COMING UP: SPORTS AS PART OF CURRICULUM

Illustration: Shyam G Menon

It is a good move but keeping a few concerns in mind wouldn’t hurt

If you take the typical Indian school and college education, there won’t be a day that passes by without emphasis on academics. In the glaring divide between curricular and extra-curricular activities, the latter – even if it contributes more to shaping an individual – is distant second. You may excel at arts and sports but it counts for little, except a sprinkling of grace marks. There is also this angle of how close to academics and bolstering its luster, your chosen interest is. Things literary agree with the Indian mind. As do music and dance, if they happen to be the classical sort. Cultural tastes that are more freewheeling or innovative, and sports – they don’t count as much.

Indeed the best way to sell sports in India is to highlight how the active life helps overall, including in studies. Needless to say, back in my school and college days, someone good at sports typically meant either an average student or a straggler in academics bailed out by grace marks. It was rare to find a combination of academic excellence and excellence at sports. For a long time, we justified the academics heavy approach on the grounds of India being a third world country where career took precedence. Now however, the continued justification reeks of conservative mindset.

Liberation from this academics-centric approach has been the dream of many Indian students. Even present day parents should agree because the number of middle aged adults and senior citizens who can convincingly say that they discovered what they are and got around to doing what they like to do, are few. Maybe none of us will ever really know that. But it remains one of life’s great quests and if great quests and questions are what education is all about, then, teaching you to discover yourself and become what you think you can be (or what all you can be), should be the purpose of going to school and college. Sport is an important tool in this journey. It tells you much about what you are the first time you rendezvous with it; it goes on to tell you what you are capable of as you train and improve. By what yardstick can you say this isn’t education? Media reports of June 11, 2020 quoted the Union Minister for Sports, Kiren Rijiju, saying that sports is set to become part of educational curriculum. It was encouraging news. The details of government policy in this regard, are still not known. But viewed as promised move, it hints of benefits.

Besides introducing young people to sports and putting sports on a more even platform with academics, it should provide job opportunities and job security to those specialized in physical education and coaching. Amidst the COVID-19 lockdown, Kolkata-based newspaper, The Telegraph, had carried an insightful article on the plight of those teaching non-core subjects at school, sports being one. When things shrink to essential (as in lockdown), like a drowning man reaching for a log, the Indian imagination of education instantly grabs academics to stay afloat. The rest become dispensable. If sport is part of curriculum, such injustice to the ` dispensable’ may become rare. Given the benefits of the government move can be imagined, let me focus on a couple of concerns. After all, good policy reserves vision to address concerns as well.

Illustration: Shyam G Menon

For most people Brie Larson is the actor who played Captain Marvel on screen. In 2017, she directed a film called ` Unicorn Store.’ Three years later, it was among films I watched during the COVID-19 lockdown. What made me click on the film when it showed up on Netflix was the presence of Joan Cusack in the cast. She is a wonderful actor. As it turned out, I found nothing remarkable about the movie. But towards the final quarter, there was a stunning piece of dialogue from Cusack’s character, addressed to her daughter played by Larson; it went: the most grown up thing you can do is fail at things you really care about. I will remember Larson’s directorial debut for that single sentence, which encapsulates an approach that is the abject opposite of what the Indian education system drills into you. Here it is all about success and winning; to the extent, very few venture into unfamiliar territory including what they actually care about. Perpetuated across the years and imposed on large populations, this authors a mental trap. It skews the imagination towards certain priorities as though nothing else matters. This tenor is present in the Indian interpretation of sport too. I never forget what I once saw at the swimming pool of a housing society. A child, who was clearly hydrophobic, being shamed in front of others by his coach as the parents watched approvingly.

In India, the drive is to excel; not become comfortable with what you are doing as prerequisite to decide in due course, how you would like to navigate further.  A good example is the popular positioning of the Olympic Games as elite aspiration in sport. That is premature strategy when exploration of sport hasn’t happened yet at the required breadth and depth in India, a country of 1.3 billion people. It is the potential panacea for this predicament, which we see in the government move to make sport part of educational curriculum as well as the realistic assessment that the 2028 Olympics and not the earlier editions would be practical goal to improve medals tally. Still if you foray with Olympics as direction, you risk putting people off through excess evangelism of one sort and search for suitable talent. Instead, can you make young people fall in love with sport? Can you make them love it such that they don’t mind failing at activities they care about and come back for more?

