His debut album was in 1978. In the late 1980s, somebody gifted me his album: Dancing with Strangers. It had the hit song Let’s Dance. From then on, I have listened to his work on and off. But of late, I have grown to genuinely appreciate his style. A talented guitarist, he keeps his music simple. His compositions often evoke a sense of space and momentum (a good example being that beautiful song: Set Me Free). I like this idiom of peaceful, spatial and moving in a world becoming more and more complicated and congested.

Working on It was a song he released in 1989.

Here are the lyrics:

Oh how I’d love it girl, just you and me

Take the day and fly

But oh this job, it’s got the best of me

Tell you why, tell you why

Somebody above is in a desperate state

Some kind of urgency, the kind that won’t wait

I say tomorrow, he say today

And the man in my head well he tell me no way

Keep working

I got eight little fingers and only two thumbs

Will you leave me in peace while I get the job done

Can’t you see I’m working

Oh, oh I’m working on it

Oh, oh I’m working on it

Well they’re coming from above me

And they’re coming from below

Yea they’re in there right behind me

Everywhere that I go

And my buddy, he’s screaming down the telephone line

He say gimme, gimme, gimme

I say I ain’t got the time

Oh, oh can’t you see I’m working on it

Oh, oh I’m working on it…

A few days ago as I revisited this old song, I felt it could be an anthem for our WFH days.

Use good headphones, speakers.

Turn up the volume.

Bass matters.

Amidst WFH, shake a leg.

Enjoy.

(The author, Shyam G Menon, is a freelance journalist based in Mumbai.)

RECORD HEAT IN DEATH VALLEY

Illustration: Shyam G Menon

Thanks to the famous Badwater Ultramarathon, Death Valley is known to running communities worldwide.

Among the hottest places on the planet, it is a desert valley in eastern California, in the northern Mojave Desert. The Badwater Basin in Death Valley is the point of lowest elevation in North America; it is 282 feet below sea level. Death Valley is roughly 136 kilometers east-south east of Mt Whitney, which at 14,505 feet is the point of highest elevation in the contiguous United States (the US excluding Alaska, Hawaii and other offshore territories). The Badwater Ultramarathon commences in Badwater Basin and proceeds to Whitney Portal, the trail head for Mt Whitney at 8360 feet. Several runners from India have participated in the 217 kilometer-ultramarathon, considered one of the toughest events in its genre.

On August 17, 2020, the BBC reported that temperature in Death Valley hit a scorching 54.4 degrees centigrade. Subject to verification, this may be the highest reliably recorded temperature on Earth. It has happened amid a heat wave on the US west coast. There is mention on the Internet of a still higher temperature – 56.6 degrees centigrade – recorded in Death Valley in 1913. The BBC report says, some experts consider that to be unreliable data.

Death Valley is the dry desert it is because it lay in the rain shadow region of four major mountain ranges. This forces moisture laden air coming in the from the Pacific, to shed its water content as rain or snow on the western slopes of the ranges. By the time these air masses reach Death Valley there is little moisture left to grace the region as precipitation. Other factors also contribute to the dryness. They include the valley’s surface experiencing intense solar heating, the area trapping warm air, warm air from nearby regions moving in and the phenomenon of warm foehn winds. According to Wikipedia, the period from 1931-1934 was the driest on record with only 16 millimeters of rain received.

(The author, Shyam G Menon, is a freelance journalist based in Mumbai.)         

TOKYO OLYMPICS: INDIA’S MARATHON ELITE AND THE SEARCH FOR VIABLE OPPORTUNITIES TO QUALIFY

Illustration: Shyam G Menon

It is only a handful of athletes. But what they have to attempt is a challenging task; match a longstanding national record and then improve it by another 30 seconds. All this must be accomplished in one or two races during the winter of 2020-2021. Will we set them up for it?

On August 12, 2020, the Paris Marathon became the latest mass participation event in running, to embrace cancellation for the year. It was initially postponed. In August, the organizers disclosed they had decided to cancel.

Earlier on July 28, World Athletics informed that the Virgin Money London Marathon, due to take place on October 4, is committed to working with World Athletics to promote the opportunity to athletes around the world and assist with their travel challenges so they can participate in London and achieve their Olympic qualifying time. It was also mentioned that World Athletics will try something similar with the ADNOC Abu Dhabi Marathon. The move followed concerns over the lack of qualifying opportunities that may be available for road athletes before the qualifying period for the rescheduled Olympics, finishes on May 31, 2021. On August 6, the organizers of the London Marathon informed that the 2020 edition of the race will be held as an elites-only affair; there will be no amateur runners participating.

The cancellation of races worldwide, caused by the COVID-19 pandemic, has become a problem for marathon runners wishing to qualify for the Olympics. While the decision of World Athletics to work with the London Marathon and the ADNOC Abu Dhabi Marathon is related to this issue, two events don’t satisfy the need of all athletes. The London Marathon is scheduled for early October while the one in Abu Dhabi is normally held in December. To utilize these events properly, you have to be in good form by then.

The qualifying time for the men’s marathon at the Tokyo Olympics is 2:11:30. This means that any Indian male marathoner seeking qualification has to smash the longstanding national record of 2:12.00. On March 17, 2019, T. Gopi had completed the Seoul Marathon and qualified for the 2019 World Championships (Doha, Qatar) in 2:13:39. That is the closest anyone has come to the 1978 national record set by the late Shivnath Singh in Jalandhar. As of August 2020, some of the country’s top marathoners were at various stages of recovery from injury. This blog spoke to Nitendra Singh Rawat, T. Gopi and Srinu Bugatha – all of them elite marathoners; two of them have represented India at the Olympics, all three have been podium finishers in the Indian elite category at some of the country’s best marathons including the Mumbai Marathon. They felt that targeting the London Marathon of October 2020, as opportunity to qualify, wouldn’t be the best option.

Recovering from injury and regaining the old tempo in training takes some time. Additionally, under normal circumstances an endurance athlete shifts between races in the plains, training center and locations for special training like those at high altitude, seamlessly. With pandemic protocols, these inter-state movements risk quarantine. The current period is thus far from perfect environment. Given the training regimen they have been traditionally used to, two to three months of diligent preparation suffices to get back to shape. But it is already past mid-August. October is too close for them to return to form, especially for a national record-breaking effort. Going by the options World Athletics presented in their July statement, this shrinks window of opportunity to the ADNOC Abu Dhabi Marathon, which has the advantage of being in India’s neighborhood. The problem then is – if you fail there, you are out; unless, more windows of opportunity open up, ideally in the first quarter of 2021.

The general tenor one could glean in race organizing circles in India was that by the last quarter of 2020, some level of activity should return to sports. Even if India chooses to be conservative in recommencing sporting activity (at the time of writing, the country had cumulatively recorded the third highest number of COVID-19 cases worldwide), for needs like top talent wishing to qualify for the Olympics, opportunities to run may open up in the Middle East. As one race organizer said, “ If ADNOC Abu Dhabi is held as scheduled, it may encourage the Dubai Marathon of January to examine its options.’’ But there is a catch. Nobody is saying yet that when events revive it will be in the mass participation format. The London Marathon – like the 2020 Tokyo Marathon of March – will be an elites-only affair. Asked if the elites-only model may work with events in India, the race organizer admitted it will be tough because sponsors may not be interested during financially difficult periods like the present. Same could hold true elsewhere in the world. If you want to help athletes qualify for the Olympics, then either a sponsor has to be sufficiently supportive or a national federation – like World Athletics did – must notice the situation, go the extra mile and make those opportunities happen. “ An additional window will be helpful,’’ K.C. Ramu, former elite marathoner and now Srinu Bugatha’s coach, said.

