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Lyng J, Morissette M, Ogborn D, Leiter J, MacDonald P, Longstaffe R. The impact of COVID-19 on national hockey league players' return to play. PHYSICIAN SPORTSMED 2024; 52:84-88. [PMID: 36744406 DOI: 10.1080/00913847.2023.2177080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/31/2023] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Evaluate the on-ice performance and return to play (RTP) rate following COVID-19 for National Hockey League (NHL) players during the 2020-21 season. METHODS Players with COVID-19 during the abbreviated 2020-21 season were identified using publicly accessible online sources. Demographics and on-ice metrics were accessed using the NHL's online statistics website. The length of time, rate of RTP, and games missed due to COVID-19 were analyzed. Primary outcomes included average time on ice (TOI) per game (TOI/G), average TOI per shift (TOI/S), and points per game (PPG) compared at different timepoints including pre- and post-COVID-19. RESULTS A total of 73 players (47 forwards, 18 defensemen, 8 goalies) had a documented COVID-19 diagnosis during the abbreviated 2020-21 season. Players missed an average of 5.6 games (14.7 days) due to COVID-19. The post-COVID-19 RTP rate was 97.3%, including playoffs. No differences were found in TOI/G between the pre- (15.7 ± 3.9 min) and post-COVID-19 (15.8 ± 3.4 min, p = 0.874) or in the first (15.8 ± 4.0 min) and second week (15.9 ± 3.8 min, p = 0.925) returned. TOI/shift did not change from pre- (45.6 ± 5.3 sec) to post-COVID-19 (46.7 ± 4.6 sec, p = 0.035) or in first (46.2 ± 5.4 sec) and second week post-COVID-19 (46.2 ± 4.8 sec, p = .854). No differences were identified for PPG between career, pre-COVID-19, and post-COVID-19 (0.44 vs 0.38 vs 0.41; p = 0.274). CONCLUSION RTP post-COVID was markedly high for NHL players. While the effects of COVID-19 on specific physiological measures remains to be elucidated, this study found NHL players do not have reduced performance following COVID-19.
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Affiliation(s)
- Jasmine Lyng
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | | | - Dan Ogborn
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Pan Am Clinic Foundation, Winnipeg, MB, Canada
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | - Peter MacDonald
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Pan Am Clinic Foundation, Winnipeg, MB, Canada
| | - Robert Longstaffe
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Pan Am Clinic Foundation, Winnipeg, MB, Canada
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Barsch F, Peters V, Morath O, Krumnau O, Maier P, Huzly D, Prettin S, Deibert P. Trends in the numbers of SARS-CoV-2 infections among students: a prospective cohort study comparing students in sports boarding schools with students in day schools during early COVID-19 pandemic. Front Public Health 2023; 11:1223748. [PMID: 38035288 PMCID: PMC10682161 DOI: 10.3389/fpubh.2023.1223748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction During the first months of the COVID pandemic it emerged that facilities where people gather or live together in cohorts, such as nursing homes or schools, were particularly at high risk for becoming hotspots of virus transmission. German political and health institutions responded with far-reaching interventions and preventive strategies to protect the population from infection with SARS-CoV-2. In this context, it remains unclear whether boarding schools for sports particularly pose a risk of infection to their residents. Methods In a single-center prospective cohort study, numbers of SARS-CoV-2 infections of students in sports boarding schools (n = 11) vs. students attending regular day schools (n = 22) in the region Freiburg/Hochschwarzwald in Germany were investigated over a period from October 2020 to January 2021 via regular virus and antibody screening (German Clinical Trials Register; Study ID: DRKS00021909). In addition, individual and behavioral risk factors for infection were stratified via questionnaire, which provide an indication of cohort specific risk factors for infection and the success of the implementation of hygiene concepts, as well as other infection prevention strategies, within the respective facilities. Results Regarding SARS-CoV-2 infection numbers, the screening detected no significant group difference between sports boarding schools vs. day schools. Discussion The study results provide indications that sports boarding schools did not pose an increased risk of infection, assuming that the facilities prevent virus transmissions with appropriate preventive strategies and hygiene measures. In future pandemic scenarios larger-scale and multicenter studies are necessary to achieve more comprehensive epidemiological data in this field.
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Affiliation(s)
- Friedrich Barsch
- Department of Medicine, Medical Center University of Freiburg, