Doctor considers risks, rewards of youth sports during a pandemic

Sep. 8--Dr. David Soma is a pediatric sports medicine specialist at Mayo Clinic in Rochester. On Tuesday, Soma conducted an hour-long question-and-answer session, the discussion centered around children and the risks versus rewards of them playing organized sports during the COVID-19 pandemic.

Soma sees big benefits to kids playing sports, both for their emotional and physical well-being. But he's advising them to do it in as safe a manner as possible during the pandemic, with a number of safety measures to follow.

What exactly is COVID-19 and what can people expect if they get it?

SOMA: Sars Cov 2 causes the pandemic COVID-19. It has a wide range of manifestations if you get it, ranging from asymptomatic to severely ill. The thing that makes it more tricky is that people can spread it before even having symptoms or can spread it when they are asymptomatic.

What special problems does that trickiness present in youth sports?

D.S.: When trying to decide how to allow children or youth to play sports, we have to weigh the risk versus the benefit of that return, and that is ultimately the million-dollar question. Each sport poses its own risks of potential spread of the disease. There are low risk sports like golf, tennis, skiing, cross country and track and field. You can do those sports with good social distancing and there is minimal sharing of equipment. Sports at higher risk are football, hockey, wrestling and basketball. Those sports require athletes to be in close proximity to one another and sometimes to share equipment. And, some of them are performed indoors which is also a risk factor. So when deciding about returning to sports it is not just a blanket statement of yes, all sports are OK or not OK. You also have to look at each community to determine if it is in an area of higher risk of spread versus a lower risk.

What are some things that can be done to keep sports safer during the pandemic?

D.S.:Obviously, one that gets a lot of attention is social distancing. Also, utilizing masks as much as possible, hand hygiene and wiping down of equipment are important. And you want to avoid "high fives," or bumping knuckles and first bumps.

What other considerations should go into allowing kids to return to sports, or not, during the pandemic?

D.S.: No. 1 is whether your child will be in close contact with anyone who has high-risk conditions (if they were to get COVID-19). If they do, you need to take a critical look at the environment of the sport they are playing to determine if that is worth the risk or not. In addition, you should determine what are the benefits of your child playing. If the answer is that you think they should play, then you might be willing to take on some additional risks as compared to others.

What should an athlete do if they get COVID-19?

D.S.: If you are suspecting you've got it, you'll want to remove yourself from sports as soon as possible. There is an important role for tracing, where you are considering those who you've been in close contact with and then monitoring them for the development of symptoms.

When is it safe to get back into sports after you've had COVID-19?

D.S.: It is recommended that you not return to sports until 10-14 days after the onset of symptoms. An athlete should be fever-free, and when they return, they should do it slowly. If they have bigger (COVID-19) symptoms, they should be monitored by a cardiologist before returning.

What efforts should coaches or managers make in order help keep kids free from COVID-19?

D.S.: Doing screenings for fever or other symptoms of COVID-19 before every practice is important. You should also keep a roll call of who is present at practice, because if someone does come down with COVID-19, you are better able to identify who should be quarantined. In addition, you need to make sure that the people around the events are safe as well, like parents, coaches and athletic trainers. And you should only have essential members attending the games, and those attending should be using masks and cleaning surfaces

When should fans be allowed back in the stands?

D.S.: That should be (determined) primarily at the local or regional level, depending on the prevalence of the disease in the community or the state.

How much safer are sports that are played outdoors?

D.S.: Sports performed outside are less risky than sports done indoors. But the proximity of athletes to each other also makes a difference. In football, when you have five offensive lineman going against five defensive linemen, and they are inherently less than 6 feet apart and in close contact for 15 minutes or longer (the risk goes up). Maintaining social distance is important no matter the sport.

What is your advice to teams transporting by bus and the close contact that is inherent with that?

D.S.: I think that when it is reasonable or possible, it would be good to have athletes transport themselves or have parents transport them. But that is not always possible.

Wrestling seems the riskiest sport to participate in during a pandemic. When do you imagine wrestling will be deemed safe enough to be allowed?

D.S.: Wrestling does pose potential risk because it is very close contact and it is indoors. I think when we start wrestling again will depend on what we find out about playing a lot of the other sports.

There has been AAU basketball going on all around the country. That is an indoor sport and done in close quarters. What are your thoughts on that being permitted?

D.S.: Basketball has done a really nice job in their AAU leagues of minimizing the number of attendees allowed at games, doing screening for all the participants, making attendees wear masks and wiping down basketballs to lessen the spread of the disease. We have to proceed with caution, but there are examples of success stories out there when things are done along with a lot of these safety precautions.

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