Team sports will be in a very difficult position.



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The national public health emergency team will not recommend a return to team sports before a coronavirus vaccine or antiviral medicine is discovered.

That is the opinion of Dr. Cillian De Gascun, NPHET member and director of the National Virus Laboratory.

“I don’t see that it is something that we can recommend from a public health perspective without social distancing,” said De Gascun. The Irish Times, “And assuming that we are not going to have antiviral therapy or a vaccine for 12 to 18 months, it is difficult to recommend it.

“I think team sports are going to be in a very difficult position.”

On Friday night, when Leo Varadkar stepped down from the pulpit in the Government Buildings on his way to RTÉ for a fireplace talk with Ryan Tubridy in the Late, Late Show – De Gascun began coloring the broad lines of the Taoiseach.

“I suppose there is a possibility of an All-Ireland this year,” Varadkar said.

Tubridy: “Is there?”

“Obviously that is a matter for the GAA,” he replied. “Not with the viewers, but it could be done. I think it is possible. “

The warnings that prevent it are multitude.

The medical expert point of view is a “perhaps” very cautious that contact sports like rugby and boxing will follow the Gaelic games and soccer on July 20, reopening their businesses on August 10.

De Gascun poured cold water on international matches in 2020, but hesitantly accepted the possibility of France and England coming to an empty Aviva stadium for the Six Nations in February 2021.

“I certainly don’t see the international matches being played in November, but it would be nice to see the Six Nations somehow next year, either without fans or with reduced capacity.”

A testing platform, funded by sports organizations, will need to be fully operational before professional athletes on this island can safely resume their careers.

De Gascun insists that community testing, to be completed in late June, is essential to understanding how infected Ireland has become since the Covid-19 outbreak.

All things are possible, but as De Gascun explained, many of them are unlikely.

“We are trying to learn from countries that are two or three weeks ahead of us. Obviously everyone is looking at New Zealand and what they have managed to achieve. But I don’t know how they will reopen their economy again with people who come from outside. It is very challenging.

“In some ways, I think we have done very well, but you look at our figures. On the other hand, we are reporting more deaths than other countries because we are actually reporting more deaths, if you know what I mean, in different settings.

“This virus, in the right situation, can start again. What we don’t know at the moment is how much of the population has been exposed or infected. “

Gavin Cummiskey: As Varadkar suggested, is there a strong possibility of a setback during these five phases of reopening society?

Cillian De Gascun: I think you are probably right. It is hard not to see if the June bank holiday is glorious, people will take risks, travel, gather in groups.

You hear things on social media about parties and garden gatherings. It is quite difficult for people. We are very aware of that.

On May 18, will we see people playing golf, tennis and sailing again?

I guess so. We did not make specific recommendations. Our public health advice in the sports arena is that physical distancing remains a huge part of everything we are going to do. Easy wins are the ones golf likes when you’re outdoors, so there’s less risk.

A walk from the car to the first tee?

You don’t want them at the bar or sitting down to eat something beforehand. You walk into the parking lot, put on your spikes, and step out onto the first tee. You keep your distance of two meters.

Is it the social culture around golf, surfing and other sports that has to suffer?

Exactly.

Now we know when, then, how can sport return in Ireland?

I really don’t know is the short answer. What we hope to do in the coming months, after having some challenges on the testing side, is to have a better idea of ​​where the virus is in the community.

The other thing we need to do is a zero prevalence study, which is analyzing a sample of the population to see what kind of percentage of the population has been infected with the virus. We don’t have that at the moment simply because evidence has not been available. We hope we have done this in June.

If we do that study and find out that 30 percent of the population has actually been infected, but only very slightly infected, which really gives them a little confidence, since only 70 percent are susceptible, so we can free things faster and still focus on vulnerable groups.

Dr. Cillian de Gascun, Director of the UCD virus national reference laboratory. Photography: Nick Bradshaw

Dr. Cillian de Gascun, Director of the UCD virus national reference laboratory. Photography: Nick Bradshaw

Most seniors don’t go to active team sports. The flip side of that is that we do those studies and less than five percent of the population has been exposed to the virus. So you have a 95% susceptible cohort out there.

Sports return has two elements: the athletes themselves and the crowds; The mass meetings are really hard to see that they will go live in the short term.

