Two runners died on Saturday after collapsing during the Xiamen International Half-Marathon in East China's Fujian Province, according to a notice issued on the website of the local organizing committee.
"One of the deceased, surnamed Lin, collapsed due to sudden heart failure 4.5 kilometers before the finish line, whereas the other, surnamed Wu, fell down right after passing the finish line," read the notice.
Both runners were given emergency treatment by medical staff carrying automatic external defibrillators (AED) and were immediately sent to a local hospital, where they were pronounced dead, it said.
The notice claimed that medical staff reached Lin within two minutes of his collapse.
The organizers expressed their deep condolences to the runners' families in the notice.
The Xiamen International Half-Marathon, which was originally a spin-off of the annual International Association of Athletics Federations' gold label Xiamen International Marathon, has been operated as an independent race since 2016. The organizers did not demand participants take compulsory physical exams as part of the race registration process, the Xinhua News Agency reported Saturday.
According to a Sunday Xinhua report, a total of 10 competitors in the Xiamen race were sent to hospital, and as of Sunday six of the eight survivors had been discharged.
The two still in hospital are no longer in a critical condition and their vital signs are stable, Xinhua reported.
Shade over the fever
Deaths and injuries have cast a shadow over the booming craze for marathons in China.
According to official statistics from the Chinese Athletics Association, there are 328 marathon events registered with the association as of November 8, while that number was 134 in 2015 and only 39 in 2013. In 2015, as many as 1.5 million runners participated in marathons and half-marathons across the nation.
In the past three years, at least 10 runners have died running long-distance races in China, CCTV reported.
Zhao Shi (pseudonym), who ran a half-marathon in North Korea in 2014, told the Global Times on Thursday that only if you train for at least a few weeks beforehand can you safely enjoy a long-distance race.
His then girlfriend, now wife, participated in the same race without training at all and ended up suffering from drastic soreness the next day, and could barely walk, he added.
A real race, where a crowd is clapping for you and giving you high-fives is much more exciting than lonely training runs, and you may be tempted to push yourself too hard, Zhao explained.
Counter-tragedy measures
Some organizers demand health certificates, some demand previous marathon finish certificates, and some request both, Liu Xiaolei, founder and general manger of Rapid Sports, a Beijing-based race organizer, told the Global Times on Wednesday, noting that, none of these requirements can completely rule out the possibility of accidents during a race.
At least three lines of defense should be set up in place to prevent sudden deaths during marathons, Li Yongsheng, a cardiologist, told the Global Times.
Organizers should remind every runner that if they have symptoms that suggest potential heart problem or if they have a family history of sudden heart failure they should be cautious, and they should also have a medical consultation, Li said.
About 5 percent of runners have medical issues that could prevent them from running, claimed Li, who has been in charge of medical operations at over 80 marathon events.
Second, physical examinations are absolutely necessary, and cannot be replaced by a marathon finish certificate from months prior, Li added.
Last but not least, medical personnel should be specially trained and communication should be clear and fast, so that emergency treatment with an AED can be conducted within three minutes, when "the chance of bringing the fallen runner back alive is at 95 to 99 percent, as once it has passed five minutes, the chance will be reduced to fatally low," according to Li.
Liu, who worked as an event manager for the Beijing Marathon from 2009 to 2012, and as event director for the 2016 Ningbo International Marathon, stressed that pre-race preparation is a must, adding that even experienced runners may not realize they are in a state of poor health, as a result of workplace stress for example, which could cause tragedies during a race.
