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NFHS revises guidance on COVID-19 transmission during high school sports


INDIANAPOLIS – After evaluating experiences of schools participating in high school sports during the COVID-19 pandemic, the National Federation of State High School Associations (NFHS) Sports Medicine Advisory Committee (SMAC) has revised its May 2020 guidance document.

Highlighting the revised guidance is the elimination of the tiered potential infection risk by sport that placed sports in high-, medium- and low-risk categories.

Instead, the SMAC suggests state associations consider five factors in assessing the potential for COVID-19 transmission.

Prevailing community infection rates appear to be the strongest predictor for athletes being infected, but proven cases of direct COVID-19 transmission during athletics remain relatively rare.

Other factors include participants in non-contact sports show lower rates of COVID-19 infection than those in contact sports, participants in outdoor sports show lower rates of infection than those in indoor sports and using face masks for indoor sports results in similar COVID-19 transmission rates to those seen in outdoor sports.

Regarding the discontinuation of the risk categories, the committee noted, “as knowledge of the virus that causes COVID-19 has evolved, we have recognized transmission depends upon multiple factors that cannot be easily accounted for by simply dividing sports into three distinct categories of risk.”

“We applaud the work of the NFHS Sports Medicine Advisory Committee throughout the past year during the pandemic,” said Dr. Karissa Niehoff, NFHS executive director. “We appreciate the committee’s attempts to reassess how student-athletes can participate in sports moving forward. Though we have to be concerned about transmission of the virus first and foremost, we also must consider the mental health of students who have been unable to play sports thus far this year.”

The final factor is based on evidence the majority of sports-related spread of COVID-19 appears to occur from social contact, not during sports participation.

As a result, the SMAC is still recommending social distancing, the use of masks, staying home when ill and using proper hygiene in the locker room/field/court while traveling and interacting in the community.

The NFHS Sports Medicine Advisory Committee is composed of medical doctors, certified athletic trainers, high school coaches and officials, research specialists and state high school association executives who regularly develop position statements related to medical aspects of conducting high school athletics.

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