If you have 50,000 in Aviva or 80,000 in Croke Park and you know that 95 percent of them are susceptible to infection, and we have recently learned that a significant proportion of infected people will either have no symptoms or be infectious before they have symptoms, it really is difficult to justify a mass meeting in that situation.

After May 18, if we have the construction and landscapers back, you can leave individual outdoor sports behind. You could probably argue in favor of cricket if you think about it with physical distance. But team sports in the early stages, no, simply because of the locker room and the interaction on the field.

And the contact sport on August 10?

Get in touch with the sports that we would see as the last to arrive.

Professional sport is entertainment: are we likely to see them return to our televisions before people can return to the pubs?

I think we’ll probably watch team sports on TV from an empty stadium before pubs open, I imagine. I think what you will see in that situation is that the players will be evaluated weekly.

I want to ask you about professional athlete testing in more detail, but what about Northern Ireland and the border? Does that make sport in the Republic of Ireland dependent on progress in the north and even in the UK? Am I correct in saying that we cannot replicate the New Zealand model on this island because of this, and how dependent are we on them?

I think you’re right. Having two jurisdictions on one island is undoubtedly one of the challenges that we have experienced and that is different from that of other countries. There have been a series of commitments with the government and the health service in the north to try to find common ground where we can have an Ireland-wide approach. There are some areas where we can do that, but it certainly is a challenge.

It will be more difficult than New Zealand. They are quite remote and have much more control.

It would be feasible for the sports teams to return to the empty stadiums, but regarding the north, we would have to have a good idea of ​​what is happening there.

We hope to combine the prevalence study with them; They have a similar plan. We will certainly share the results in order to get an idea of ​​the prevalence of infection in the northern population.

Philip Browne, CEO of IRFU, spoke a few weeks ago about the need for clarity for September about international rugby returning to Dublin. Have you or other NPHET members spoken to the three major sports bodies on this island: FAI, IRFU, and GAA?

No, it’s the short answer that I know of. They would not be directly involved with NPHET. The department of transport, tourism and sport would be where those commitments are carried out. I have not been a part of that.

We are open to receive specific requests.

The high-profile one in recent days has been American football at Croke Park: it is not a licensed event, so it has not been officially canceled, but as a mass gathering it would be difficult to watch in the future.

Professional sports worldwide is watching the Bundesliga’s plan to return, and despite an increase in German cases this week, as Angela Merkel’s government eased closure restrictions, the plan is to limit stadiums to 300 essential people: players, coaches, doctors, cleaners. Is that safe before something close to zero infection in the community?

Everything is a balance of risk. If the 300 people stay more than two meters away, it is reasonably safe.

The professional sports organization may have the money, the capacity and the facilities to do the test. “

Social distancing will not be possible or respected in these stages. There is the ability for Bundesliga players to try themselves every two to five days, what do those security measures sound like, in an Irish context?

I do not see that it is something that we can recommend from a public health perspective without social distancing, and assuming that we are not going to have antiviral therapy or a vaccine for 12 to 18 months, it is difficult to recommend it.

It’s about getting a better idea of ​​how many people have been infected and how severe the disease has been.

Part of the paradox of what we are doing right now is that we are controlling the epidemic quite well, but the downside of this is that people are not necessarily infected; Even healthy people who aren’t going to get a serious illness aren’t heavily infected either, and that’s when we come to a situation where only a small proportion of the population has some form of immunity. We believe that people will have some level of immunity, but that’s an unanswered question at the moment.

Even if you know people who have become infected and recovered, can you allow them to return to a situation where they are at risk again with people who may be vulnerable?

So I think team sports are going to be in a very difficult position. Even with testing, you can do it on a daily basis, but all it tells you is that it’s negative right now, and then there’s a 24-hour window to interact with other people.

At some point, your test turns positive because you have been infected and the viral load is building up in your system. You reach a threshold where you become infectious, and depending on where you are in your testing program, you can’t completely eliminate the risk.

Professional clubs can certainly mitigate risk. Physios can wear personal protective equipment. Without physical distancing. . . I still don’t see it as something we would recommend. It may not be banned or prohibited, but I don’t think it can be recommended for public health reasons simply because it will never go to zero risk.

Team sport behind closed doors is probably the first step. At some point we have to take some calculated risks because we all know that we cannot remain in our current situation forever. “

The calculated risk is logical, but that means that professional athletes and coaches have no contact with their family. Should they be isolated? Is it essential that these groups enter a bubble?