Amid times of international travel deemed risky and need for athlete to preserve health as best as possible, domestic opportunities to qualify for the Olympics attract. Unfortunately, the Mumbai Marathon (January) and the New Delhi Marathon (National Marathon / February) which have traditionally served as qualifying grounds for various events, are not perceived as well-suited for the purpose. Mumbai’s weather conditions have rarely been ideal for top notch running. The city marathon’s course has a hill; it is not the flat, fast type that runners seek when chasing a qualifying mark. Delhi has better weather conditions than Mumbai in the winter months (keeping aside the problem of air pollution) and a flatter course. But there is a portion of the course having too many twists and turns. This assessment won’t sit well with some observers. And there is a valid reason for it – every male winner (overall winner) of the Mumbai Marathon since 2011, has timing below 2:11:30. The latest course record, set in January 2020, is 2:08:09. What are Indian athletes complaining of then? All one can say in defence, is that as a country we are not yet in the same league as those churning out such timings although Shivnath Singh touched 2:12:00 once. Additionally, Singh’s record, unbroken since 1978, makes breaking it a project of sorts. “ How many Indian athletes are we talking of as those eligible to try qualifying for the Olympics; four or five at best? It makes better sense to have them fly overseas and qualify,’’ the race organizer said. He clearly has a point, if decision is left to economics and scale.

Illustration: Shyam G Menon

However, a race to qualify for the Olympics doesn’t have to be as elaborate as your regular road race. The upcoming London Marathon for instance, has an altered blueprint for 2020.  According to the statement of August 6, put out by the event’s organizers, “ elite races for men, women and wheelchair athletes will take place on an enclosed looped course in St James’s Park in a secure biosphere (a contained safe environment like that of Formula 1 and England cricket) with times being eligible for Olympic qualification.’’ This means the course can be smaller than usual and repeated as a loop to meet the distance required; something similar to Eliud Kipchoge’s iconic run in Vienna last year, when he dipped below the two hour-barrier. A well-organized race, oriented towards qualifying with pacers to ensure required momentum – this was the wish list. “ Even a good five kilometer-course that can be repeated as a loop will do. February-March should be the cut-off period, not beyond that,’’ Nitendra said. Depending on whether you can locate a good enough course, how motivated a national federation is and how supportive sponsors can be, this should be feasible in India.

Amid pandemic will we go the extra mile for the marathon and a handful of our elite athletes?

(The author, Shyam G Menon, is a freelance journalist based in Mumbai.)   

SPORTS GETS A MENTION

Illustration: Shyam G Menon

After raising hopes in June ahead of its release, the National Educational Policy 2020 as currently available on the website of the Ministry for Human Resource Development, restricts mention of sports to little over a paragraph.

On Pages 12 and 13, under the sub-section titled Experiential Learning, the policy says, “ sports-integration is another cross-curricular pedagogical approach that utilizes physical activities including indigenous sports in pedagogical practices to help in developing skills such as collaboration, self-initiative, self-direction, self-discipline, teamwork, responsibility, citizenship etc. Sports-integrated learning will be undertaken in classroom transactions to help students adopt fitness as a lifelong attitude and to achieve the related life skills along with the levels of fitness as envisaged in the Fit India Movement. The need to integrate sports in education is well recognized as it serves to foster holistic development by promoting physical and psychological well-being while also enhancing cognitive abilities.’’

A quick perusal of the document did not reveal any reference to sports more prominent than this, elsewhere in the text. The Fit India Movement referred to in the policy was launched on August 29, 2019 by Prime Minister Narendra Modi. It is a nation-wide campaign aimed at encouraging people to include physical activities and sports in their everyday lives. The educational policy document (as available on the Internet) is divided into four parts – school education, higher education, other key areas of focus and making it happen. The reference to experiential learning including the paragraph on sports-integration is under school education. The part titled other key areas of focus, has sub sections devoted to professional education, adult education and lifelong learning, promotion of Indian language, arts and culture, technology use and integration and online and digital education: ensuring equitable use of technology. It had no sub-section on sports.

The National Education Policy 2020 received cabinet approval on July 29. On June 11, 2020 media reports had quoted the Union Minister for Sports, Kiren Rijiju, saying that sports is set to become part of educational curriculum.

(The author, Shyam G Menon, is a freelance journalist based in Mumbai.)

LOCKDOWN & ME / THREE PROJECTS FROM ALIBAG

Image, courtesy: Sumit Patil

When this blog met Mumbai-based long distance cyclist Sumit Patil for a chat in February 2020, COVID-19 wasn’t yet the stuff of lockdown in India.

The disease was somewhere between worry and real worry; there was what it did in China and Europe and it had made its presence felt in the country. But mask to every human face, deserted roads and loss of livelihood didn’t seem hinted at for immediate future. Shops and cafes at Prabhadevi in the city were busy; people were out, traffic was heavy – there was little pointing to gathering storm, except that sense of uncertainty lingering within. Sumit had projects in mind for the year. The following days indicated need for course correction. The disease was quickly gathering momentum. It was clear that cycling projects in far off locations and travel to those places had become a shaky proposition. Originally a resident of Alibag near Mumbai, the cyclist shifted out from the city to his home in the coastal township, where his parents lived.

Alibag is known for its farmland, beaches and resorts. Not one to idle, Sumit’s first project upon arrival was to get the people around interested in a ride designed such that the aggregate elevation gain of participants would match the elevation of Mt Everest (8848 meters). The project design was clear. This wouldn’t be about people tackling inclines and logging great doses of elevation gain for individual milestone. On the other hand, it would be about keeping personal milestones modest and spreading the effort around so that sense of community is strengthened through goal achieved collectively. The place Sumit chose for the project was Karli Khind in Alibag where a loop of 1.4 kilometers entailing elevation gain of 96 meters (figures are approximate) was possible. That meant close to 95 repeats of the loop would be needed to equal the height of Everest. Sumit had done this on March 13, 2015, a date he recalls as a Friday the 13th. “ For 2020, we decided to restrict the number of loops per head to a maximum of three so that people of varying ability can participate,’’ Sumit said. On the appointed day – March 13 again and a Friday to boot – fifty four people turned up on their bicycles to attempt the project. Riding from 4AM to 7AM, they accumulated in all, 150 loops. Everest and more, was in the bag. A little over ten days later, India slipped into nationwide lockdown. From then till the time of writing, the virus and its capacity for havoc would dominate people’s imagination.

Sumit Patil on his home trainer in Alibag; riding to raise funds for Prabodhan Trust (Photo: courtesy Sumit)

The initial part of the nationwide lockdown was strictly enforced. Those loving the active lifestyle were reduced to working out at home and trotting around in their courtyard or the space around their housing complex. This was the case with Sumit too in Alibag. He ran a bit. Further, among the classic endurance trio – swimming, cycling and running – cycling was best placed to tackle lockdown. Not all cyclists therein, but those with access to home trainers. With a trainer you could do a stationary ride at home. Connect it to one of the emergent virtual reality apps and you could do a ride with self as avatar on computer screen and even have others – represented by their avatars – join you on the ride. Sumit has a home trainer in Alibag. But he is also the sort who can’t shut himself out entirely from reality. It wasn’t long before the pains of the outside world got to him. A major tragedy unfolding through April-May was that of migrant workers. They are the manpower – often overlooked – building big cities and keeping them running. As cities shutdown in panic, these workers were left in the lurch. Thousands of them began trying to get home from the cities and towns they were stuck in. With no public transport available due to lockdown, people walked and cycled long distance to reach their villages. Concerned citizens responded. But given the scale of the problem, the initiatives were often inadequate. Yet for those with a conscience, what little intervention they could do, mattered. The migrant worker issue troubled Sumit. As he put it, if you have been a cyclist, hiker or runner pushing your limits, you would have known what hardship is; you would have also known what a food stall operated by utter stranger or some such relief in the middle of nowhere means to exhausted human being.

Already on Zwift and with the virtual riding season underway, Sumit moved to fashion an initiative around his home trainer. He would ride on the trainer, spread the news of his pedaling on social media and seek contributions. He wanted to ensure that there would be no leakage in the pipeline delivering the funds raised to those in need. A friend introduced him to the Dhule-based Prabodhan Trust. They were already working on the migrant workers issue. Sumit structured his initiative such that people wishing to contribute could do so directly to the Trust. The basic unit of the contribution was fixed at Rs 100 per kilometer ridden.  It was intended to discipline monetary inflows. The hundred rupees could be split as required by those wishing to donate; that is their choice. On May 20, pedaling on his home trainer from Alibag, Sumit covered 644 kilometers in 30 hours. As the ride unfolded on Zwift, some of his friends from the cycling world occasionally kept him company.  “ We raised close to Rs 190,000,’’ Sumit said.

The BRO signboard (Photo: courtesy Sumit)

Virus wasn’t the only challenge nature had in store. Cyclones usually lash India’s east coast washed by the Bay of Bengal. Depressions forming in the calmer Arabian Sea to the west rarely bloomed to cyclone proportion and when they did, generally tended to move north or north-west. The Indian state of Maharashtra had been spared damage by cyclone for long. Thanks to climate change, the behavior of the Arabian Sea has altered in recent years.  Some ten days after Sumit’s ride to raise funds for migrant workers, on May 31, an area of low pressure developed over the Eastern Arabian Sea. In the next couple of days it evolved into a deep depression and by the noon of June 2, it had become a cyclonic storm christened Nisarga. On the afternoon of June 3, it made landfall at Alibag leaving a trail of destruction in the region. “ It was bad, really bad,’’ Sumit said. People rallied around in their respective localities to clean up the damage.

For the past several years, Sumit has been a regular visitor to Leh (Ladakh). He has cycled much in the region and been a guide multiple times for the classic Manali-Leh bicycle trip. The Border Roads Organization (BRO), which maintains important roads in these parts, is known for its memorable signboards. One such board had stayed in Sumit’s memory; it said: Kashmir to Kanyakumari, India Is One. Around mid-June the process of relaxing the nationwide lockdown commenced. Among the rights restored in part during this phase was the freedom to exercise outdoors. A modest amount of running and cycling became possible. Alibag has a young outfit called Alibag Cycling Club. When the idea of a group ride was proposed, it was soon realized – this social tradition loved by every riding club wouldn’t be ideal amid pandemic. Protocols recommend no bunching of people. The paradigm shifted to riding with masks on, maintaining adequate distancing and dispensing with the socializing over refreshments `group’ typically implies. Next you needed an objective that respected above mentioned mode of riding and yet stayed interesting.

Members of the Alibag Cycling Club; this photo was taken on an occasion preceding pandemic and lockdown (Photo: Dr Akshay Koli)

The club picked on Sunday, June 21 – the year’s longest day (summer solstice) – as occasion to host every participant’s longest ride. Once again, the emphasis wasn’t on a few strong riders logging 100-200 kilometers. “ What we wanted was just longer than your longest yet. That could be any small amount. We also suggested ways to make the strain less. In a sunrise to sunset endeavor, you could cycle some hours in the morning, go home for lunch and then cycle again a few hours in the evening,’’ Sumit said. To make the whole thing even more engaging, the imagery in that BRO signboard was invoked and the aerial distance from Kashmir to Kanyakumari, which is roughly over 2500 kilometers, pointed to. It would be wonderful if the aggregate mileage of all participants matched or exceeded that figure. By now, some of Sumit’s friends in cycling sought that the affair not be kept exclusive to riders from Alibag. They should be able to pitch in with rides at other locations. The June 21 ride saw 172 people take part. Their cumulative mileage was in excess of 7000 kilometers. The youngest cyclist participating in the initiative was five year-old Ovi Pathre, who cycled 20 kilometers. Riders from Pune, Panvel and Uran brought in some 200 kilometers. The rest was met by cyclists from Alibag.

At the time of writing, the lockdown was still going on (its severity depending on location and level of infection) and Sumit was still in Alibag.

(The author, Shyam G Menon, is a freelance journalist based in Mumbai. Photos of the rides of March 13 and June 21 couldn’t be had; according to Sumit, pandemic related protocols and participants cycling on their own meant no opportunity for group photo.)                     

SWIMMING’S PHASE OF WOES

Illustration: Shyam G Menon

The closure of swimming pools has meant tough times for swimmers, coaches and support staff

While COVID-19 has been a setback for sports at large, it has been particularly harsh on swimming.  And within that the impact has been hardest on competition swimmers.  “ Pools have been shut since around March 19. In competition swimming, there is no real replacement for the swimming pool. Dryland work outs cannot fully substitute training in the pool. It will be difficult for swimmers to get back to earlier performance levels,’’ Zarir Balliwala, President, Greater Mumbai Amateur Aquatics Association (GMAAA) said. The prolonged closure of pools has derailed this year’s district and state level competitions. Question mark graces the nationals too.

According to Zarir, the Swimming Federation of India (SFI) is seized of the matter and it has spoken to the government. But with no response that can be acted upon available yet, the closure continues. With it, elite swimmers training for events like the Olympic Games, endurance swimmers who have crossed channels and straits worldwide as well as recreational swimmers – all have been left high and dry. The tough situation was brought to focus when ace Indian swimmer Virdhawal Khade tweeted mid-June that he may have to consider retiring from the sport if pools stayed shut. Virdhawal is the current national record holder in 50m, 100m and 200m freestyle events and the 50m butterfly. He represented India at the 2008 Beijing Olympic Games. “ Regaining form will be an uphill task if elite swimmers don’t have access to the pool for long,’’ Sebastian Xavier, former national record holder in swimming who represented the country at the 1996 Atlanta Olympic Games, said. On June 30, 2020, espn.in carried a report by Jonathan Selvaraj on swimmer Sajan Prakash, the only Indian elite swimmer who is currently training, thanks to him being in Thailand. Sajan who is still recovering from injury described his return to the pool after the virus triggered-lockdown. “ Going back to the water, I felt as if my body was made out of stone,” he was quoted as saying in the report.

Most people linked to swimming realize that with the virus sparing little room to argue their case, one has to simply hope for the best amid existing challenges. “ You have to look at the positive side,’’ Kaustubh Radkar, former national level swimmer and now a well-known triathlete and coach, said when asked how swimmers may tackle the predicament. He suggested that the best option would be to treat lockdown with its lack of access to pools, like a period of injury. “ Take it as if you are addressing injury. If I dip into personal experience, I had shoulder surgery in 2009 and was out of action for three months. You have to make the most of what is available. What you can do right now is indulge in shore based exercises and keep a positive attitude,’’ he said. With shoulder injury, Radkar estimates the dip in fitness levels he experienced over those three months at about 50 per cent. Without injury – which would be the apt way to estimate for the current situation – he felt the dip in swimmers’ fitness levels should be 25 per cent.

The above encapsulates only the physical aspect of how swimming is missed. Most people see the pool as a fun environment. That is typical landlubber perspective, one in which swimming is the exception and activity on land is the norm. This isn’t necessarily the perspective when you are a committed swimmer who is very comfortable in water. In that predicament, the way you miss swimming is more visceral. Asked how a dedicated swimmer may miss water, Radkar said that the question cannot be answered generically as the nature and extent of impact varies from person to person. Speaking for himself, he said, “ for me, water is very calming. When I am in the water, it is a perfect state of existence. There is no distraction. It is meditative and positive,’’ he said.  Zarir too recalled tranquility as the essential quality of water. This should give an idea of what exactly those embracing water as preferred medium of sport must be missing in these times of pools shut due to pandemic.

Illustration: Shyam G Menon

Swimming pools have been studied in the past for how they spread disease. The National Center of Biotechnology Information (NCBI) is part of the United States National Library of Medicine. There is a study titled “ A Review and Update on Waterborne Viral Diseases Associated with Swimming Pools’’ by Lucia Bonadonna and Giuseppina La Rosa, published January 9, 2019, available on its database. The introduction to its abstract says:  Infectious agents, including bacteria, viruses, protozoa, and molds, may threaten the health of swimming pool bathers. Viruses are a major cause of recreationally-associated waterborne diseases linked to pools, lakes, ponds, thermal pools/spas, rivers, and hot springs. They can make their way into waters through the accidental release of fecal matter, body fluids (saliva, mucus), or skin flakes by symptomatic or asymptomatic carriers. In its concluding remarks, the study noted: In light of the health hazards posed by swimming pools, it is essential to constantly monitor water quality in swimming pools and to assess the effectiveness of treatment and disinfection processes and compliance with standards. Specifically, appropriate chemical and microbial evaluation of water quality should be carried out, especially when large numbers of bathers are expected to use the pools. Overcrowding should in any case be prevented. Since the behavior of swimmers may affect water quality, strict rules of behavior in the pool should be followed and enforced, including shower before entering the water, wash hands after using the toilet, take children to bathroom before swimming, and, importantly, avoid swimming while sick. This study provides an overview of the health risks associated with swimming pools. In other words, you can’t pretend risks don’t exist. However the study precedes the COVID-19 pandemic by almost a whole year.

Similar studies specific to our COVID-19 times, were hard to locate. On May 15, 2020, www.covid19facts.com, a website hosted by Reckitt Benckiser (in India, their best-known brand is Dettol) posted an analysis by EIU (Economist Intelligence Unit) Healthcare on the risk of contracting COVID-19 from swimming in the pool or the sea. According to it, the biggest risk with swimming is likely getting too close to other people, for example in enclosed pools, changing rooms or on beaches, rather than infection from the water itself. Citing a report from the Spanish Consejo Superior de Investigaciones Científicas (Higher Council for Scientific Research), the analysis said that its authors concluded: it was “highly unlikely” that people would be infected from contact with water. However, they warned, leisure swimming tends to involve a loss of social distancing, which is the major risk from using pools or beaches. In swimming pools, the authors say, “the use of disinfecting agents is widely implemented in order to avoid microbial contamination of the waters” by users. They say that “the residual concentration of the disinfecting agent present in the water should be sufficient for virus inactivation.” They admit there is “currently no data” on what happens to SARS-CoV-2 in seawater, but say that “the dilution effect, as well as the presence of salt, are factors that are likely to contribute to a decrease in viral load and its inactivation.” They say this is based on what happens to other, similar viruses. Rivers, lakes, and untreated pools are riskier, they say, and are “ the most inadvisable aquatic environments” for swimming. The report authors stress that the most likely way people could get infected while swimming “ is through respiratory secretions that are generated by coughing, sneezing and person-to-person contact” in busy spaces. The analysis also cited what the US Centers for Disease Control and Prevention had to say on the subject. It quoted CDC: “ There is no evidence that the virus that causes COVID-19 can be spread to people through the water in pools, hot tubs, spas or water play areas. Proper operation and maintenance (including disinfection with chlorine and bromine) of these facilities should inactivate the virus in the water.” They also advise that the salt in the sea and dilution effects make it unlikely the virus would survive. CDC’s recommendations in full may be viewed on this link:  https://www.cdc.gov/coronavirus/2019-ncov/community/parks-rec/aquatic-venues.html

In March, when nationwide lockdown was announced in India, the total number of COVID-19 cases was around 500. By July 6, that had changed to a total count (since the disease appeared in India) of almost 700,000 cases; third highest in the world. The original lockdown had relaxed but with relaxation of norms leading to further spread of infection in some places, stringent lockdowns were happening at local level. Such imagery stacks the cards against adopting a kinder view towards swimming pools. The people this blog spoke to agreed that the reopening of pools would have to be a well thought through decision; one that authorities may take only when they are absolutely sure of allowing it. At least one senior coach this blog spoke to said he was anticipating another couple of months of closure. He explained the reason. “ At the complex where I work, during busy hours, we may have around 100 people in the water and almost double that number on land. You can’t have that in a situation like the present. Only when infection numbers have dropped significantly, can we examine possibilities of return to swimming with new protocols in place,’’ he said. Pools have opened in some countries and the general practice seen there is not allowing use of shower rooms, changing rooms and locker rooms. You come ready to swim and once you finish your session, you put your clothes on top of wet swimsuit and go. Asked if it would be possible to open pools just for elite swimmers (so that their training isn’t damaged beyond repair), they felt it should be possible to do that with above said restrictions and strict lane discipline in place. The report on espn.in provided insight on how Sajan Prakash is training at Phuket’s Thanyapura Aquatic Centre. “ Among the rules we have to follow since the opening of swimming pools has been to train in separate lanes. In the past, because we had to share the pool with other members of the centre, we would all have to swim in a single file in the same lane. Very often you’d find someone’s hands touching your toes. It’s much less distracting to have your own lane,” Sajan, who represented India at the 2016 Rio Olympic Games, was quoted as saying, in the report.

Illustration: Shyam G Menon

Athletes are only one aspect of sport. When sport is an industry, there are many others dependent on it. Their livelihood is hit when pandemic strikes and sports goes for a toss. With pools shut, there are swimming coaches and support staff finding it difficult to make ends meet. As with any industry, vulnerability depends on how secure your employment was. “ Those working for big institutions that run swimming pools and those located in major metros, may not be affected severely. But freelancers and the employment ecosystem around pools in smaller cities and towns would have been affected,’’ the head coach at a school in the Mumbai Metropolitan Region, reputed for its strength in swimming, said. Sebastian Xavier is among those trying to raise resources to help. He forwarded to this blog information on the fundraiser Lets Pool In, which seeks to support 100 persons from the affected category with a one-time financial grant of Rs 10,000. “ It is a good move,’’ the earlier mentioned coach also said, adding he wished the amount per capita was more. Resident in the emergent livelihood problem around shut swimming pools is a little remembered detail. India’s lockdown started in March, just as summer vacation was approaching. The warm months of summer are when pools are at their busiest; Lets Pool In estimates that the summer months contribute as much as 60 per cent of annual revenues for this industry. So in 2020, the business of swimming pools and coaching therein has already lost its best earnings season. Not to mention – the coaching camps of summer play a role in scouting the next generation of the talented young.

(The author, Shyam G Menon, is a freelance journalist based in Mumbai.)

COVID-19 AND THAT DRUG IN A MOUNTAINEER’S FIRST AID KIT

Illustration: Shyam G Menon

A drug that is familiar to mountaineers finds mention in humanity’s ongoing tussle with COVID-19. We use the juncture as an opportunity to reacquaint ourselves with Acute Mountain Sickness (AMS) and the drug in question.

Dexamethasone has been part of medicines used to treat high altitude illness for several years. Notwithstanding the lives it may have quietly saved so, its moment in the limelight happened in mid-June 2020 when news reports from the UK said, it was proving to be a life-saver in the battle with COVID-19. The drug’s name wouldn’t have escaped the attention of mountaineers and outdoor enthusiasts. Proper acclimatization, hydration, descent to safe altitude when beset with discomfort and having acetazolamide and dexamethasone in the first aid kit, form the classic defence against high altitude illness.

Colonel (Dr) S. P. Singh (Retd) is currently Additional Professor, Department of Physiology, All India Institute of Medical Science (AIIMS), Rishikesh.  He runs India’s first course in High Altitude Medicine there. A product of the Armed Forces Medical College (AFMC), Pune, Dr Singh has been working in the field of high altitude medicine and physiology since 2008 when he was posted to the Indian Army’s High Altitude Medical Research Centre, in Leh (Ladakh). He has a number of publications in the field and was a member of the team that wrote the latest edition of the army’s guidelines for prevention and treatment of high altitude illness. Dr Singh responded to questions posed by this blog.

“ Dexamethasone is a medicine that is used for treating a large number of illnesses, including those due to inflammation (within that, auto-immune diseases where the body’s immune system attacks its own cells; for example: rheumatoid arthritis) and allergy; for example: skin allergies, eye allergies etc. It is also used as a life-saving drug when severe inflammation threatens dire consequences. The body produces corticosteroid hormones (better known to doctors as glucocorticoids) which are essential for life and continuously regulate a host of functions including energy production, water content of the body, immune regulation and behavior. An important function of glucocorticoids is to help us overcome stress. The term stress implies any shift in the environment that changes or threatens to change the existing optimal state of the body. Thus, extreme heat, cold, low environmental oxygen ere all examples of stress. Large amounts of glucocorticoids are secreted by the adrenal glands of the body to help overcome stress, ‘’ he said.

Dexamethasone in the context of AMS

In mountaineering, dexamethasone is spoken of in the context of Acute Mountain Sickness (AMS).  According to Dr Singh, AMS is the most common illness to occur in un-acclimatized sojourners arriving at High Altitude (>2700m/9000ft). It consists of a constellation of symptoms viz., headache, decreased appetite, nausea, vomiting, giddiness / dizziness and weakness / fatigue. Most people who develop these symptoms recover spontaneously or with symptomatic therapy (pain killers, anti-vomiting drugs and rest) within 2-3 days. Thus, AMS is a harmless illness, in terms of no threat to life and limb. Yet, it is important that people with AMS not ascend higher till their symptoms resolve completely. This is so, because we believe that approximately one per cent of people with AMS will develop High Altitude Cerebral Edema (HACE) if they ascend higher while symptomatic. HACE involves collection of excess water in the brain (brain edema) and can kill a person within hours of onset.

Hypoxia (the condition in which, the body or a portion of the body is deprived of adequate oxygen supply at the tissue level) is the direct cause of AMS. It leads to an increase in the pressure of Cerebro-Spinal Fluid (CSF – a derivative of blood in which the brain and spinal cord float) inside the skull. This is associated with increased leakiness of brain capillaries, which allows excess water to enter the brain from the blood causing very mild brain edema (in contrast to the florid edema of HACE). The cause of the increased leakiness of capillaries might be mild inflammation due to low oxygen at high altitude. Dexamethasone appears to prevent / treat AMS / HACE by inhibiting inflammation, preventing / reducing capillary leakiness and improving blood oxygen levels by salutary effects on the lungs. Because steroids have a general action to help us overcome stress, dexamethasone helps overcome the stresses of high altitude in the first few days while the body responds to and settles down in the new environment.

Since dexamethasone decreases capillary leakiness and has positive effects on the lungs to improve blood oxygen levels, it is of benefit in the prevention and treatment of AMS, HACE and HAPE. However, dexamethasone is a synthetic corticosteroid. “ It is important to remember that much higher doses of (synthetic) corticosteroid are given, than are naturally present in the body, to suppress inflammation and allergy. These high doses also carry the risk of significant adverse effects. For instance:  when given in the case of pneumonia due to a bacterial infection, dexamethasone will suppress fever and symptoms of lung infection but if the infection is not treated simultaneously with antibiotics it will spread throughout the body. Therapeutic doses must, therefore, be given with great caution, under strict supervision, along with other therapy,’’ Dr Singh said.

Descent is the definitive cure for all high altitude illness

The other major drug for AMS is acetazolamide (Diamox). According to Dr Singh, acetazolamide creates a mild acidosis in the body. This counters the alkalosis (the normal pH of blood is 7.35 – 7.45. pH<7.35 is acidosis and pH>7.45 is alkalosis) that is inherent on ascent to altitude. As a result of the acidosis caused by acetazolamide the rate and depth of breathing increases and the water content of the body reduces (due to excess urination). These effects are bound to be beneficial because more breathing means more oxygen in the body. Also, since AMS / HACE / HAPE are all conditions of excess water in the brain / lungs; maybe less water in the body helps. Acetazolamide also has a mild direct effect of decreasing the pressure inside the skull by reducing formation of CSF. “ Acetazolamide is best known for preventing AMS / HACE and has a smaller role (as dexamethasone) in the treatment of these conditions too, although dexamethasone is far superior for treatment. Clinical experience and some scientific studies suggest that acetazolamide may have a role in the prevention of HAPE too. This is, however, not yet established,’’ Dr Singh said.

High altitude; from an expedition to Denali (20,310 ft) in Alaska (Photo: courtesy Seema Pai)

In the context of AMS, both these drugs – acetazolamide and dexamethasone – are typically talked of as prophylactic treatment. Dr Singh explained it. “ Prophylaxis means to administer a drug before the occurrence of an illness, when the chances of the illness occurring are high, to prevent the occurrence of the illness. For example: hydroxychloroquine (HCQ) has been touted for prophylaxis / prevention of COVID-19. As already brought out, dexamethasone is effective in the cure of AMS but is usually not necessary. AMS is amenable to symptomatic therapy (pain killer for headache, anti-vomiting drugs for nausea / vomiting) and if needed some oxygen supplementation for a short period (usually 30-60 minutes helps significantly). Descent is not necessary for the treatment of AMS, but the decision must be guided by local conditions, tour itinerary and logistics. For example: if the rest of the team has no option but to ascend and the person with AMS can’t be left alone, it is better to send him down with one more person rather than risk HACE by ascent. Cases of HACE and HAPE must descend as soon as possible, unless, of course, institutional care is available at the altitude of occurrence. For instance: people arriving in Leh, who develop HAPE or HACE are treated in the hospitals there. After recovery, the patient with HACE should not ascend further but the person with HAPE may, with exercise of due caution. Descent is the definitive cure for all high altitude illness,’’ he said.

In general, acetazolamide (Diamox) would seem more popular with the outdoor fraternity as a means to check AMS. It is a good drug for prevention of AMS / HACE and may be of benefit for prevention of HAPE too. “ More importantly acetazolamide is a safe drug. It is given to some patients with eye problems (glaucoma) for months and years with minimal adverse effects. So, we know it is safe. With dexamethasone one must be careful of the dose and duration it is taken and even so, some people might develop adverse effects at lower doses or shorter durations,’’ Dr Singh said. He feels that a first aid kit for mountaineering should contain both the drugs. “ Acetazolamide is our old friend that will prevent all three acute high altitude Illnesses – AMS, HACE and HAPE; whereas dexamethasone is the life saver in an emergency situation. No medical supervision is required for ingesting acetazolamide. If you know you have no drug allergy to sulfonamides (an antibiotic with structural similarity to acetazolamide) go ahead and take acetazolamide. A dose of 125mg (Diamox) twice a day or 250mg sustained release preparation (Iopar) once a day, starting the day before you ascend to altitude and continued to the second day there, is a great way to prevent / reduce the severity of AMS / HACE. If you intend to continue climbing and know you are prone to AMS, continue acetazolamide to the second day of reaching your target altitude. Should you find the benign side-effects such as a metallic taste in the mouth or tingling of the lips, hands and feet troublesome you could shift to dexamethasone tablet 4mg twice a day. But it would be good to not take dexamethasone in this dose for more than 10 days. A combination of both drugs in the same doses may also be used if you want to go high (from sea-level to >3500m in one day) very fast and have to indulge in strenuous activity there without time to acclimatize. Given in these doses for the recommended duration, medical supervision is not needed, provided the cautions mentioned above are adhered to,’’ Dr Singh said.

None of this however takes anything away from the merit in patiently acclimatizing to high altitude. That is the safest method. Patience – respecting the time needed for the body to gradually acclimatize – is, key. “ In my experience, there is nothing that can replace natural acclimatization,’’ Dr Tsering Norbu of Ladakh Institute of Prevention (LIP), said. Based in Leh, the retired physician is known well to visiting mountaineers. “ If you are not allergic to sulfa drugs, then we prescribe Diamox. We don’t approach dexamethasone in a similar fashion because it is typically used as a life saver in cases of AMS where the situation is bordering HACE,’’ he said. Being a tourist destination 11,500 feet up from sea level, Leh gets its fair share of high altitude illness. LIP is a NGO working in the domain of health. When patients require formal medical intervention, he refers them to the district hospital, Dr Norbu said.

COVID-19 and dexamethasone

On June 16, 2020, amid world battling COVID-19, BBC reported that dexamethasone “ cut the risk of death by a third for patients on ventilators. For those on oxygen, it cut deaths by a fifth.’’ This was a finding from the UK. What made dexamethasone significant beyond its stated life-saving ability was the fact that it was available in good supply and was affordable. The name of the drug must have struck a bell immediately with mountaineers worldwide. Asked what likely made dexamethasone relevant in the treatment of COVID-19 patients on ventilator support and whether medically there is any parallel in the stress the body underwent with what happens during AMS, Dr Singh said, “ since dexamethasone helps combat stress it could possibly help in COVID-19 pneumonia or Acute Respiratory Distress Syndrome (ARDS). COVID-19 involves inflammation which damages the lungs even as it fights the virus. Dexamethasone can suppress inflammation and because it reduces capillary leakiness it should reduce the severity of the symptoms caused by ARDS. The caution that needs to be kept in mind, I believe, is that dexamethasone is not the definitive cure (it does not kill the virus) and by suppressing inflammation which controls the infection even as it causes symptoms, it might worsen the infection. If, however, adjunctive therapy to kill the virus is available then dexamethasone could help tide over the critical time in ARDS when inflammation does more harm than good to our body. The disease process of ARDS in COVID-19 involves increased capillary leakiness. Other than that, there is little in common with HAPE. Having said that, I believe a respiratory physician may be able to help you better with this question,’’ Dr Singh said.

