Return to sport in COVID-19 pandemic: Be involved in the complex decisions
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The COVID-19 pandemic has changed normal life. As we adjust to the many changes, politicians and public health specialists try to find safe methods to recover from the catastrophic economic impact.
Fortunately, our ability to return to elective surgery improved significantly with testing, adjustments in preoperative assessment, development of safe zones and a better understanding of ideal methods to prevent the spread of COVID-19 to health care providers.
As we approach fall, however, a major issue that still confronts us is the return to school and sports. The impact of children remaining at home has short and long-term effects. Children at home require supervision, organization, consistent parenting efforts and execution of a plan to avoid educational deficits and to a healthy life. Active children and adolescents are both physically and mentally healthy.
Manage injury, illness
As some schools restart sports programs, the role of the team physician becomes an essential part of the dialogue. While the media focuses on professional sports, most orthopedic surgeons who serve as advisors and team physicians are involved in the health, care, safety and injury prevention of nonprofessional athletes at the high school and college levels. The impact of the COVID-19 pandemic challenges us to be aware and involved in the complex decisions related to sports when we serve as team physicians.
The essential roles of the team physician include, but are not limited to, establishing a chain of command for injury and illness management, final decisions on clearance to participate and medical management of illness. With COVID-19, the overall process is influenced by local, regional and national authorities, departments of public health, as well as sports-specific organizations. It is critical team physicians remain aware of these factors and work with athletic departments, coaches, parents and athletes to understand guidelines and regulations. In some cases, a violation can be met with fines or shutting down the sports program.
For those who return this fall to their roles as team physicians, frequent efforts to update your knowledge regarding COVID-19, the status of the pandemic and the local community’s effort to manage disease transmission and create environments to improve safety are part of the leadership role. Unfortunately, it is likely to be essential to avoid legal issues, especially if there are permanent consequences for the athlete after a COVID-19 infection. Documents, such as the recent “Return to Sports and Exercise during the COVID-19 Pandemic: Guidance for High School and Collegiate Athletic Programs” from the Korey Stringer Institute at the University of Connecticut are a detailed effort to define and describe responsibilities and activities specific to team physicians, including preparticipation physicals, conditioning, injury prevention and education now substantially modified by the pandemic.
Clear plan is needed
If recent events during the return to professional sport are any indication the return to sports at the high school and college level, along with in-class education, may result in COVID-19 outbreaks and challenges. Unlike professional sport leagues, there will not be daily viral tests, strict enforcement of quarantine, separation from the public, and full-time dedicated medical staff to manage COVID-19 infections.
A clear plan must be developed with the athletic department, local government officials and advice from the school’s legal consultant. The plan should be shared with athletes and parents, with notice that there is a possibility of canceling the season if COVID-19 issues cannot be controlled once the season starts.
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For more information:
Anthony A. Romeo, MD, is the Chief Medical Editor of Orthopedics Today. He can be reached at Orthopedics Today, 6900 Grove Road, Thorofare, NJ 08086; email: orthopedics@healio.com.
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