Opening up young minds to the myriad possibilities indulging in athletics or playing a game offers, is an engaging task. Some won’t have a mountain to climb; they are already so good that all they need to do is slide into the lake of success. It is a coach / teacher who works with average talent and takes them places that you should applaud, not the ones making a beeline to train the best primed talent.  India has too many teachers / coaches of the latter sort; it is also what parents endorse. So you see, before we make tall claims for the future, there is a way of looking at human beings that has to be put in place. Without it, we risk doing to sports what we have already done in our mainstream academic education. One approach worth mentioning in this regard is India’s amateur running movement. Except some from the corporate category who are forced into it because it is the in thing to do at offices, amateur running is a personal choice. It is also a conscious choice because for many, it is an option exercised in midlife. There is no compulsion; no coercion. Yet the performances returned by Indians in their thirties, forties and fifties – long past the energy of school and college – has been fantastic. There are now several people running sub-three marathons from these age groups and in 2019, we had the first Indian finisher in a 555km ultramarathon at altitude. Marathons and ultramarathons are not for school and college. Point is – isn’t there something for educational curriculum to learn from these cases of results gained through affection for something and not, compulsion to do it?

Second, not everyone will be good at sport. There will be those whose wiring is different. There will also be those whose wiring is neither for academics nor sports. If the intention of making sports part of the curriculum is to treat these segments the same way those inclined to sport were once treated, then, you are not educating. You merely author one more reason to rank youngsters into winners and losers. Under education, we must all be helped to find ourselves and our capabilities. Sport – and academics – should not be put on a pedestal. It must be there at the same level as any other potential, resident in the human being.

Illustration: Shyam G Menon

Finally, there is the issue of a blindness upon us that isn’t for want of eyes but happens because we block vision with our insularity. In sport, there is an insularity born from world view by nothing but athletic prowess and the disciplined focus which goes into accessing that prowess. When everything is focused on performance, the mind becomes dull to so many things that are critical to keeping us aware overall. That is when like art hijacked for propaganda, sport degrades to being an appendage in service of other goals, political ideology and image building being examples. Mass displays of athleticism and physical coordination – the sort seen at certain giant ceremonies – also betray this tenor. Just like money is no guarantee of brilliance and some billionaires have uttered the most stupid things, pursuit of sports holds forth promise of awareness; it does not guarantee it. If you want a mind that is conscious of existence and responds consciously, then introduction to sport and one’s rooting in it has to be an experience immersed in appreciation of freedom. Individual and freedom – these are the two fundamental building blocks of awareness. That’s why the swimming pool episode matters – that little boy’s sense of individual was crushed; forced to perform and conform he would have also lost his appreciation for freedom. Instead, doesn’t he deserve the chance to overcome his fear of water, fall in love with it and find out if a swimmer lives in him?

It is this author’s personal opinion that notwithstanding instances of excellence produced, India’s mainstream academic education has contributed little to overall awareness and appreciation of existence. We are like foot soldiers following set recipes (all reform seeks to do is replace one curriculum with another). We shouldn’t repeat the same mistake in sport. Sport should set us free.

(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.)

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.)

LOCKDOWN & ME / SIGNS OF LIFE

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.)

MAY THEN, MAY NOW

Haseeb Ahsan, Dona Ann Jacob and Clifin Francis (Photo: courtesy Clifin)

It was to be an enjoyable journey on bicycle across a few countries. But the virus decided otherwise.

May 2018, Clifin Francis was on a bridge connecting Azerbaijan and Georgia. The cyclist had officially exited Azerbaijan at one end when Georgia on the other side, denied him entry. Trapped on the bridge in no man’s land, he was saved by a small, unexpected gesture. A German cyclist who crossed the border just ahead of him left him a local SIM. With that installed in his phone, he first contacted the Georgian embassy in Baku for help and when nothing came of that, he applied for an e-visa to return to Azerbaijan. It was night by the time he was admitted back into the country he had left. “ The experience taught me patience,’’ Clifin would tell this blog some six months later in Kochi. The bridge episode had been part of his journey, cycling from Bandar Abbas in Iran, to Moscow in Russia, for the 2018 FIFA World Cup.

May 2020. This time there isn’t any no man’s land to worry of. Clifin is well within the boundaries of India, albeit a long way off from his home state, Kerala. Along with two other cyclists – Dona Ann Jacob and Haseeb Ahsan – the freelance mathematics teacher is at Asha Holy Cross in Agartala, an organization engaged in social work. The trio had started out from Kochi on December 15, 2019; their plan was to cycle from India to Japan and be there in time for the 2020 Tokyo Olympic Games.  A report in the New Indian Express dated November 30, 2019, said that Haseeb, who is based in Bengaluru, had met Clifin in 2018 at the FIFA World Cup in Moscow while Dona, who is based in Mumbai and worked in Mexico, had backpacked in Mexico and Guatemala and cycled 1000 kilometers around Cuba. Their route (as per the New Indian Express report) was to take them from India to Bangladesh, Myanmar, Thailand, Laos, Vietnam and China before catching a ferry from Shanghai to Japan. “ We should have been in China now,’’ Clifin said, May 27 from Agartala in Tripura, where the trio had reached after cycling through Kerala, Tamil Nadu, Karnataka, Andhra Pradesh, Odisha, West Bengal and Bangladesh. With India under lockdown, they have been stuck in Agartala since mid-March.