I don’t think it’s feasible. You can argue that a professional team could do it. It would be very difficult for amateur sports like GAA to do that across the country.

We could get to a situation where you have a small city, town, or county that doesn’t have a lot of viruses circulating. Perhaps within county limits they could operate quite normally.

Could the GAA club championship happen?

Potentially. Maybe, like golf, they don’t share the locker room. They come and warm up, play and then shower at home.

At small club championships, you can probably have a few hundred people in the game, socially estranged. But you probably can’t bring a team or group of Dublin supporters to that county.

A county championship could take place under certain circumstances if you are creative. I don’t have all the answers to this situation, but it is like all companies that try to go back to work.

What GAA, IRFU and FAI should think about is a return. It won’t be a touch of the switch. There has to be creative thinking about what a gradual return looks like.

It might seem like curling up, playing the game and not hanging around in large numbers. You allow that to happen and wait a month, and if you haven’t had a massive outbreak in your team or club or community, then you say “Ok, this is fine.” Then look at the next step. . .

Before the sport returns, should we have capacity for 100,000 tests each week?

We are about two weeks from 100,000 per week. We assume that it will be for people in the community with symptoms, health workers, hospitalized patients and nursing homes, obviously.

At this time we have not considered a large cohort of asymptomatic tests just because they are about to do some activity. I’m not saying it’s something we shouldn’t be looking at, but right now we are looking at the sick or the contacts of people who are sick. “

Does that cover more than 100,000 per week?

I think the HSE has 100,000 employees and a significant number of them are facing patients. The health service should answer in the next few weeks what kind of tests we do for people who are well.

Health workers represent more than 25 percent of our cases. That is something that we should seriously consider.

The 100,000 will be funded by the state. This is less likely to happen in sport in Ireland, although Leinster and Munster could probably afford it, so they could get a test rig at the center of excellence to assess their players weekly. “

Should it be financed by sports organizations themselves?

I think so. To my knowledge, there has been no focus on this. The 100,000 are for the health sector.

This is the reality check for Irish sport; Can’t testing sports athletes be in the hierarchical order during this pandemic?

Obviously, it is very important for society that sport returns, but you are right, it certainly would not be a priority in that regard.

But it is an open market.

In the first week of March we put together a six to eight week plan to reach 100,000 tests per week. That slipped. To listen to some of the reports, it seems like it’s been six to eight months. We have slipped from eight to ten weeks. In the middle of a pandemic that is not so bad.

Again, looking at the Bundesliga plan, each club has been assigned a laboratory in Germany, would it be possible in Ireland this year? Let’s use the four professional rugby provinces as an example, would that be possible?

I think it might At the moment we are in a case to find exercise. We want to evaluate as many people as possible. That does not need to continue forever. When we have a better idea of ​​what and where the infection is, people talk about the second and third waves, and when we understand what it will be like, protecting the population and the health service, and generally speaking, 1,000 cases a day will flood our intensive care units very quickly.

In the last two weeks we have been around 500 or 600 cases a day. If we reach a stage, perhaps six months from now, where many people have been infected and not as many people are susceptible, and we only need to focus on those who are sick, then there will be significant capacity in the system.

We may have a regional focus by then. Take Munster, there is laboratory capacity in Cork and Limerick. At Leinster we have laboratory capacity at UCD and St. Vincent is testing.

So that’s something that could work. For example, in the UCD lab we can comfortably handle 1,000 to 1,200 samples per day for the next few weeks or months. So for the sake of argument, if Leinster wanted to send us 100 samples once a week, that’s nothing.

How fast can they get the results?

They can be turned around in 24 hours. The 1,000 samples that arrive on a Monday morning end on Monday night and result on Tuesday morning when another 1,000 samples arrive.

We didn’t have that capacity on the island two months ago and that’s why we ended up sending 30,000 samples to Germany.

One last question about the Germans. Soccer authorities warned that many clubs will be in a “threatening existence” financial position if play is not resumed in June. How much influence does the threat of financial collapse have on health councils?

It is a consideration. It has not been a priority in the first three months of this year. Efforts have been made to control the epidemic, to the extent possible, by protecting hospitals and our intensive care capacity, buying time to develop additional capacity, and to learn more about the virus.

If we remain in this position for another six weeks, the country could have difficulty recovering. We are aware that the cure cannot be worse than the disease.

