Sports Participation During a Pandemic
As we head into the fall, our local schools, teams, and clubs are trying their best to safely allow a sports season. At the time of this post, both Kansas and Missouri schools are planning to continue some sort of athletic schedule for middle and high school students. Meanwhile, parents all over the city are running into their child’s pediatric office for sports physicals and signatures on sports forms.
But, is it safe for our kids to play sports during a pandemic?
Just like every other decision these days, the answer is unique to each family. Sports have a ton of physical and emotional benefits for kids, but (need I remind you…) we are still in the middle of a global pandemic. While COVID-19 cases continue to rise in many parts of the country, the decision to participate has to be based on the type of activity, health of our children, and risk factors of our families; all sprinkled with our level of general anxiety or lack thereof. Here are some things to keep in mind.
The safety of the sports season is primarily determined by the level of infection in your community. In Johnson County, where I practice, the local Health Department has determined levels of community infection in which extracurricular activities can be safely continued. Generally speaking, most infectious disease experts and epidemiologists recommend sports continue when community positivity rates are less than 3-5% and with good risk-mitigation practices in place.
In other words, to keep kids in sports, we have to do our best as a community to keep our local infection rates down. This means continuing physical distancing, washing hands, staying outdoors, wearing a mask inside all buildings, choosing carry-out rather than inside dining, and limiting personal gatherings to less than 10 people.
Some sports are inherently safer than others. Sports that naturally allow physical distancing and are performed outdoors carry less risk. Additional risk is added when activities share equipment and facilities, have a large number of players, and require longer duration of close contact with other athletes, coaches, and spectators. Dr. Kelly Fradin, pediatrician and author, included this helpful infographic that includes examples of lower and higher risk sports. Of course, modifications can be created to limit risk in any chosen activity, so talking to your child’s coach about these details is important.
Understand the modifications that your child’s team is using to reduce risk. The CDC has compiled practical guidance that can be used by coaches and teams to help mitigate infectious risk during practice and competition. Dividing larger teams into training pods, limiting travel, increasing ventilation, enforcing routine hygiene, and wearing cloth face coverings as much possible (including during play, if safe to do so) are examples of ways to keep teams healthy.
We do not know the long-term consequences of COVID-19 in children. Over the past few months, the severity of COVID-19 illness in children has generally remained low. Doctors are increasingly concerned about the possibility of myocarditis as a result of viral infection. Also, the long-term effect of the virus in children is something that we simply don’t know. Due to this concern that children may experience cardiac stress from the virus, the AAP has provided specific guidance for COVID-19+ athletes. In an abundance of caution, athletes need to modify their activity if infected with SARS-CoV-2.
If an athlete is COVID-19 positive, the athlete needs to be isolated per CDC guidelines. In addition, it is recommend the athlete stop all exercise for minimum of 14 days, resuming light exercise 7 days after symptoms resolve. It is recommended all COVID-19+ athletes be cleared to return to play by a medical provider, while considering additional cardiology evaluation depending on severity of illness. Some states, including Missouri, have a return to play protocol for COVID+ athletes to begin after medical clearance (see the form here.) Please call your child’s doctor for details about these recommendations as they may change throughout the year.
Know your AED. All facilities where kids play organized sports should have an easily locatable AED in case of emergencies. Athletes, coaches and spectators should know where the AED is located and how it should be used. (Take a class.)
Prepare for a healthy season. Now, more than ever, we want our athletes hitting the field as healthy as possible. So, encourage immune-boosting habits as your child practices and competes. These include balanced nutrition, considering a multivitamin with iron and vitamin D supplement*, promoting restorative nightly sleep, and encouraging adequate hydration. And don’t forget to get your entire family vaccinated against influenza, as soon as the flu shot is available.
Being a team player will require tough conversations. I know it’s not going to be fun to call your coach and let them know of an exposure or illness, but this level of honesty and full disclosure will be required to keep your team safe and complete full sports seasons. In addition, I believe this communication reflects personal integrity and respect for the coaches, staff, and teammates who dedicate their time for your success.
As in all things, we have to be flexible and choose to be positive. I know how important sports are for so many kids and families. From tee-ball to college prospects, sport seasons are part of the fabric of normalcy that so many of us are craving. We have to remember, however, that we are facing a uncontrolled virus. As much as we may want to participate in our pastimes, our priority needs to be on the health and safety of our community, educational systems, and families. Showing anger towards administrators, community leaders, or coaching staff is not productive. Rather, showing a positive outlook through possible disappointments will demonstrate sportsmanship and leadership to the young athlete you are raising.
Good luck and stay safe.
*Always check with your child’s doc before offering supplements.
