American Academy of Pediatrics Provides Interim Guidance on Returning to Sports Amid Coronavirus

Pediatricians advise that weighing the risk versus benefit of returning to sports activities is driven by the type of sport and setting, local disease activity, and individual circumstances

Sports activities offer children and teens many physical and psychological health benefits besides fitness, such as socializing with friends, a critical part of development. Many children have missed these activities during the COVID-19 pandemic, and re-engaging youth in sports will require careful thought and safety precautions.

The American Academy of Pediatrics (AAP), drawing on the most current research, has published interim guidance to help families weigh the individual benefits and risks of their children’s sports activities and ensure that safety precautions are in place. The guidance is here.

“We recommend that parents talk to their pediatrician about the type of sport and setting, local disease activity, and individual circumstances, such as an underlying health condition that places the athlete or family members at high risk,” said Susannah M Briskin, MD FAAP, an author of the guidance. “The risk can be decreased, but not eliminated, by athletes, parents, coaches, and officials who follow safety protocols. Ultimately, this will be an individual choice for the parent to decide if they will allow their child to participate in sports.”

Current evidence suggests children are infected with the COVID-19 virus less frequently than adults and, when infected, typically experience less severe disease. Although children have generally not been the source of disease outbreaks, it is possible that children could infect adult coaches, officials, or family members after contracting the virus.

Parents can expect sports governing bodies to recommend modifications to practices, competitions and events. This guidance should be consistent with the CDC recommendations and current local government restrictions for youth sports

“Before returning to sports, all children should have an annual health visit that ideally includes a preparticipation physical evaluation, which most parents know as a sports exam,” Dr. Briskin said. “If kids have not been physically active for a lengthy period of time, they are at higher risk of an overuse injury.”

AAP also recommends that families, coaches and teams:

• Prioritize non-contact activity such as conditioning and drills where physical distance can be maintained.
• When physical distancing cannot be maintained, athletes should wear a cloth face covering during non-vigorous exercise. Cloth face coverings should not be worn in water activities or in activities where they could pose an injury risk due to catching on equipment or accidently impairing vision.
• Reinforce appropriate hygiene and respiratory etiquette with signage, parent/athlete education and frequent of handwashing stations or hand sanitizer.
• Maintain practice groups in consistent pods of small sizes that do not mix youth athletes to help limit team-wide virus outbreaks.
• Minimize travel outside to other communities and regions.
• Clean and disinfect frequently touched surfaces on the field, court, or play surface at least daily, or between uses as much as possible.
• Reduce sharing of equipment where possible and use of communal spaces like locker rooms. Athletic areas with poor ventilation, such as weight rooms and small spaces where distancing cannot be maintained should be avoided when possible.
• Athletes should not share food or drink.
• Athletes who have any COVID-19 symptoms should not attend practices or competition.
• Patients who have had COVID-19 should see their pediatrician before returning to sports to provide guidance.

The guidance also offers recommendations for sports spectators and addresses questions about what will happen if an athlete or coach shows signs or symptoms of illness.

“We know that children are suffering without their usual sports activities this summer and would really like to see them regain some of the fun and healthy benefits of athletics and games,” Dr. Briskin said. “All of us are in this together. By following safety precautions, we can work toward minimizing risk and allowing some return to the sports activities.”

The interim guidance: COVID-19 Interim Guidance: Return to Sports

More information is available for parents at HealthyChildren.org, include sports safety checklists.

• Youth Sports Participation During COVID-19: A Safety Checklist
• Youth Sports & COVID-19: Understanding the Risks

The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.