The Association of COVID-19 Incidence with Sport and Face Mask Use in United States High School Athletes

Context: The relationships between different sports, face mask use and COVID-19 risk among high school athletes remains unknown. Objective: The purpose of this study was to evaluate the influence of sport characteristics and face mask use on COVID-19 incidence among high school athletes. Design: Descriptive Epidemiology Study Setting: United States High School Athletic Departments Participants: Athletic Directors Interventions: None Main Outcome Measures: Surveys were completed regarding sport re-initiation, COVID-19 cases, and risk reduction procedures in fall 2020. Separate mixed effects Poisson regression models were developed to evaluate the associations between reported COVID-19 incidence and 1) sport characteristics (contact/non-contact, individual/team, indoor/outdoor) and 2) face mask use while playing (yes/no). Results: 991 schools had restarted fall sports, representing 152,484 athletes on 5,854 teams. 2,565 cases of COVID-19 were reported, representing a case rate of 1,682 cases per 100,000 athletes and an incidence rate of 24.6 cases per 100,000 player-days. COVID-19 incidence was lower among outdoor versus indoor sports (incidence rate ratio [IRR]=0.54, 95% CI=0.49–0.60, p<0.001) and non-contact versus contact sports (IRR=0.78 [0.70–0.87], p<0.001), but not team versus individual sports (IRR=0.96 [0.84–1.1], p=0.49). Face mask use was associated with a decreased incidence in girls' volleyball (IRR=0.53 [0.37–0.73], p<0.001), boys' basketball (IRR=0.53 [0.33–0.83], p=0.008) and girls' basketball (IRR=0.36 [0.19–0.63], p<0.001), and approached statistical significance in football (IRR=0.79 [0.59–1.04], p=0.10) and cheer/dance (IRR=0.75 [0.53–1.03], p=0.081). Conclusions: In this nationwide survey of high school athletes, lower COVID-19 incidence was independently associated with participation in outdoor versus indoor and non-contact versus contact sports, but not team versus individual sports. Face mask use was associated with decreased COVID-19 incidence among indoor sports, and may be protective among outdoor sports with prolonged close contact between participants.

The risk of indoor sports and culture events for the transmission of COVID-19

Nearly all mass gathering events worldwide were banned at the beginning of the COVID-19 pandemic, as they were suspected of presenting a considerable risk for the transmission of SARS-CoV-2. We investigated the risk of transmitting SARS-CoV-2 by droplets and aerosols during an experimental indoor mass gathering event under three different hygiene practices, and used the data in a simulation study to estimate the resulting burden of disease under conditions of controlled epidemics. Our results show that the mean number of measured direct contacts per visitor was nine persons and this can be reduced substantially by appropriate hygiene practices. A comparison of two versions of ventilation with different air exchange rates and different airflows found that the system which performed worst allowed a ten-fold increase in the number of individuals exposed to infectious aerosols. The overall burden of infections resulting from indoor mass gatherings depends largely on the quality of the ventilation system and the hygiene practices. Presuming an effective ventilation system, indoor mass gathering events with suitable hygiene practices have a very small, if any, effect on epidemic spread.

Portuguese adults’ concerns on the return to indoor sports practice after confinement due to COVID-19 pandemic -mitigation strategies proposals

