Children's Hospital Colorado

COVID-19 Return to Play Guidelines for Youth Sports

As communities continue to navigate the COVID-19 pandemic, participation in youth sports offers many opportunities to promote physical and mental health. However, there are a few additional considerations for youth sports settings given the unprecedented circumstances posed by the novel coronavirus pandemic.

Julie Wilson, MD, and Aaron Provance, MD, physicians in the Children’s Hospital Colorado’s Sports Medicine Center, offered some COVID-19 return to play guidance.

Get vaccinated

COVID-19 vaccines offer the best protection for athletes, their families, coaches and officials to protect themselves from serious illness or death related to COVID-19. Children ages 5 and older, as well as adults, are now eligible to be vaccinated against COVID-19. Youth sports organizations can encourage vaccination for their athletes and staff as a means of helping reduce COVID-19 transmission and disruption of training and competition.

Know the facts about COVID-19

  1. Athletes who have been diagnosed with COVID-19 (or were presumed to be positive) must obtain medical clearance from their primary care provider prior to return to sports participation.
  2. Infection risk varies by sport, depending on the setting (indoor versus outdoor), physical proximity of athletes and coaches, duration of close proximity, the total number of people present and the vaccination status of those participating. Team-related activities away from the playing field, including team meals and travel, also pose risk of transmission, especially when unvaccinated and unmasked individuals are present.
  3. Traveling out of your local area for competitions or tournaments may require additional testing or quarantine before or after travel. Organizations and families should be familiar with local public health requirements as well as competition/tournament COVID-19 protocols and develop a plan to manage a symptomatic player or coach during travel.

COVID-19 return to play protocol

Youth sports organizations, teams and their members should be aware that COVID-19 is still an emerging disease, and information and guidelines related to this disease are subject to change. Vaccines and COVID-19 mitigation protocols are powerful tools in reducing virus transmission, but athletes and families should evaluate their personal situation when considering sports participation. Youth sports organizations should weigh the potential risks and benefits of conducting training or competitions, and coordinate with public health officials as they’re able.

In order to conduct any in-person training (even individual or small group sessions), youth sports organizations and teams should develop protocols in several areas that align with public health guidelines.

COVID-19 screening for athletes, coaches and staff

  • Everyone participating in training or competition should be:
    • Screened for current or recent symptoms of COVID-19
    • Screened for potential or known exposure to someone diagnosed with COVID-19
  • Athletes, coaches or staff who screen positive must stay at home and should contact their healthcare provider for medical advice if they develop symptoms and for guidance on returning to work and sports.
  • Travel outside of local city/county area, especially to areas with higher rates of disease transmission, may be another risk factor for infection, so those who have recently traveled should remain vigilant for onset of symptoms.
  • Rapid tests are becoming more accessible and can be used to screen athletes before or after travel or competition as a transmission mitigation strategy.

COVID-19 infection prevention measures for training sessions and competition

Youth sports organizations should take the following precautions to prevent the spread of COVID-19:

  • Maintain physical distancing requirements consistent with public health guidelines by keeping the following in mind:
    • Maintain 6 feet of distance when entering and exiting venues.
    • Control the number of participants in training sessions.
    • Control the number of spectators.
  • Avoid shared equipment and water stations.
    • Participants must use their own water bottle, towel and other personal supplies.
  • Maintain hand hygiene stations (hand sanitizer or soap and water).
  • Frequently clean equipment and facilities.
  • Follow face covering guidelines for coaches, staff and spectators consistent with local public health orders, and for athletes when not involved in active training.
    • Wearing face masks during indoor sports can reduce transmission risk to similar rates as outdoor sports, although the ability to safely wear a mask should be considered, especially for activities such as tumbling/stunting, gymnastics, wrestling, swimming and diving.
  • Athletes, coaches and staff should follow public health guidelines for reducing risk of infection.

Develop a COVID-19 response plan

Create a COVID-19 response plan that will help your organization act quickly and safely in the event of a positive test or potential exposure. Include the following steps:

  • Keep track of athletes, coaches and staff present at training sessions to facilitate contact tracing in the event of symptoms or a positive COVID-19 test.
  • Coordinate with public health officials in the event of positive cases or an outbreak.
  • Communicate promptly to potentially exposed parties in line with public health guidelines, including information regarding how to self-isolate and how to quarantine.
  • Be prepared to adjust or postpone training or competition in the event of positive COVID-19 cases in athletes or teams.

Continue to provide or recommend sports physical evaluations

Drs. Wilson and Provance recommend that all youth athletes see their primary care provider for an annual wellness exam, including sport pre-participation evaluations. The primary care setting is most appropriate for updating routine vaccinations, managing mental health concerns, evaluating for possible cardiac or pulmonary conditions that may arise after COVID-19 infection, and many other aspects of routine healthcare.

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