Will schools be ready for classes in the fall? Will there be a second wave? Are school based sports going to return? Is travel going to be allowed into and out of hard hit areas? In this update we present our current state and expectations for the coming weeks and months. As always it is important to follow the numbers and respond according not only to projected risks, but also the objective outcomes at each stage of reopening.
As we continue to monitor new coronavirus virus cases, there is increasing talk of a second wave. Is the current infection pattern across the United States a second wave? Experts such as Anthony Fauci agree that the rising numbers of infection in areas not previously impacted is the continuation of the first wave as geographical areas in the South experience the novel infection for the first time. Nine states including, Alabama, Arizona, Florida, Nevada, North Carolina, Oklahoma, Oregon, South Carolina, and Texas have seen logarithmic increases of infections with as many as 3,000 new cases per day in Florida. While President Donald Trump has joked that increasing numbers are due to increased testing, the reality is that hospitalizations and deaths in the areas mentioned above are following the pattern we have seen in hard hit states such as New York and New Jersey. New York, New Jersey, and Connecticut have ordered a travel advisory for anyone coming from a state with a transmission rate above 10 per 100,000 people on a seven-day rolling average, or 10 percent of the total population testing positive on a seven-day rolling average, to quarantine for 14 days.
This growth in disease spread has followed relaxed stay at home orders and reopening strategies in regions that have flattened the curve. While the Northeast is progressing through opening stages we must remain vigilant in tracing COVID to prevent unnecessary death. The impact of each phase of reopening will not be fully understood until we can measure our population response to policy. It remains important that everyone continue to practice social distancing, wash your hands, and wear your face mask when out in public. These basic hygiene precautions will diminish risk. Limiting unnecessary infections by limiting contact, using hygiene strategies, contact tracing, and predicting the threshold for herd immunity is the goal until we have a vaccine. We do know that about 25% or more of NYC metropolitan area citizens were infected during the surge in the Northeast. We do not know if there were actually more infections, nor do we know if that threshold will protect the population from a resurgence.
AN IMPORTANT CONCEPT IN STATISTICS IS THIS: PERCENTAGES AND RISK ANALYSES, SUCH AS THE ABOVE, REFER TO POPULATIONS, NOT INDIVIDUALS!
Risk assessment for any individual needs to be considered with your personal and team physician (for athletes). Underlying health concerns, medications, age, activity level, and unavoidable exposure risk are examples of variables that should be considered. While charts and graphs can help to discern risks to a person, each individual’s risk tolerance and overall goals should be considered for decisions that can severely impact health or might lead to death. Remember that exposure is not confined to the athletes themselves, but also coaches, parents, and other family members of athletes.
In NJ, the State Department of Health has placed sports into a three-tier risk category. Non-contact sport practices and low risk sports, such as golf, begin on June 22. However, when it comes to NJSIAA rules and regulations the summer recess does not being until July 13 (tentatively), so all school sports must follow the out of season rule. Medium risk sports include those with larger teams such as basketball and soccer, and these teams may resume play by July 6 if the trends remain on the decline, according to Governor Murphy. At this time, the tentative date for high risk sports, such as football, to resume competitive play is scheduled for July 20th; however, these dates could change pending a sudden spike in cases.
A bill was passed by the New Jersey Senate to unanimously allow student athletes to participate in fall sports provided they have a physical before the end of the season. Understandably, the COVID-19 pandemic has made it difficult to schedule pre-participation exam (PPE) sports physicals, with limited hours in physician offices. The law was passed to allow student-athletes to fully participate this coming season without the usual PPE requirement. A health history form will be required as is shown below.
Click here for more information regarding September 2020 school openings in NJ.
As always, Be Safe & Be Well.
By: Andrea Happli, ATC/O-PA & Thomas Bottiglieri, D.O.