Updated Guidance for the Operation of Interscholastic, Youth and other Amateur Sport Activities during the COVID-19 Pandemic

Revised November 9, 2020

 

Introduction

In the interest of primary prevention of COVID-19 disease, the Connecticut Department of Public Health is offering revised guidance for the continued operation of sports activities for private, municipal, and interscholastic youth and adult sports leagues. This latest revision is offered given the increase in the number of infections and shift in the age distribution of cases to younger individuals currently occurring across our state, as well as , the anticipation that colder weather will force more activities indoors. The guidance is based on the recognition that by their nature of play certain sports are more likely to promote exposure to the virus that causes COVID-19 (SARS-CoV-2) through respiratory droplets. Sports organizations should pay specific attention to these risks when making a determination whether or not to engage in activities in the coming months, should inform players and parents of the risks of participation, and should be aware of any additional restrictions or requirements from their local health department or other local agencies.  

While the spread of COVID-19 within and among athletic teams during practice and play presents a risk to participants and their families, there are additional potential down-stream effects of these activities as well. Most notably, the continuation of “higher risk” sports and “moderate risk” sports that are played indoors where mask wearing and other mitigation strategies cannot be used safely and effectively threatens the ability of school districts to continue to offer in-person learning opportunities. The dynamics of quarantine and isolation are such that, when individual cases appear on youth athletic teams, all children who have had contact with that case (teammates and recent opponents) are unable to attend school in-person for at least 14 days. Similarly, coaches and other adults may not be able to go to work for a 14-day period or longer. Subsequently, if that individual youth case inadvertently attended school in-person during their infectious period, their classmates and teachers may be required to quarantine and miss out on in-person learning as well. This negative effect on in-person learning could be significantly intensified in the case of youth club sports, where an individual team may involve youth from many different school districts.

Risk Categorization for Various Sports

In developing this guidance, DPH has considered guidance for risk categorization of various sports published by the National Federation of State High School Associations (NFHS) Sports Medicine Advisory Committee[1], to categorize individual and team sports and the various activities common to all sports according to their differential risk for the spread of COVID-19 among teammates, between teams, and in the wider community. Table 1 lists the current risk categorizations defined by NFHS, with applicable individual sports identified for each category.

Table 1:  Risk Categorizations with Associated Sports, National Federation of State High School Associations, Sports Medicine Advisory Committee, May 2020

HIGHER RISK

 

Sports that involve close, sustained contact between participants, lack of significant protective barriers, and high probability that respiratory particles will be transmitted between participants.

Wrestling

Martial Arts1

11-on-11 Football

Rugby1

Boys Lacrosse

Boxing1

Competitive Cheer

Competitive Dance Teams

MODERATE RISK

 

Sports that involve close, sustained contact, but with protective equipment in place that may reduce the likelihood of respiratory particle transmission between participants OR intermittent close contact OR group sports OR sports that use equipment that can’t be cleaned between participants.

 

Basketball

Volleyball

Baseball

Softball

Soccer

Water polo

Gymnastics

Ice hockey

Field hockey

Tennis (doubles)

Swimming relays

Pole vault

High jump

Long jump

Girls lacrosse

Rowing/Crew (with two or more rowers in shell)

7-on-7 football

LOWER RISK

 

Sports that can be done with social distancing or individually with no sharing of equipment or the ability to clean the equipment between use by competitors.

Individual running events

Throwing events (javelin, shot put, discus)

Running/Cross Country (staggered starts)

Individual swimming

Golf

Weightlifting

Alpine skiing/ snowboarding

Sideline cheer

Rowing/Crew (single sculling)

 

Tennis (singles)

1 Identified as “Level 1” risk by United States Olympic & Paralympic Committee: Sports Event Planning Considerations Post-COVID-19, May 7, 2020 – v0.14,  https://www.teamusa.org//-/media/TeamUSA/Documents/Coronavirus/USOPC-Sports-Event-Planning-Considerations-V1.pdf

In assigning risk categories, NFHS considered the fact that direct person-to-person spread via respiratory droplets is the most likely route of transmission for COVID-19, the factors associated with the generation of respiratory droplets and the dynamics of their travel between individuals, and the specific aspects of normal play that require close contact or lend themselves to the implementation of mitigation strategies.  The categorical decisions made by the NFHS Sports Medicine Advisory Committee were made with deference to guidance originally provided by the United States Olympic & Paralympic Committee.[2]

Table 2:  Recommendations for the Operation of Interscholastic, Club, and Recreational and Other Amateur Sports Activities 

 

CT State Current Sports Risk Categories (from Table 1)

Activities

Lower Risk Sports

Moderate Risk Sports

Higher Risk Sports

Indoor*

Outdoor

Indoor*

Outdoor

Indoor*

Outdoor

Tier 1

Small group conditioning and non-contact drills

Recommend allowing if appropriate modifications are feasible

Recommend allowing

Recommend allowing if appropriate modifications are feasible

Recommend allowing

Recommend allowing if appropriate modifications are feasible

Recommend allowing

Tier 2

Team practices, intra-squad scrimmage

Recommend allowing if appropriate modifications are feasible

Recommend allowing

Recommend allowing if appropriate modifications are feasible

Recommend allowing

Not recommended

Not recommended

Tier 3

In-state contests between two teams

Recommend allowing if appropriate modifications are feasible

Recommend allowing

Recommend allowing if appropriate modifications are feasible

Recommend allowing

Not recommended

Not recommended

Tier 4

In-state multi-team meets or tournaments

Recommend allowing if appropriate modifications are feasible

Recommend allowing

Not recommended

Not recommended

Not recommended

Not recommended

Tier 5

Out-of-state competitions

Not recommended

Not recommended

Not recommended

Not recommended

Not recommended

Not recommended

* In all cases, indoor activities should be limited to the extent possible, with appropriate mitigation strategies for indoor settings in place (face covering masks, 6 ft or more distancing, etc.)

