olympians' most dreaded foes: cold and flu

The issue: Olympians' health while competing in Vancouver this month.
The vocab: Banned performance-enhancing substances ... in the International Olympics Committee's eyes, cold and flu medications are equivalent to doping.

The Olympics are always wrought with controversy over alegations of performance-enhancing substance abuse. While the summer games tend to have higher rates of offenders, the winter games aren't immune from illegal performance enhancement. In Turin's 2006 games only one athlete was busted for using a banned substance. But back in 2002 when Salt Lake City was host, seven competitors were caught - including four medalists, all of whom had to forfeit their prizes.

The International Olympic Committee surely prides itself on rigorously ensuring fair competition through frequent testing and harsh consequences.

But has anyone thought about the negative side effects of such stringent substance bans on the athletes in Vancouver this month?



The New York Times came out with a story today about Olympians' battles with their harshest competitors - The Common Cold and The Flu. Athletes have the triple whammy that increases their susceptibility to illness:

1. Being around millions of people, and being in close quarters with fellow athletes in Olympic Village, increases the chance of transmission.
   
2. Intense physical activity suppresses the immune system, decreasing the body's ability to fight off cold and flu.


3. Athletes aren't allowed to take many of the everday cold and flu meds because of the IOC's strict rules against banned substances. Some cold and flu remedies contain stimulants just like the ones in banned amphetamines - in smaller doses, yes, but still detectable via routine drug testing.

Dr. P. Gunnar Brolinson is a team physician at the Vancouver games, and is the author of a 2007 article published in Clinics in Sports Medicine about the immune-suppressing effects of rigorous exercise. In the NYT article, Brolinson says, "The biggest reason for poor performance at an internation, multisport games is a respiratory infection."

So what we have here is a public health tradeoff - do the risks of acquiring a cold or a flu outweigh the risks of allowing these medications?

Until drug testing becomes sophisticated enough to distinguish between a small dose of cold/flu medicine and a true banned substance, Olympians will have to deal with the regulations by becoming more proactive in preventing illness. Vancouver is literally giving away flu vaccines. Over 40% of the city's residents have been vaccinated, and the Canadian Olympians have set a stellar example for their colleagues, with more than 80% of the Canadian team receiving vaccines throughout the flu season. And I suppose you could go one step further like U.S. cross-country skier James Southam, who admitted to carrying a hospital mask in his carry-on bags just in case one of his co-riders was looking under the weather. But recall the reports from the beginning of the swine flu epidemic: there's doubt that hospital masks protect casual wearers all that much. (Plus it makes you look like a massive dork.)

And what if, despite preventive efforts, a cold or flu begins to emerge?

Old school remedies are the answer, in this case. Lozenges, ibuprofen and antibiotics (if necessary) are perfectly fine. Some Olympians are actually spokesmen for anti-cold remedies - U.S. speedskater (and much hunkier without his ridiculous soul patch) Apolo Ohno has an ad for DayQuil/NyQuil. Both of which are allowed by the IOC.



While it may be tricky for athletes to stay cold- and flu-free during the Vancouver games, the winner of the public health tradeoff is clear: The IOC would much rather risk athletes getting sick than risk allowing athletes an unfair competitive advantage.



[An aside... Chuck Klosterman wrote a fairly famed essay about the Olympics back in 2004 for Esquire magazine. Not public health related, sadly. But as always with this guy, it's a fascinatingly convoluded and hilarious read.]