Roughly a fortnight after the trio commenced their journey from Kochi, China reported to the World Health Organization (WHO) of a cluster of cases of pneumonia of unknown cause, in Wuhan. That date of reporting to the WHO – December 31, 2019 – is generally treated as official start of the COVID-19 pandemic, which then proceeded to paralyze normal life in many countries (it has since been reported that the earliest cases in China likely go back to November 2019). In the initial stage, the difficulty for everyone was with regard to properly gauging the disease outbreak – what is it; will it be contained and extinguished, will it spread? Nobody really knew. The world celebrated the intervening New Year with usual enthusiasm. By January, 2020 the three cyclists were aware of the situation evolving in China. They had a long stint of cycling to do there in order to reach Shanghai. So it was a concern. “ But we pushed on nevertheless because we thought things would improve,’’ Clifin said. Further, the immediate world around them was still normal although on January 30, India reported its first case of COVID-19 (a student in Kerala, who had returned from Wuhan). The trio planned to enter Myanmar from Northeast India. To save time and distance, they crossed from West Bengal to Bangladesh for further passage to Tripura. When they were in Dhaka, the first reports emerged of COVID-19 in the city.

Illustration: Shyam G Menon

By now, there was uncertainty over the Olympic Games as well. Japan was among countries affected by COVID-19 and in a mass gathering like the Olympics, visitors come from many countries, several of those already impacted by virus. Further on March 11, the WHO declared COVID-19, a pandemic. The number of cases was also slowly picking up in India and the disease claimed its first victim in the country on March 12. Question marks were now weighing down the bicycle journey. Proceeding on from Dhaka, the trio reached Akhaura, the border crossing between Bangladesh and the Indian state of Tripura. It is less than ten kilometers from Agartala, the state capital. They crossed into Northeast India on March 17. From the border crossing, they were taken in an ambulance to the government quarantine facility in Agartala. Seven days later, on March 24, the International Olympic Committee (IOC) announced postponement of the 2020 Tokyo Olympic Games to a date beyond 2020 but no later than the summer of 2021 (it has been rescheduled to July 23-August 8, 2021). Same day, midnight onward, India entered the first phase of a nationwide lockdown that has since been extended and was in its fourth phase at the time of writing.

Its website says that the Association for Social and Human Advancement (ASHA) was registered as a social service society in 1999. It is the official development wing of the Society of the Fathers of Holy Cross, Northeast India. After completing their quarantine at the government facility, the three cyclists shifted to Asha Holy Cross. They have been helping the organization with some of its charity work; they assist in making masks and packaging food for distribution. The organization has taken care of their food and stay. Asha Holy Cross also became shelter for a Spanish lady cyclist who met the trio at the government quarantine facility; on May 25 Hindustan Times reported that Yesenia Herrera Febles had left for Delhi by train to catch a relief flight back to Spain. “ I am hoping things ease up some more from June first week,’’ Clifin said. Flying home to Kerala with bicycles for baggage will be expensive. “ You have to first fly to Kolkata and then from there to either Hyderabad or Bengaluru before catching a flight to Kochi. Train will be cheaper but about as complicated in terms of connections. I don’t think there are any direct trains from the Northeast to South India at this point in time. Hopefully we find more options in June,’’ Clifin said. An IT engineer who once worked with Tata Consultancy Services (TCS), Clifin had resigned his job and become a freelance mathematics teacher after the travel bug got to him. Given COVID-19, the institute he taught at in Kochi has closed down. He is looking for online teaching assignments.

Clifin Francis (Photo: Shyam G Menon)

Aside from figuring out a way to get back to Kerala, what bothers is the altered reality cyclists now confront. Riders like him, who travel long distances on their bicycle, count on the hospitality of people along the way. Theirs is not a race (competition is what most people live to court) but a way of seeing and knowing the world. The bicycle keeps you mobile but unlike motorized vehicle, it proceeds at an unhurried pace and keeps you in communion with the surrounding environment. You carry your own camping gear and live independently or you find cheap lodgings or you stay at the houses of those who take you in. You halt and hang around if a place engages your interest. “ People are a part of the journey,’’ Clifin said. It is possible that such human equation has been altered by the virus. Wary of catching infection, the old goodwill and warmth people had for travelers, may have ebbed, adversely impacting models of cycling like the one Clifin loves. It will be some time before the world is back to being as relaxed and welcoming of people as before. “ I think it will take time,’’ Clifin said.