There have been many conversations about mental and social health issues, the domestic violence issues you’re seeing on television, all of those things fuel our discussion; There has to be a society for us to return to whenever we can lift all the restrictions.

The priority has been public health. We have a better handle on the dynamics of the epidemic now. That puts us in a better position to balance risk, look at the economy, and ultimately our NPHET recommendations for the government to take into account and decide what we can do.

International sport: rugby, soccer, olympics. I spoke to the CEO of Pro14 on Friday and they are still trying to end the 2020 season in October, without the South African teams, so how realistic is that? Or, looking further ahead, can you see a scenario where France and England can safely come to Dublin in February 2021?

I think that is really difficult. In my own opinion, I would like to think that it can happen, but I don’t see how at the moment. Even simple things like flying again.

There is always a chance that the first wave was horrible and things will calm down from here. I don’t think it’s likely, but you never know.

People will have adverse risks. Many people will not want to get on a plane.

Let’s keep the crowds out for 2020: Can you watch international sporting events early next year?

There is the possibility behind closed doors. Will the pubs be open to go see them? In short, it is about managing risk.

When could we have a social distancing of around 2,000 people in RDS or Dalymount Park?

Go back to what we learn from testing. [IN JUNE]. We have limitations in mass meetings. But the phase process goes from being home alone to being in small groups and going to restaurants of less than 50 people.

Every time we take a step, we’ll be waiting to see what the impact of that will be. If we take a step and the mass meetings reach 50, we wait three weeks and if there has not been a significant uptake of disease activity in the community.

If we go to meetings of 500 people and things start again, we go backwards.

Unfortunately, there is no instruction booklet for this virus. We will be wrong on the precautionary side because what we have seen in Italy, Spain and our own nursing homes is how quickly this can get out of control.

We are going to see what other people and countries are doing and we will try to learn from that.

The social distancing will continue with the hammer and the dance. . .

If the virus remains unpredictable or aggressive in the coming months, we will have to be very cautious and I think the sport will suffer due to the nature of the beast.

Until we have a decent antiviral or vaccine, physical distancing remains a big part of this. That is really the new normal we are talking about.

Maybe we will be lucky and realize that more people have been infected than we think and just have not been sick. Perhaps it is a milder disease than the one we are seeing in hospitals, which is the serious end.

Do you think that is the case?

I’m not convinced yet. Go back to what the virus wants. We are a new host. It is finding its feet in a new host. We all want to find that balance in three or four months. That’s not going to happen.

From the virus’s perspective, three months is nothing. It will evolve with us, your new host, for years to come and settle on something like the flu or the common cold. Or it could just disappear.

Would you risk setting a timeline for antiviral or vaccine discoveries?

Antivirals are more realistic in the short term. We have been successful with treatments for HIV and hepatitis C.

I think with science and medicine, with most people who are very bright working in an area they generally tend to get somewhere in a short period of time.

It is a bit like the man on the moon. If you have a concerted effort and money is not an object, which at the moment does not appear to be from a financing perspective, I think people will get there.

There are still 12 to 18 months left. And the other thing is when it’s available who gets it? Just the elderly?

Billionaire athletes will do it. . .

You are probably right. It was really weird in the United States with the NBA. They were one of the first to close [ON MARCH 11TH]because a couple of high-profile basketball players had access to the tests, they were positive and the league ended.

That will be the other problem: are the sports stars a worthy group?

The general public will hardly complain as they will get their sports back.

It is true.

I remember you as a Terenure center in the early 1990s. When did medicine interrupt your sports career?

I was not chosen by Leinster. I had exams in Med first year, so I missed a test match. After going from school where I was academically very good to university where I was academically very average, the tests were very important.

But did you play Irish schools?

I did. With Anthony Foley, James Blaney, Jeremy Davidson, Conor McGuiness. We have a trip to New Zealand in 1992.

Did you play against Jonah Lomu?

Yes, and Jeff Wilson, Trevor Leota and Carlos Spencer. Wilson posted a penalty in injury time to earn it.

When I graduated and started my internship in 1999, I stopped playing entirely. If he had turned professional a couple of years earlier, he could have tried more.

To be honest, I wasn’t sure I wanted rugby to be my life. He was on a really good team at Terenure and turned out to be good at something without loving him. I prefer to have been good at soccer.

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