Why is the safe reopening of high school sports going to be so much more difficult than opening college and professional dance?

Along with the rebirth of professional sports comes a longing for a return to amateur sports: high school, college, and club. Government officials now offer guidance on when and how to resume play.

However, what is lost in the current conversation is how schools and sports clubs with limited resources can safely reopen. As an exercise scientist who studies athlete health and an emergency medicine physician who heads Michigan’s COVID-19 mobile testing unit, we want to train athletes, coaches, and parents by sharing information related to the risks of re-playing. without the COVID-19 test. This includes blood tests to see if athletes have already had COVID-19 plus nasal swabs to detect the active SARS-CoV-2 virus.

Regular COVID-19 testing on all athletes may seem excessive, but the current count of 150 college athletes, mostly soccer players, who have tested positive for COVID-19 grows more day by day.

In sports, particularly contact sports, it is essential to eliminate asymptomatic athletes, or those who do not show symptoms, before infecting others. This did not happen in South Korea, where an asymptomatic fitness instructor transmitted the virus to 112 people in 12 facilities, over 124 miles and in 14 days. All of this happened after a vigorous four-hour dance session. The scariest point in this story is that these fitness instructors were spreading the virus before showing symptoms.

When the amateur sport returns, you will likely see players and coaches wearing facial covers and observing social distancing as much as possible.
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The risks can be considerable

The risk of virus transmission from an undetected positive COVID-19 athlete is considerable, particularly those who compete without a face covering and in close proximity to others. Recent data suggests that virus particles can travel through the air up to 27 feet, well beyond the six-foot recommendation for social distancing. Aerosol virus clouds can remain suspended for up to three hours. Also, during maximum intensity exercise, athletes breathe faster and more deeply, up to 20 times faster, than when they rest comfortably. This increases both the quantity and the depth of the inhaled and exhaled virus particles.

Athletes also spit and sweat, further contaminating equipment, clothing, and playing surfaces. Saliva has been shown to contain 92% active SARS-CoV-2 particles, and sweat can transmit the virus through contamination with saliva or respiratory droplets. Along with all of this, vigorous training can lower an athlete’s immune function, making him more susceptible to infection.

The latest NCAA report confirms that approximately 8 million high school athletes and 480,000 college athletes participate in sports each year. How many could become infected? One way to estimate is by examining current models. They suggest that the virus could infect 20% of people, with a death rate of about 1%. Extrapolate those numbers, and the estimate is terrifying: about 1.7 million involved in amateur sports in the US. USA, which does not include coaches, trainers and parents, could become infected. Around 16,000 could die.

We recognize that evaluating young athletes is not easy. Considerable time and expense are required. Our team, with approximately 80 investigators and four COVID-19 mobile units, can reliably evaluate up to 500 people per day, at a cost of $ 75 to $ 100 per person. And those most at risk – frontline workers, symptomatic individuals, and people in poor communities, nursing homes and prisons – should be screened first. That means that routine testing of amateur athletes before weekly competitions can become unsustainable.

Those on the sidelines should also observe social distancing and wear face covers.
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Our five suggestions

The recent reopening of college football practice has already got off to a rocky start, with LSU isolating 30 of 115 players after approximately two weeks of practice, while Kansas State and the University of Houston have suspended voluntary practice due to the outbreaks. of COVID-19. In this evolving natural experiment, this small sample simply represents college football players returning to voluntary summer practice, where COVID-19 cases and player-to-player contacts are expected to be low. If you extrapolate to the 8 million high school athletes competing in the fall, with limited resources, you can imagine the consequences. However, to keep sports participation safe in high school, college and club, we recommend the following:

  • Before each competition, all athletes and coaches on the field should be tested for the virus. Anyone who is COVID-19 positive will be removed from the game and quarantined for 14 days, with contact tracking initiated. Game officials must verify that competitors have been negative 24 hours before the game. Pooled tests would save time and money. If a pooled sample shows a positive test, all athletes will be evaluated.

  • Blood tests should be considered. Athletes who have COVID-19 and are positive for IgG antibodies were exposed at least two to three weeks before the test; They are likely to carry a dead virus and are not at risk of infecting others. As long as they are asymptomatic, they could return to sports earlier. But those with the IgM antibody probably have an acute infection; Those athletes shouldn’t be on the field.

  • Those who participate in the event, including athletes / competitors, must wear face covers. The production of “athletic-fit” facial coatings, for use during vigorous training and competition, would reduce viral transmission.

  • Social distancing, hand washing, and frequent disinfection of equipment, surfaces, and clothing should be strictly adhered to, especially on the sidelines.

  • You should avoid sharing food, liquids and utensils. Athletes must use personal water bottles.

An important point to remember is that the professional sports safety bubble is an impossible dream for amateur sports. Daily temperature controls and symptom tests in free-living, i.e. amateur sports, are not suitable replacements for daily COVID-19 tests and imposed quarantines, as in professional sports. Forehead temperature controls are inaccurate and often underestimate fever. Once an athlete begins to develop signs and symptoms of COVID-19, he has already started transmitting the virus for about two days. Therefore, the rapid identification and removal of asymptomatic athletes, at all levels, must be enforced throughout the season and among competing individuals. Otherwise, our true hope of normality becomes complicit in the continuous transmission of the disease.

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