 

Risk Categorization for Various Athletic Activities

In addition to categorical risks applied to specific sports, similar risks can be applied to the types of progressive activities that are generally similar across sports.  Sport-related activities can generally be divided into the following groupings (listed in order of risk):

Tier 1:  Individual one-to-one training, Small group aerobic conditioning, Small group sport-specific non-contact skill development drills

    Tier 2:  Team practices, Intra-squad scrimmages

Tier 3:  Interscholastic or in-state contests (2 teams)

Tier 4:  In-state multi-team meets or tournaments

Tier 5:  Interscholastic or other contests between teams from different states or teams that include athletes from different states

As with the risk assignment of sports, assigning risk to athletic activity-types requires attention to the size of the group participating in the activity, the ability of participants to utilize general public health prevention strategies (distancing, mask wearing, hand hygiene), the ability of coaches or other supervisors to control and ensure compliance from participants, the environment in which the activity is taking place, and the dynamics of contact and potential respiratory droplet spread involved with each activity. 

COVID-19 Mitigation Strategies and Community Spread

On October 16, 2020, DPH launched a weekly Town-Level Alert System for COVID-19.[3] The system is designed to identify communities where community COVID-19 infection rates are approaching or have reached a level of concern, and to direct appropriate resources and action.  Guidance included within the system outlines specific actions that should be taken by individuals and organizations at various underlying levels of community spread.  Athletic club organizers should be aware of the alert level within the town(s) in which they operate and/or where their athletes and coaches reside and take appropriate action as the conditions in those communities change.  In addition to the recommended general restrictions for individual sports and activity types in Tables 1 and 2, athletic club organizers and participants should take additional restrictive measures as communities move into and through the various alert levels, particularly as prescribed for “Individuals” and “Organized Group Activities” (which includes group/team athletics).

Some of these more restrictive actions include (but are not limited to):

  • Requiring the use of face covering masks that completely cover the nose and mouth by all coaches and players (including during active play)
  • Postponing indoor activities and/or moving indoor activities outdoors
  • Keeping individuals in small cohorts
  • Limiting/eliminating interactions with individuals outside of your household
  • Increasing and maintaining distance between participants
  • Implementing rule changes that reduce the number, frequency, duration, and/or exertional level of person-to-person physical contact
 


The ability to operationalize and ensure compliance with appropriate mitigation strategies (for example, mask wearing by participants during play) are other important factors that should be considered and applied to decision-making for various sports. If athletic team organizers, their sports medicine consultants, or participant families determine that the wearing of face covering masks by athletes during competition is not desirable, practical, or advisable, those activities should be postponed and reconsidered for the Spring 2021 season.

Specific Actions

At this time, DPH recommends the following for the 2020-2021 Fall and Winter interscholastic, club, and recreational athletic seasons:  

 

Athletic club organizers:
  • develop and implement specific written protocols for strategies to be utilized during practices and contests 
  • provide written protocols to the appropriate local health department and participant families
  • educate coaches and families about the COVID-19 risks associated with athletic activities and the need for strict compliance with protocols (including
  • quarantine/isolation requirements for cases and contacts)
  • keep rosters of participants for all practices and games with appropriate contact information and make that information available to health officials as needed for contact tracing

Lower Risk Sports: 

  • allow continued activities, up to and including in-state competition (Tier 3)
  • add mitigation strategies for indoor activities (including mask wearing at all times)
  • where the nature of play is such that two or more athletes would not be expected to have any close contact (i.e. tennis singles, individual running, etc.) athletes are not required to wear face coverings during active competition (face coverings should still be worn at all times by individuals not engaged in active, non-contact competition)

Moderate Risk Sports: 

  • allow continued activities outdoors, up to and including in-state competition between 2 teams (Tier 3)
  • allow continued activities indoors, up to and including in-state competition between 2 teams (Tier 3), provided routine public health protocols for indoor activities are in place (including mask wearing by all participants, social distancing, cohorting, hygiene procedures)
  • suspend indoor activities and reconsider for the Spring 2021 season where mask wearing (including during active play) and/or other appropriate mitigation strategies cannot be used
  • suspend Tier 4 activities (multi-team meets or tournaments) and reconsider for the Spring 2021 season

Higher Risk Sports: 

  • allow continued activities outdoors, up to and including small group conditioning/skill building (Tier 1), 
  • allow continued activities indoors, up to and including small group conditioning/skill building (Tier 1), provided routine public health protocols for indoor activities (e.g. mask wearing by all participants, social distancing, cohorting, hygiene procedures) are in place
  • Suspend all Tier 2, 3, and 4 activities and reconsider for the Spring 2021 season

Tier 5 activities (i.e. involving athletes from different states): 

  • suspend and reconsider for the spring 2021 season for all sports

DPH agrees that there are real and significant benefits of athletic activity for physical and mental health and well-being for both children and adults.  However, DPH also agrees with NFHS and other governing bodies that not all sports are equal in their risk for their potential to spread infectious respiratory droplets, and therefore certain sports and activities have more potential to be conducive to the spread of COVID-19 infections in our communities.  This, coupled with recent changes in the data trends for COVID-19 infections, our understanding of the dynamics and the role of asymptomatic drivers of spread in our communities, and our continuing experiences both within our state and nationwide with outbreak events all point to the need for a continued cautious approach to organized athletic activities.