Colonel Muthukrishnan Jayaraman is an endocrinologist with the Indian Army. A regular runner, he has contributed in the past to articles related to health on this blog.  “ Dexamethasone in COVID-19 is as an anti-inflammatory to counter the cytokine storm that happens especially in the more severe forms of the disease,’’ he said. Further on June 17, BBC followed up with another report explaining how dexamethasone works in the case of COVID-19. “ This drug works by dampening down the body’s immune system. Coronavirus infection triggers inflammation as the body tries to fight it off. But sometimes the immune system goes into overdrive and it’s this reaction that can prove fatal – the very reaction designed to attack infection ends up attacking the body’s own cells. Dexamethasone calms this effect. It’s only suitable for people who are already in hospital and receiving oxygen or mechanical ventilation – the most unwell. The drug does not work on people with milder symptoms, because suppressing their immune system at this point would not be helpful,’’ the report said.

Illustration: Shyam G Menon

For a pulmonologist’s view, this blog reached out to Dr Jacob Baby, Lead Consultant (Pulmonology), Aster Medcity, Kochi. “ Dexamethasone is a synthetic corticosteroid; they are naturally occurring chemicals produced by the adrenal glands located above the kidneys. Corticosteroids affect the function of many cells within the body and suppress the immune system. They also block inflammation and are used in a wide variety of inflammatory diseases affecting many organs. Dexamethasone is 20-30 times more potent steroid action than naturally occurring cortisol. It reduces inflammation by blocking an enzyme named phospholipase A2, which breaks cell wall phospholipid and releases inflammatory mediators. Glucocorticoids function through interaction with the glucocorticoid receptors by up-regulating the expression of anti-inflammatory proteins and down-regulating the expression of pro-inflammatory proteins. It is cheap and easily available and used as effective anti-inflammatory in many inflammatory diseases like asthma and rheumatological disorders like inflammation of muscles, inflammation of blood vessels, chronic arthritis, and lupus. It also exerts excellent anti-edema (reducing swellings) action enabling its use in cancerous conditions, brain swelling and also swelling in the spinal cord,’’ Dr Baby said.

On how dexamethasone works in the case of COVID-19, he said, “ Recovery Trial in the UK – for treating COVID 19 – had an arm investigating dexamethasone. Oxford researchers announced the results of the dexamethasone trial, in which 2104 enrolled patients were administered 6 mg of the drug for 10 days. Dexamethasone reduced deaths by one-third in ventilated patients and by one-fifth in patients receiving only oxygen. One death would be prevented by treatment of around eight ventilated patients, or around 25 patients requiring oxygen alone. The drug reduced the 28-day mortality rate by 17 per cent with significant benefit among patients requiring ventilation. COVID-19 causes accumulation of cytokines mainly IL-6 in the lungs. IL-6 increases inflammation in the lung cavity which causes the production and accumulation of fluids in the lungs. Dexamethasone reduces inflammation and suppresses immune activation of immune agents. The drug induces anti-inflammatory effects by reducing the secretion of cytokines into the lungs.’’

(Compiled and edited by Shyam G Menon, freelance journalist based in Mumbai.)

SPORT AND THE SHADOW OF RULE 50

Illustration: Shyam G Menon

On January 14, 2020, the website of Time magazine carried an article by Melissa Godin listing the instances when athletes brought political protest to the Olympic Games.  The incidents range from support for Irish independence to fists raised in Black Power salute, protest against the erstwhile Soviet Union and declining to compete against Israel as means to highlight the plight of Palestinians. What prompted the compilation was – earlier that month, the International Olympic Committee (IOC) disclosed new guidelines regulating protest by athletes at the 2020 Tokyo Olympic Games.

Rule 50 of the Olympic Charter, which guards the political neutrality of sport and the Olympic Games already deals with this subject.  But it was vague about what constitutes protest. Time magazine noted that the new guidelines, which mention examples of what count as protest, coincide with rising activism among athletes, especially those from the US. In August 2019 two US athletes had been placed under probation for a year after one knelt and the other raised a fist during medal ceremonies at the Pan American Games (they were protesting against gun violence, racial injustice and the recent acts of their country’s president). The report cited the president of the International Olympic Committee (IOC), Thomas Bach, saying that the Olympic Games must never be a platform to advance political or any other divisive ends. He maintained that the political neutrality of the Games is undermined when the occasion is used by organizations and individuals “ as a stage for their own agendas, as legitimate as they may be.’’

At the same time as the magazine article appeared, COVID-19, which would characterize 2020 in a defining way, was only weeks into being reported. It would be another two months before the World Health Organization (WHO) declared it a pandemic and the question of whether the 2020 Olympic Games would be held or not would haunt the IOC. On March 24, the Games were eventually shifted to 2021. On May 25, 2020, George Floyd died as a result of police excess in Minneapolis, USA. It was a horrific incident, one that sparked a wave of protests in the US with reverberations elsewhere. In the mood of protest following Floyd’s death, Bach’s observation from January and Rule 50 of the Olympic Charter attracted attention afresh. Early June, the IOC confirmed to the Daily Telegraph that it stood by Rule 50. Days later, Sebastian Coe, President, World Athletics told the Independent, that he wouldn’t discourage athletes from expressing their views as he felt the current generation is more willing to speak out than previous generations were. “ There is nothing in World Athletics’ Integrity Code of Conduct to prevent athletes from protesting as long as it is done in a respectful manner, considers other athletes and does not damage our sport,’’ Coe was quoted as saying in the report by Lawrence Ostlere. For proper perspective, it must be mentioned here that Coe, a former world record holder and Olympic champion, who also anchored the organization of the 2012 London Olympic Games, has been nominated to the IOC. World Athletics hasn’t had a member on the IOC since 2015. To be admitted, Coe needs to first step down from other private business responsibilities he holds which constitute potential conflict of interest.

Over the last decade or so, the factors that contribute to social justice have taken a beating in many parts of the world. Governments have veered to authoritarianism, there is a general feeling that justice is partial to capital, inequality in wealth distribution has grown and those left out feel marginalized. Simply put – topics for protest are many. So are governments with trumped up public image and skeletons in the cupboard, who will be sensitive to protest. Amid this, 2020 will be remembered as the year of the virus. As COVID-19 swept across a planet devoid of vaccine to combat it, the best solution we had was to break the chain of transmission. Hygiene protocols and physical distancing became primary defence. Above all, it demanded that we accept a cardinal truth – the virus exists. If you don’t accept that it exists then all the hygiene protocols, physical distancing; even the frantic search for a vaccine – they lose relevance. The protests over George Floyd’s death happened because people acknowledged that the problem at its core – the virus causing it – exists. Compared to that, Rule 50 sanitizing Olympic venues of protest is the equivalent of pretending that the world’s problems don’t exist in the first place. Athletes may be elite by virtue of being at the Olympics. But they hail from mainstream society and many of them have experienced firsthand, discrimination based on race, gender, economic and social inequality. How can you pretend that society beyond the stadium doesn’t exist? It is what you come from; it is what you go back to.

