Thomas S. Bottiglieri, D.O.

COVID-19 has increased stress & uncertainty for individuals and families.  This is import to recognize. A focus on the “controllables” is vital to healthy response to the isolation and ambiguity of what is to come next.

As many athletes want to get back to their normal sports activities, we need to also remind them that they first need to get back to a schedule – focusing on sleep habits, general exercise, and nutrition. Due to the stay-at-home restrictions, de-conditioning may have weakened muscles and slowed athletic reactions. To diminish the likely increased risk of injury and overtraining, those at home should initiate a regimen focused on cardiovascular, muscle strengthening, and sports specific movements. We will be posting more specific programming for athletes and coaches, but encourage zoom sessions and challenges to keep student-athletes engaged. Our team is available to you for discussion and engagement if you would like.  We have athletic trainers, physical therapists, and physicians that are all at home doing their own fitness programs, coaching, and rehabilitation. We welcome your questions & suggestions.

Specific sport types have varying risk for COVID infection. The “high-risk” and “lower-risk” categories, are assigned based on physical proximity, exertion level, and physical contact.  Sports such as golf or tennis, will have an easier time social distancing and might return sooner.  Baseball or softball can practice utilizing a net to hit into, or a wall for throwing/fielding. However, “high-risk” sports, such as football or soccer, can practice independently, focusing on individual skills/drills such as dribbling, change of direction drills, and speed training. Sooner small groups will be able to convene and can practice in a socially distant manner such as passing, catching, and mirroring types of drills.  At this time it is not recommended to convene group practices.

When it comes to the return of youth sports, there is an enormous challenge as there is not a clear picture of how children experience COVID as a whole. We need to remember that there are asymptomatic carriers, acting as a vector for spread.  The reality that not all children will be spared this infection has, unfortunately, been realized in the pulmonary and vascular complications that have recently been reported.  While it is promising that most children and young adults will be spared severe illness, the fact that some are at risk should remain a cause for maintaining caution with contact until the numbers are low enough to test and contact trace persons of interest that have suspected exposure to COVID infected people.

Aspen Institute’s Project Play recently provided a statistic stating that only “52% of parents are comfortable with their children participating in travel sports at this time, much less than that of school sports (68%), and community sports (67%).”  This is an important finding.  In the spirit of fairness and free play, we recommend outdoor activities at a safe distance and social interaction remotely to maintain connection for young athletes.  Until we can more reliably protect one another from the uncontrolled spread of SARS-CoV-2 virus we must remain vigilant.

Travel sports are also considered higher-risk, as children are in ways that can increase exposures to unknown infected people.  Limiting group sizes, travel reduces variables and helps to maintain a means of tracing contact if/when infections do happen. It is important to remember that both Spain and Italy experienced high numbers of infections, many of which are traceable to a sporting event (soccer match).  Additionally, the NCAA’s suspension of the basketball tournament helped to drive the subsequent moves by other sports organizations and ultimately businesses to close. Sports are a vital part of our culture, and as such, drive many of our interactions.  The policies we put in place may very well have impact beyond the direct risk to players and coaches, extending to their families and communities.

Many organizations are following the lead of schools.  While we ponder what will be in the fall, I currently recommend strong consideration of moving fall sports to the Spring with the possibility of abbreviated seasons that would allow both sports that are normally scheduled in the Fall as well as Spring sports to happen after we have dealt with whatever reality presents itself with the changing seasons this September.  A second wave is anticipated.  The question is how big will that curve be? It is our responsibility to drive the infection rate down to protect as many of our friends and neighbors as possible.  We need to act in a socially responsible way planning to prevent unnecessary death, while progressing re-entry to our new normal methodically.

Many organizations have suggested ways to minimize the risk, when returning to activity.

• Modify layouts for each environment, positioning children at least 6 feet apart.
• Stagger the start times, to enable separation of group interaction when arriving or leaving the facility.
• Consider small groups of players and keep them together – consider conducting daily health checks such as symptom or temperature screenings.
• For those at higher risk, continue to consider virtual coaching and in-home drills.
• Group size counts includes not only athletes and coach, but anyone on the premises.
• Spectators must also follow guidelines for social distancing. Consider use of one-way traffic when able, entering and exiting at separate locations.
• Discourage high-fives and handshakes, fist bumps, or hugs – encourage tipping your hat or bowing.
• Place guidelines such as signage and tape on the floors to ensure that a social distance is kept.
• Discontinue the use of a hydration stations, all athletes should bring their own water bottles.
• Cleaning supplies on hand should include disinfectant (germicide), hand sanitizer (greater than or equal to 60% alcohol), paper towels or disinfectant wipes which can be disposed of.
• Cleaning and sanitation procedures should also be extended to restrooms, locker rooms, flooring, exercise mats, water fountains, and commonly shared pieces of equipment (non-essential equipment should be removed from the area, minimizing surfaces to be cleaned).
• Wipe down commonly touched surfaces, before and after use.

The United States Specialty Sports Association (USSSA) has laid out guidelines, procedures, and recommendations for post COVID-19 return to play, which will be updated as new knowledge becomes available. Any person experiencing symptoms of COVID-19, or directly exposed, should stay home and not plan to attend any practices or events. Ultimately, all local and state guidelines for facilities and events should be followed.

Having a face covering for scenarios in which social distance is not possible is currently recommended, but wearing a mask during athletic activity is not.  IF a mask is visibly soiled or wet it won’t work.  So there are some details that require further thought and planning, but for now it is a good idea for those exercising outdoors to have a mask handy for moments when proximity is unavoidable.

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