(The author, Shyam G Menon, is a freelance journalist based in Mumbai. Please click on this link for an account of Clifin’s 2018 bicycle trip to Moscow:  https://shyamgopan.com/2018/11/30/football-with-a-difference-the-fan-who-cycled-to-moscow-for-fifa-world-cup/ Please click on this link: https://www.instagram.com/snails.on.wheels for the cyclists’ Instagram handle.)        

COPING WITH THE MASK

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.)

CYCLING / AMID LOCKDOWN, AN EXAMPLE FROM BENGALURU

Illustration: Shyam G Menon

Late April 2020, authorities in Bengaluru formally approved cycling as a means of transport during lockdown. Here’s how it happened:

An erstwhile technology worker currently active in public policy related to mobility solutions, Sathya Sankaran is Bengaluru’s Bicycle Mayor.

It is an honorary position awarded by a NGO called BYCS in the Netherlands. Its website describes BYCS as “ an Amsterdam based-social enterprise driven by the belief that bicycles transform cities and cities transform the world.’’ Volunteers apply for the post of bicycle mayor; they are screened, selected and appointed. There are around 100 bicycle mayors worldwide at present, including in several Indian cities.

As the city most representative of the IT boom that followed economic liberalization, Bengaluru sits in an engaging matrix. It combines old world charm and a wealth of educational and scientific institutions with the subsequently emergent trends of skilled, well-traveled workforce and the ideas they gather from various parts of the world. The city is one of the major hubs of the active lifestyle in India. It has a large community of cyclists, a regular calendar of races and is among the bigger bicycle markets. All that ground to a halt when lockdown set in. Along with the rest of the country, whatever norms for transport amid lockdown applied in Bengaluru, concerned motorized transport. “ It was extremely disappointing to find that there was no mention of the bicycle in directives from the Union Ministry of Home Affairs. They issued specific guidelines on how to be out in cars and on motorized two wheelers; there was nothing similar about bicycles. In the absence of specific mention of the bicycle in protocols issued, people were hesitant to take their cycles out for permitted outings like purchase of essentials. It was a case of nobody objecting but permission not specifically granted,’’ Sathya said. He wrote to the Home Ministry. Till the time of speaking to this blog (May 23, 2020), there hadn’t been any response.

Sathya’s first initiative during lockdown was a concept called ` Relief Rider’ under which, volunteer cyclists delivered medicines and groceries to senior citizens in various parts of the city. Relief Rider commenced operation on March 29. There was a phone number provided for people to call up and inform of their requirement. The cyclists brought the consignment to their doorstep. Within a month to month and a half, 75 cyclists under the program had pedaled over 1600 kilometers; a figure that can also be viewed in terms of that much less motorized vehicles used and pollution avoided. The program was tangible evidence to authorities on the merits of having a community of cyclists. It was time to take things a notch higher. Dr Arvind Bhateja is a prominent neurosurgeon in Bengaluru and Medical Director of the city-based Sita Bhateja Speciality Hospital. A keen cyclist, Dr Bhateja came to Sathya with a campaign called ` Reset with Cycling’ under which, the duo decided to submit a proposal to authorities recommending a few measures. Its gist was the following:

  • Declare bicycle shops and associated businesses like bicycle repair and maintenance, as essential service.
  • If authorities can allow people to walk during lockdown, then they should be willing to accept the use of bicycle as well.
  • Major shopping avenues should be closed to vehicular traffic and opened only for walkers and cyclists in the interest of maintaining physical distancing.
  • Create roughly 57 kilometers of bicycle lanes across four major transport corridors in the city.

Sathya Sankaran (Photo: courtesy Sathya)

The website of ` Reset with Cycling’ introduces itself as a collective effort to revive cities post-lockdown. “ Let’s not go back to old habits. Let’s use the bicycle to reduce traffic, stress, improve health, air quality and renew our cities. Build a city for our children,’’ the website said. Sathya put the recommendations submitted, in perspective. Physical distancing has been identified as a major tool to combat spread of COVID-19. It is difficult to enforce it in public transport. That may serve as incentive to bring back private cars. In the months before lockdown, Bengaluru was notorious for its traffic jams while cities like Delhi and Mumbai experienced high air pollution levels. On the other hand, cycling allows for transport with physical distancing factored in; it is also healthy being a form of exercise. Further, when frenzied human activity on the planet temporarily ceased due to lockdown, the quality of air improved almost everywhere. “ In Bengaluru, pollution levels were down by 50-75 per cent. If upon relaxation of lockdown, we revert to world as it used to be and bring back motorized vehicles in strength, then we lose whatever gains we made,’’ he said.