To its credit, Rule 50 does not altogether ban protest. A document called Rule 50 Guidelines Developed by the IOC Athletes’ Commission, available on the IOC website, explains the details. According to it, Rule 50 of the Olympic Charter provides a framework to protect the neutrality of sport and the Olympic Games. It states that no kind of demonstration or political, religious or racial propaganda is permitted in any Olympic sites, venues or other areas. “ It is a fundamental principle that sport is neutral and must be separate from political, religious or any other type of interference.  Specifically,  the  focus  for  the  field  of  play  and  related  ceremonies  must  be  on  celebrating athletes’ performance and showcasing sport and its values,’’ the document said. For emphasis, it pointed out that even the head of state of the host country gets to utter only a preset sentence declaring the Games open. Neither they nor any government official is allowed any further comment on any occasion during the Games. Besides no government official can appear in a medal ceremony. “ While respecting local laws, athletes have the opportunity to express their opinions, including:

  • During press conferences and interviews, i.e. in the mixed zones, in the International Broadcasting Centre (IBC) or the Main Media Centre (MMC)
  • At team meetings
  • On digital or traditional media, or on other platforms.

It should be noted that expressing views is different from protests and demonstrations. It should be noted, too, that these guidelines are also applicable to any other accredited person (trainers, coaches, officials, etc.)’’ the document said, adding, “ Here are some examples of what would constitute a protest, as opposed to expressing views (non-exhaustive list):

  • Displaying any political messaging, including signs or armbands
  • Gestures of a political nature, like a hand gesture or kneeling
  • Refusal to follow the Ceremonies protocol.’’

The problem here – it would seem – is one of comparative mileage. Since protests seek public attention, the proverbial valve on the pressure cooker that Rule 50 provides is only worth its weight in visibility and media coverage. At any Olympic Games, the most watched footage probably relates to the opening and closing ceremonies, the competition at various sport venues and the medal ceremonies. Who watches press conferences and interviews? Only journalists go there and reports filed subsequently are allotted due significance by editors depending on the overall news flow from the larger sport event. Consequently, someone could ask this question and it would seem relevant: what matters more in a stadium – the advertisements of sponsors selling this and that or a black band on an athlete’s arm reminding us of social injustice the world is yet to comprehensively address? It goes to the heart of human existence: what are we alive for? Having said that; it must be mentioned, protesters too need to keep a few things in mind. Just as advertisements become irritating through excess, an overdose of protest can progressively leave us indifferent to calls for social justice. That’s the danger in world by trend and perception management, which is what our times have become. So perhaps there is relevance in leaving sport alone?

Illustration: Shyam G Menon

Although rarely said as such, one strong motive for keeping sport free of controversy is that it helps sport events happen by making available a sanitized platform sponsors can support. To be precise, it isn’t total no-no to controversy; it is opportunistic leverage with partiality to clean slate as best bet for sustaining long term. On the other hand, money’s aversion for conscience and its appetite for opportunism catches the goat of anyone with a conscience. Notwithstanding this tussle, fact is, political neutrality has its benefits. Cast so, sport becomes an avenue for engagement among people when other options more easily lost to politics, are exhausted. Neutral sport is an important instrument in humanity’s tool box. It brings us to the question: what if you have a grievance but don’t protest? What if you let your performance in sport, do the talking instead?

Jesse Owens is among the biggest icons of the Olympic Games. He came up the hard way. Although a successful university athlete, he had to live off campus with other African-American athletes. He enjoyed no scholarship and worked part time jobs to pay for his education. On May 25, 1935, at the Big Ten meet in Michigan, he rewrote three world records and equaled another in a span of 45 minutes. Next year he won four gold medals at the Berlin Olympics. The world sat up and took note. However on return home, his life continued to be a struggle. He had difficulty finding work given the social environment of that period. He filed for bankruptcy in 1966, hitting rock bottom before his predicament improved. Despite his personal struggles, he didn’t initially support the protest on the podium at the 1968 Olympics (according to Wikipedia’s page on Jesse Owens, he became more sympathetic of the incident, later); he tried to convince President Jimmy Carter that the US shouldn’t boycott the 1980 Moscow Olympics as sport is politically neutral. Yet eighty four years after the Berlin Olympics, with more sterling performances by athletes to show and more social fissures and inequalities added worldwide, we are left wondering: will Olympic triumph alone suffice to focus the world’s attention on social justice delayed or do we need to sport a black band on prime time as well? How different is 2020 from 1936? Or is it not different at all? If things haven’t changed significantly, what kept it so? Those are the questions. The answers won’t be easy for IOC or anyone, to handle.

On June 14, 2020, Global Athlete – it calls itself “ an athlete-led movement that will inspire and lead positive change in world sport, and collectively address the balance of power between athletes and administrators” – put out a statement claiming that recent statements of the IOC and the International Paralympic Committee (IPC) proposing banning of athletes who take a knee in solidarity with the anti-racism movement, constitutes “ a clear breach of human rights.” The statement which said that the “ collective voice” of athletes had “ pressured the IOC to pivot on its position and now consult with athletes on Rule 50,” also called upon the IOC and IPC to abolish the rule.

(The author, Shyam G Menon, is a freelance journalist based in Mumbai.)

THE SUNSHINE VITAMIN

Illustration: Shyam G Menon

Few things encapsulate the relevance of the outdoors as vitamin D does. It has been aptly called the sunshine vitamin. When human life recedes indoors – as it has in recent times dominated by work and workplace, sedentary lifestyle and growing atmospheric pollution – we turn our back on sunshine. In India, that should provoke thought because we were already a population associated with vitamin D deficiency. This blog spoke to two doctors who lead an active lifestyle for an overview of the role vitamin D plays in our life:

“ In the basket of vitamins, vitamin D is an important one. Yet ironically, it isn’t strictly a vitamin. Vitamins cannot be produced by the human body. What we call vitamin D is more a hormone. Thereby, it is the only vitamin, which can be produced in the body,’’ Colonel Muthukrishnan Jayaraman, an endocrinologist with the Indian Army and a regular runner, said. The main role of vitamin D is in bone mineralization and calcium metabolism. Research has shown that vitamin D has receptors in many cells. It has an anti-cancer role; cancer can get out of control in cells that are deficient in vitamin D. Although not yet established beyond doubt, vitamin D is believed to influence immunity. Deficiency in vitamin D can lead to inflammation and autoimmune diseases. Further, there are connections between vitamin D levels and diabetes.

In general, nutritionists advise a Recommended Dietary Allowance (RDA) of 600 to 800 units of vitamin D (600 being for those up to the age of 70 years; 800 for those above 70). Over time, the body needs more vitamin D. There is also an optimum level of 30 nanograms per milliliter, assigned for vitamin D in the blood. Below 20 nanograms is deemed deficient. Above 30 is good for bone health. However, above 100 is toxic. “ Between 30 to 100 nanograms – that is what we need. There has been a recommendation that the RDA be more,’’ Col Jayaraman said. The body gets vitamin D through synthesis and supplementation. In the latter, sources of vitamin D include select fishes and egg. “ Some of the food items we turn to for vitamin D are expensive. But we have an inexpensive avenue to process vitamin D in sunlight. The sun’s ultraviolet B (UVB) rays affect cholesterol in the skin cells and provide the energy for vitamin D synthesis. It is generally noted that the sunshine available between 11AM and 3PM works best for this purpose. The recommended period of exposure to sunlight is 15-20 minutes. You can expose as much of your skin as you wish. Don’t go overboard. Excessive exposure, prolonged exposure – these can be counter-productive. We are all familiar with the sensation of sunburn. At about the point of being sunburnt, you may conclude that you have done enough to synthesize a month’s worth of vitamin D. That is a practical thumb rule,’’ he said.

The population of South Asia – including India – is generally deficient in vitamin D. This has been attributed to the darker skin of the region, which is not very efficient at vitamin D conversion. The predicament has been compounded by acquired habits like excessive use of sunscreen (especially brands sporting high PF value) and emergent environmental problems like atmospheric pollution. “ A study from Mumbai last year showed that almost 80 per cent of the survey sample was deficient in vitamin D. There was another from North India, which showed deficiency of 15-30 per cent. Deficiency was higher in urban areas and less in rural areas. It betrays the impact of lifestyle and varying degrees of exposure to sunlight therein. However what should worry us in India is that even solders and farmers, who are generally associated with greater time spent in the outdoors, have vitamin D deficiency,’’ Col Jayaraman said. Further, contemporary lifestyles are not helpful for vitamin D production. “ Modern day life has grown progressively sedentary and courted the indoors. We don’t indulge in sports; we spent less time outdoors. What we should note is that the risk associated with fair skin – that of excessive exposure to sunlight causing skin cancer – is not high in the Indian context, ‘’ he said.