Objetivo: Este estudio tuvo como objetivo obtener una visión de las preocupaciones de adultos portugueses en lo que refiere al regreso a la actividad deportiva en instalaciones deportivas cubiertas, tras el confinamiento al que obligó la pandemia COVID-19. Posteriormente, se planteó un enfoque adicional a las estrategias tradicionales de mitigación. Métodos: han participado un total de 173 personas que solían practicar actividad deportiva en instalaciones deportivas cubiertas antes de la pandemia. Se aplicó un cuestionario en el que preguntó lo preocupados (1 – nada, a 5 – completamente) que estarían en diferentes aspectos relacionados con este regreso. Resultados: Los encuestados estaban extremadamente preocupados, especialmente por tocar superficies de uso común y por la proximidad con otros usuarios. Todos los contextos (desplazamiento en transporte público al lugar de entrenamiento, vestuarios y características de la práctica de la actividad propiamente dicha) fueron señaladas como grandes fuentes de preocupación, sobretodo en cuanto a la primera citada. Se propuso modificar algunos objetos (o crear otros) que permitan un uso con partes del cuerpo distintas de las manos y utilizar instrumentos intermediarios en la manipulación de objetos deportivos. Conclusión: tocar superficies de uso común y la proximidad de otros usuarios reveló altos grados de preocupación al regresar a la práctica deportiva después del confinamiento. Además del respeto de las reglas de distanciamiento personal, etiqueta respiratoria e higiene de superficies, se sugiere que los practicantes utilicen, en la medida de lo posible, partes corporales alternativas e instrumentos intermedios que eviten el contacto directo con superficies y objetos. Objective: This study aimed to get an insight of Portuguese adult people concerns about returning to physical activity and sports practice at indoor sports facilities, after confinement due to COVID-19’ pandemic. Subsequently, an additional approach to the traditional mitigation strategies was to be proposed. Methods: A total of 173 Portuguese practitioners on indoor physical activity or sports before pandemic participated in this study. A questionnaire asking how much concerned (1 – nothing, to 5 – completely) would they be on different contexts and aspects related to this return was applied. Results: respondents were considerably concerned about this theme, especially with touching on common surfaces and proximity to others. Although considerable concerned if having to travel by public transport to the training facility, using locker rooms and with features of the sports’ practice itself, the former received the highest concerns. Additionally, we have suggested modifying some objects (or creating others) that may allow their use with body parts other than hands - an important contagion source - and exploiting the possibility of using intermediate instruments on objects and sports equipment manipulation, preventing users from touching their surfaces directly. Conclusion: touching on common surfaces and proximity to others revealed high degrees of concern on the return to indoor sports practice after confinement due to COVID-19 pandemic. Alongside the rules of personal distancing, respiratory etiquette and surfaces hygiene, it is suggested that sports practitioners, whenever possible, use alternative body parts and intermediate instruments that avoid direct contact of hands with surfaces and sport objects. Objetivo: Este estudo teve como objetivo obter uma visão das preocupações de adultos portugueses sobre o regresso à atividade física e à prática desportiva em instalações desportivas cobertas, após o confinamento devido à pandemia COVID-19. Subsequentemente, ir-se-ia propor uma abordagem adicional às estratégias tradicionais de mitigação. Métodos: Um total de 173 portugueses praticantes de atividade física ou desportiva em instalações desportivas cobertas antes da pandemia participaram no estudo. Todos preencheram um questionário informando o quão preocupados (1 – nada, para 5 – completamente) estariam em diferentes contextos e aspetos relacionados com este regresso. Resultados: os entrevistados estão consideravelmente preocupados com tocar em superfícies comuns e com a proximidade a outros utentes. Todos os contextos (uso de transporte público para o local de treino, balneários e caraterísticas da prática desportiva propriamente dita) receberam manifestações de preocupação considerável, com o primeiro a obter as maiores preocupações. Sugeriu-se modificar alguns objetos (ou criar outros) que possam permitir o seu uso com partes do corpo que não as mãos e explorar a possibilidade de usar instrumentos intermediários na manipulação de objetos e equipamentos desportivos, evitando, assim, tocar nas suas superfícies diretamente. Conclusão: Ttocar em superfícies comuns e proximidade de outros utentes induzem altos graus de preocupação no regresso à prática desportiva após as restrições provocadas pela COVID-19. Além das regras de distanciamento pessoal, etiqueta respiratória e higiene das superfícies, sugere-se que os praticantes, sempre que possível, utilizem partes alternativas do corpo e instrumentos intermediários que evitem o contacto direto das mãos com superfícies e objetos desportivos.

The Association of COVID-19 Incidence with Sport and Face Mask Use in United States High School Athletes

ABSTRACTPurposeTo evaluate the influence of sport characteristics and face mask use on COVID-19 incidence among high school athletes.MethodsSurveys were distributed to high school athletic directors throughout the United States regarding sport re-initiation, COVID-19 cases, and risk reduction procedures in fall 2020.Separate mixed effects Poisson regression models were developed to evaluate the associations between reported COVID-19 incidence and 1) sport characteristics (contact/non-contact, individual/team, indoor/outdoor) and 2) face mask use while playing (yes/no).Results991 schools had restarted fall sports, representing 152,484 athletes on 5,854 teams. 2,565 cases of COVID-19 were reported, representing a case rate of 1,682 cases per 100,000 athletes and an incidence rate of 24.6 cases per 100,000 player-days. COVID-19 incidence was lower among outdoor versus indoor sports (incidence rate ratio [IRR]=0.54, 95% CI=0.49-0.60, p<0.001) and non-contact versus contact sports (IRR=0.78 [0.70-0.87], p<0.001), but not team versus individual sports (IRR=0.96 [0.84-1.1], p=0.49). Face mask use was associated with a decreased incidence in girls’ volleyball (IRR=0.53 [0.37-0.73], p<0.001), boys’ basketball (IRR=0.53 [0.33-0.83], p=0.008) and girls’ basketball (IRR=0.36 [0.19-0.63], p<0.001), and approached statistical significance in football (IRR=0.79 [0.59-1.04], p=0.10) and cheer/dance (IRR=0.75 [0.53-1.03], p=0.081).ConclusionsIn this nationwide survey of US high school athletic directors representing 152,484 athletes, lower COVID-19 incidence was independently associated with participation in outdoor versus indoor and non-contact versus contact sports, but not team versus individual sports. Face mask use was associated with decreased COVID-19 incidence among indoor sports, and may be protective among outdoor sports with prolonged close contact between participants.