Notwithstanding the merit in the proposal made by Dr Bhateja and Sathya, approval for it hinged on those in authority being sufficiently empathetic. Having administrators, who understand new lifestyle trends, helps. According to published news reports, it was in August 2019 that Bhaskar Rao assumed charge as the Police Commissioner of Bengaluru. He is a cycling aficionado. On April 25, 2020, Rao was shown the proposal submitted by Dr Bhateja and Sathya. That same day, he sanctioned permission for cyclists to be out on city roads. Authorities are studying some of the other recommendations. The Police Commissioner’s decision was welcomed. “ I don’t recall any opposition from the public to the move or reluctance to embrace it. During lockdown there had been mental issues and domestic problems. Cycling provided a means to gain relief from all that besides addressing practical transport needs,’’ Sathya said.

Meanwhile in some other parts of the world – as reported earlier on this blog – the pandemic and its subsequent need for physical distancing fueled steep rise in bicycle sales. Realizing that public transport would be challenged to offer physical distancing and not wanting a complete return to the earlier paradigm of motor vehicles and air pollution, some foreign governments have unveiled bicycle-friendly policies and investments to improve cycling infrastructure. Sathya said he has more plans for Bengaluru.

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

AFI ISSUES STANDARD OPERATING PROCEDURE FOR ITS ATHLETES, COACHES AND SUPPORT STAFF

Illustration: Shyam G Menon

The Athletics Federation of India (AFI) has issued Standard Operating Procedure (SOP) for AFI athletes, coaches and support staff at the national camps. The SOP has been prepared with focus on the current environment characterized by pandemic (COVID-19). While issuing the SOP on May 18, 2020, AFI noted alongside that although as of that date, there have been relaxations in the rules and regulations of the ongoing nationwide lockdown, athletes, coaches and support staff are strictly advised to remain inside the protected environment of national camps at Patiala and Bengaluru.

Besides the SOP, the periodic guidelines issued by the central and state governments must also be followed. “ The re-opening of training facilities including outdoor training and weight training will be as per the programme schedule circulated by the Chief Coach,’’ the circular on SOP, available on the website of AFI, said.

According to it, athletes should not go for training if they have any flu-like symptoms such as sneezing, coughing, difficulty in breathing, fatigue etc or if they have been in close contact with someone who showed above-mentioned flu-like symptoms or tested positive for COVID-19 in the past 14 days. They should inform the Chief Coach / Deputy Chief Coach or HPD about any sickness or if they have come in contact with any sick person. They should not also go for training if the training has been cancelled by the coach or center in-charge due to unavoidable circumstances.

Before they go for training, athletes should be aware of their timings for outdoor training and weight training session; they should speak to their coach, group athletes before leaving their room so that everyone is present at the venue on time and there is no delay. They should leave their room exactly five minutes before their scheduled training. Use of disposable gloves by athletes is highly recommended. For relay athletes practising baton exchange, use of hand gloves is mandatory. Athletes should always wear full sleeve T-shirts, tights and shirts whenever they step out of the room

During training they should maintain a safe and isolated distance of minimum two meters from others while walking to the training ground and during the training. They should carry their own water bottle, energy drink etc. as well as their own personal hand sanitizer, paper napkins, towels. They should not exercise / train / walk in groups; they should not take the help of other athletes / coaches. They should not shake hands or hug other athletes, coaching staff members and at any point of time if they feel ill, they should immediately report to their coach, support staff. Athletes should avoid using public toilets as far as they can; they should not sneeze or cough without covering their mouth and nose. They should not spit on the ground. They should always use dustbins to throw any waste such as empty water bottles, paper napkins etc. They should not call any person from outside to the training area or en route to training area / hostel / dining hall.

After training, they should apply their own personal hand sanitizer. They should check their belongings carefully and make sure it has not been touched by others. Similarly, they shouldn’t touch anything that does not belong to them. They should go back to their hostel room as soon as their training is over and not hang around in groups. They should take shower immediately upon reaching their room put used clothes for washing and not wear the same clothes after shower. Sauna / ice bath facilities will not be available during the restricted training phase. They should relax and re-asses their health after sometime, report to their coach or administration immediately if they feel sick. They should keep their personal hygiene level high at all times, not take on mental stress and keep in touch with their families, friends remotely through mobile phones, video conferencing.