“ Vitamins refer to a group of nutrients which are not synthesized by the body and are required in small amounts through dietary sources. In Latin, vita means life. Vitamine was the original word as Thiamine was the first vitamin to be discovered. At that time it was thought that all such nutrients would be amines (they are organic compounds which contain and are often actually based on one or more atoms of nitrogen). The amine angle wasn’t found to be true.  So the `e’ in vitamine was dropped to de-emphasize the amine reference,’’ Dr Pravin Gaikwad, a pediatrician based in Navi Mumbai, who is also a runner and triathlete, said.

Vitamins are micronutrients necessary for cell function, growth and development. There are 13 essential vitamins required for the body to work properly. Vitamin D, through a historical accident, became classified as a ` vitamin.’ It is produced in the human body. It is absent from most natural foods except certain fish and egg yolk. Even when it’s obtained from food, it must be transformed by the body before it can do any good.  It’s actually a fat soluble pro hormone steroid that has endocrine (hormonal) and extra hormonal functions. Hormonal function is involved in calcium homeostasis and extra hormonal function is related to genetic mechanisms required in cell multiplication, differentiation and death (apoptosis). The dietary sources of vitamin D are oily fish such as salmon, mackerel (100 gm gives 1006 units); cod liver oil and egg yolk (100 gm egg yolk offers 218 units of vitamin D; each measure of egg yolk is approximately 18 gm, so 5-6 eggs would be required). Red meat and animal liver supply negligible amounts of vitamin D.

Illustration: Shyam G Menon

The main raw material for vitamin D is sunlight. Therefore, it is also known as the sunshine vitamin. The recommended requirements are: adults up to 70 years – 600 IU per day, beyond 70 – 800 IU per day. Vitamin D has been found to regulate the expression of almost 900 genes involving calcium phosphate metabolism, immune system and brain development. It is well-known that vitamin D deficiency causes rickets in children and osteomalacia (softening of bones) in adults. It also aggravates osteoporosis. Further, vitamin D deficiency causes chronic muscle pain and muscle weakness. Several observational studies have demonstrated the association between robust levels of vitamin D and reduced mortality and the risk of developing certain types of chronic diseases.

“ Vitamin D has been found to be important for physiological functions such as muscle strength and neuromuscular coordination. Deficiency may lead to increased risk of falling, especially in the elderly. This vitamin’s role in preventing development of colo-rectal cancers, breast and prostate cancers has also been observed. Vitamin D’s role in brain development and function has been a subject of study lately. It has been found to be so crucial that it is also regarded as a `neurosteroid.’ Further, it has been documented that vitamin D can influence fundamental processes for brain development in the embryonic brain. The influence of vitamin D is also suggested in complex planning and formation of new memories. Vitamin D deficiency could be responsible for the patho-physiology of schizophrenia,’’ Dr Gaikwad said.

As said earlier, the main raw material of vitamin D for human beings is sunlight. It is derived through the photo conversion of 7 dehydrocholesterol to cholecalciferol (vitamin D3) in the skin by UVB radiation – 299-310 nm – following exposure to sunlight. The amount of vitamin D produced depends on several variables like environmental factors, personal variations and personal habits. The environmental factors include latitude; season, time of day, weather conditions, amount of air pollution, natural ozone layer and surface reflection. Personal variations include skin type; age and obesity. Habits include sociocultural habits like clothing and religious preferences, lifestyle, workplace and sun avoidance-practices like using sun block. Exposing the whole body to UVB radiation inducing a light pink color for 15-20 minutes will prompt production of up to 10000 IU of vitamin D. As per the Endocrine Society’s clinical practice guidelines, vitamin D deficiency in blood is less than 20 ng/ ml; insufficiency is 21 to 29 ng/ ml and sufficiency: 30 – 100 ng/ ml. “ Over 50 per cent of the world’s population and around 75 per cent of the Indian population is supposed to have insufficiency or deficiency of vitamin D,’’ he said.

The solar radiation between 11AM to 3PM is maximally helpful for vitamin D production. Over 7AM to 11AM and 3PM to 7PM, the radiation is around 40 per cent of what you get at the earlier mentioned time. “ It’s obvious that most of us (including children nowadays) are not outdoors at the time of peak exposure,’’ Dr Gaikwad said. According to him, a study published in 2018 from Pune indicates that men in western India, living in an urban setting at 18.5 degrees north and having dark skin, required over one hour of casual sunlight exposure to the face, forearm and hands (15 per cent of surface area) between 11AM and 3PM or scaled equivalent time to maintain vitamin D level above 20 ng / ml and 2 hours for 30 ng / ml.

Challenges to proper vitamin D synthesis include: increased air pollution, which makes solar radiation available less on the planet’s surface and the thinning of the natural ozone layer, which actually helps with getting radiation but is found to increase incidence of skin cancer. To note further is that it is direct sunlight and not reflected sunlight from surfaces (of buildings) which has maximum UVB for vitamin D production. “ We Indians have skin type 5 (Fitzpatrick type 5) due to which we are able to produce less vitamin D compared to lighter skins. However, the same factor plays a favorable role in preventing skin cancers,’’ Dr Gaikwad said (according to Wikipedia, the Fitzpatrick scale was developed in 1975 by Thomas B. Fitzpatrick as a way to estimate the response of different types of skin to ultraviolet [UV] light. Type 5 is described therein as: very rarely burns; tans very easily).

The older one’s age, less is the skin thickness. That leads to decreased capability for vitamin D production. With incidence of overweight and obesity increasing alarmingly, cases of vitamin D deficiency have also increased because vitamin D available in the blood reduces as it gets deposited more in fat cells. Sociocultural habits like clothing also makes production of vitamin D that much more difficult. Our present day lifestyle and workplaces offer no outdoor exposure during the peak hours. Sunblock with SPF 15 and more reduces UVB penetration by more than 95 per cent. High fiber phosphate in the diet makes calcium in food less available for absorption. Low calcium in diet exhausts vitamin D stores fast. Finally, in South Asians, there is a gene which may also contribute to low body stores of vitamin D by activating its turnover thereby exhausting its stores, Dr Gaikwad said. Generally, we get around 10 per cent of vitamin D from food and the rest from the sunlight. In August 2018, FSSAI allowed fortification of food with vitamin D. Certain milk brands are now fortified with vitamin D. It is also pushing for the fortification of oils.

There’s no evidence to suggest that very high doses of vitamin D can prevent or treat COVID-19 and that individuals with limited access to sunlight should consider a supplement, a British Medical Journal (BMJ) report on nutrition, prevention and health has stated, Dr Gaikwad pointed out.

Illustration: Shyam G Menon

Immunity depends on many variables of which sunlight is just one factor. If we maintain a healthy lifestyle – meaning thereby proper nutrition, exercise (at home in the present pandemic situation) and adequate sleep – and ensure ways to withstand the stress of modern life, immunity would not be compromised. In general, given that modern lifestyle demands we be less exposed to sunlight, vitamin D production would obviously be less. The best option seems to be to monitor the blood levels of vitamin D and take supplements, if necessary. Vitamin D is a fat soluble vitamin (not water soluble like vitamin C and B complex vitamins). It remains stored in the body for a long time and does not get excreted if taken beyond required levels. In Nordic countries, where the winter lasts for a long time, blood vitamin D levels are known to fall by only 20 to 40 per cent. “ If lockdown extends for a long time, a blood test to check vitamin D levels – especially in the elderly population above 70 years of age – may be considered,’’ Dr Gaikwad said.

The risk of taking very high doses of vitamin D is vitamin D toxicity. As it is a fat soluble vitamin, vitamin D accumulates in the body gradually and shows symptoms of hypervitaminosis D after a few months, which are largely reversible but may cause kidney damage and calcium deposition in arteries. So it is always recommended to be taken under medical guidance with monitoring of blood levels, if necessary.

(Compiled and edited by Shyam G Menon, freelance journalist based in Mumbai.)