Referring to safe use of exercise equipment, the SOP said that athletes should use such equipment cautiously. All handheld implements should be sanitized prior to and after use e.g. shots, javelins, discus etc. Upon conclusion of training, equipment should be cleaned with a disinfectant spray. “ Although there is no specific evidence that equipment can spread COVID-19, we know that contamination from respiratory droplets from an infected person can potentially survive on hard surfaces for up to three days,’’ the SOP said.

On coaches, the SOP noted that respective coaches will be responsible for maintaining social distancing. Clean and disinfected equipment should be used during training sessions and the supply and requirement of disinfectants must be reported in time to the Chief Coach. “ The coaching sessions following proper protocol will be supervised by Chief Coach, Deputy Chief Coach & High-Performance Director,’’ the SOP said adding that persons other than those already in the camps are strictly barred from access to the training area.

As for dealing with the outside world, the SOP said that social distancing should be maintained at all times. Athletes must try to clean their rooms themselves and not leave their hostel rooms except for training / medical / rehab purposes. Visit to barbershops /saloons / beauty parlors / shopping malls is strictly prohibited. They should not eat outside or order food parcels. They should wear a mask before leaving their room; carry a small bottle of hand sanitizer if visiting ATMs and use sanitizer after operating the ATM machine. They should avoid touching parcels / letters delivered to them and always sanitize such articles before any contact. They should try not to touch any surfaces and if they do, they should sanitize their hands as soon as possible.

The SOP made it clear that athletes are not allowed to leave the camps. Any leave from the camp can only be sanctioned by the AFI President / Chairman, Planning Committee. Athletes leaving the camp will have to go through 14 days of quarantine before rejoining.

AFI has said that the SOP will be updated and circulated again depending on changes to the COVID-19 control scenario.

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

INDIA WATCHES FROM THE SIDELINES AS PANDEMIC FUELS BICYCLE SALES OVERSEAS

Illustration: Shyam G Menon

COVID-19 and its accompanying need for physical distancing and maintaining good health, has caused bicycle sales to zoom in some countries. Any chance the trend may offer cycling in India, fresh impetus? Unlikely – that is the feedback from the cycling community. But there is hope.

For those into cycling and reading, a series of recent articles in The Guardian, would have been particularly heart-warming.

On May 15, 2020, Matthew Taylor reported in The Guardian that the city’s mayor proposed to close large areas of London to cars so that people can walk and cycle freely when the COVID-19-induced lockdown is eased. It would be one of the biggest car-free initiatives by any city worldwide. The reasons for encouraging walking and cycling: physical distancing would be tough to observe in public transport while the return of cars could precipitate traffic jams and increase air pollution.

Earlier, on May 10, 2020, Sean Ingle wrote in The Guardian about the growing relevance of cycling as mode of transport in a world where COVID-19 is forecast to linger. The resultant need to maintain physical distancing directs us to measured use of mass transport systems. We also seek avenues to stay healthy. It is in this matrix that cycling merits attention. It is viable non-polluting personal transport for short to medium distances. Further, as done by normal cyclists, it is a mild form of exercise satisfying the type of physical activity recommended by researchers as ideal to stay healthy. Ingle’s article mentioned a study by scientist David C. Nieman which helped establish that regular exercise assists in lowering upper respiratory infection rates while at the same time improving immunosurveillance. Also mentioned was a report by the US Surgeon General in the 1990s, recommending exercise as a vital component of preventive medicine. According to the article, Grant Shapps, Transport Secretary of the UK, has promised two billion pounds “ towards plans to double the number of cyclists and walkers by 2025.’’

The next day, May 11, 2020, Miles Brignall writing in the same publication reported that bicycle sales have been booming in the UK. Shares of listed companies in the segment had risen in value and the country’s biggest bicycle retailer had informed that sale of some equipment was up 500 per cent with bike sales itself prevailing at double the normal level. At smaller shops, stocks were running out and some had a waiting period. The article noted that cities around the world were rushing to improve their cycling infrastructure. In Germany, cycle lanes were being expanded and Paris was installing 650 kilometers of cycleways.

A couple of weeks earlier, on April 22, 2020, Justin Landis-Hanley reported in The Guardian that Australian bike retailers were struggling to keep up with booming sales following imposition of restrictions on general life due to COVID-19. The reasons cited ranged from people wanting to avoid infection and therefore staying off public transport, to regular avenues for exercise like gyms and pools being shut and the bicycle suddenly seeming attractive, to the aptness of the bicycle as a combination of exercise and transport in troubled times to simply having more time on one’s hands and therefore taking up a new hobby. The underlying instincts were visible in the sales mix; a considerable portion of bikes being sold belonged to the entry level segment.  The report said that a major worry among retailers in Australia was about exhausting stocks. Replenishing it would be tough as manufacturing facilities in Taiwan and China haven’t yet recovered from operations ceased due to pandemic. Further both the above mentioned articles pointed out that it wasn’t just sale of new bikes that was picking up; business in a range of services associated with cycling – including servicing of old bikes – had gone up.

When India slid into lockdown on March 24, 2020, all forms of transport – save those used for essential services – ground to a halt. There were even reports of people out for a morning walk, penalized by authorities. Flights and trains ceased to operate and automobile sales declined sharply. Yet even as air quality improved thanks to less vehicles being out, one of the early news reports based on equity analysts’ views cited potential recovery in car sales post lockdown, on the basis that the car offered an insulated cocoon for mobility amid contagion. Bizarre as this reasoning is in times of respiratory diseases growing, it is a fine portrait of the Indian approach to life. Needless to say, while the government has recommended specific protocols for using four-wheelers and two-wheelers (all motorized), there hasn’t been any utterance yet on cycling, forget its emergent virtues. In the absence of that and given how lockdown-rules are interpreted at ground level, you hesitate to take your cycle out for shopping and errands. India is among the world’s biggest producers of bicycles but the manufacturers’ lobby too has been strangely quiet. One can’t recall a single public service advertisement taken out amid COVID-19, reminding people of the bicycle’s ability to contribute to health; health of user through exercise and health of others by not polluting.

Illustration: Shyam G Menon

This blog spoke to the country head of a leading international bicycle brand to gauge whether anything similar to what has been reported from UK and Australia, could be expected in India. He confirmed the developments overseas; it featured in business conversations with colleagues abroad. But hoping for the same in India would be premature because the overall matrix governing cycling here remains bicycle-unfriendly. While there was the pet peeve of high duties imposed on imported bicycles, there was also the undeniable fact that India’s crowded, congested ambiance and lack of consideration by motorists for cyclists, continue to make cycling unenjoyable. Sample the following: on May 15, 2020, Times of India reported that despite lockdown (it started on March 24; at the time of writing it was still on) an estimated 321 lives had been lost in 1176 road accidents in India according to data compiled by Save LIFE Foundation, a NGO. When general lack of road safety hits home, it fuels the argument that only cars and similar steel cages on wheels are viable option for transport. Given personal safety trumps concerns for environment and climate change, nobody then has the patience to sample cycling’s virtues. It is a vicious cycle. There is also another angle, which neither the bicycle industry nor cyclists, openly agree to, although in private, they concur. It has to do with the ink of Indian imagination these days – GDP. Viewed through GDP’s prism, the automobile industry’s voice dominates like a foghorn. That of bicycles is a squeak you strain to hear.

According to one senior cyclist, notwithstanding the above mentioned handicaps, the last decade or so has laid the foundation for a cycling movement in India. The choice won’t be driven by supportive cycling infrastructure – that is a role the government may or may not perform. It will be based on informed choice. As paradigm shifts like work from home set in, more of us may consciously choose a healthy, non-polluting form of transport that is light on planet, maintains the physical distancing mandated by COVID-19 and is also more connected to world as compared to the steel cocoon and quick passage of a car. In fact, if life is going to be in and around the house for the near future, why would you congest your neighborhood bringing out your car all the time? So far climate change was a debate. But the days of pandemic, which saw humanity locked up indoors, proved that human activity restrained has the ability to revive nature, restore air quality. There is thus palpable evidence to base your questions to old world on. However the key to promoting cycling – those from this school of thought argue – may not lay in petitioning the central government. “ Local governments will probably understand better,’’ the senior cyclist said emphasizing the need to go local when it comes to promoting cycling. Reportedly, such lobbying has yielded results in the past. Closer to the present, local also makes sense because the relaxation of lockdown will be in line with what zone (based on severity of infection) your area falls into. The seed for change exists in the evidence we experienced due to COVID-19. Question is – will we plant that seed and let it grow?

Update: On April 25, 2020, authorities in Bengaluru formally permitted the use of bicycles during lockdown. 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 author, Shyam G Menon, is a freelance journalist based in Mumbai.)              

“ THE NEW NORMAL DOESN’T FEEL SO BAD TO ME’’ / KILIAN FISCHHUBER

Kilian Fischhuber (Photo: Shyam G Menon)

Kilian Fischhuber is among the most decorated competition climbers in the world. Hailing from Austria and participating in bouldering and lead climbing events, he has the rare distinction of winning more than 20 World Cup events. Having retired from competitions in 2014, Kilian has enhanced his repertoire of climbs. He travels the world in search of routes to climb; in the process he has visited India. Kilian worked for a while as a teacher in Innsbruck. Since end-2019, he has been a national team coach for Austria Climbing. Thanks to this, has been able to train since April 20, 2020 with elite athletes at the gym “ Ki” in Innsbruck, which is also the national training center. They were given special permission. “ We have to maintain strict protocol including distance, number of athletes, disinfection and the like,’’ Kilian said. He spared time to respond to questions mailed by this blog on the new normal in climbing forced by COVID-19. 

Reports have now begun coming from Europe of lockdown relaxation and the resumption of climbing. To your mind, how do we reconcile the need to observe disease related protocols with the sport of climbing? Is this a sport that can coexist comfortably with COVID-19 protocols or do you see climbers being pushed to situations where it is a choice between enjoyable sport and protocol?

We had a serious outbreak of COVID-19 here in Austria. Due to strict regulations, a lockdown and maybe a pinch of luck we avoided a larger mess. Now we see protocols relaxed and some kind of normality return. However, we kind of live under the shadow of a future outbreak and possible repeated lockdowns. Austria Climbing and the Austrian alpine federations worked on regulations for climbers and I hope we can enjoy our sport almost as before, soon. We’ll need more space per person and will have to follow hygiene protocols and use common sense to maintain our reclaimed freedom. As we have no other choice I guess we’ll have to coexist with the new rules. I’ve been climbing since more than two weeks now and the new normal doesn’t feel so bad to me.

If we broadly divide climbing into bouldering, lead climbing and mountaineering, do you see the impact of COVID-19 protocols as being fairly uniform for all these segments or do you suspect that a branch like bouldering, which is generally more social, requiring spotting and capable of climbs over shorter distances may be hit harder?

I’m afraid some will be hit harder than others. The virus definitely does not treat us fairly in any sense. It’s the same with sports. Contact sports or sports where you have to touch others (as in spotting) will see a larger impact. But again, I think with common sense we can live with the new normal.

Can you give us an idea of how a typical climbing session looks like for you these days? There has also been this debate around chalk powder versus alcohol based-liquid chalk for the present times. Which type of chalk do you use?

When I go rock climbing, I climb with my partner Anna. We live in the same household. When we meet other climbers we try to maintain the distance which is usually no big deal. I use normal chalk but I bring hand sanitizer to the crag.

From a 2015 visit to India; Kilian Fischhuber climbing in Badami, Karnataka (Photo: Shyam G Menon)

Indoor climbing gyms are now a major part of the sport. How do you think COVID-19 protocols will affect climbing at these venues? While physical distancing may be possible, frequent sanitizing of surfaces will be a challenge depending on the size of gym. Are there any practical approaches with protocols included, beginning to emerge at climbing gyms in Austria and elsewhere in Europe?

I don’t think it is possible to disinfect climbing surfaces in climbing gyms after each climber. I feel that sanitizing your hands frequently, avoiding contact with others, more space and using face masks is all we can do. If there’s another major outbreak the gyms will be closed again anyways. Our gyms have gradually begun opening last week. First the outdoor walls opened and soon, with new protocols, indoor walls too. What I don’t know is whether it will still be lucrative for gym owners to run large gyms with only few people inside.

What is the general attitude you sense with regard to climbing in the months immediately following relaxation of lockdown? Are people coming out to climb or is there reluctance? Are they waiting to see what protocols to follow at crags and gyms?

The vast majority runs with the protocols. I’ve been rock climbing again since about two weeks (when relaxation began in Austria) and most people I met behaved responsibly and showed understanding.

Who do you think should take the lead in setting health related protocols so that sports like climbing can resume in a safe fashion when lockdown relaxes?

The Austrian Climbing Federation, the alpine federations and the gyms proposed a protocol to the Austrian Health ministry which has been adopted so far. All the decisions are aligned with what health experts from the government propose.

How was the situation like in Austria when the pandemic was at its peak? Were all the major climbing crags and gyms shut?

All gyms shut, nobody went climbing.

(The author, Shyam G Menon, is a freelance journalist based in Mumbai. Please note: the above interview should be seen in the right perspective. It reflects circumstances in Austria, which is very different from the predicament in India, a nation of 1.3 billion people with crowded cities. The interview is presented here to foster awareness and hopefully, contribute to templates for the new normal.)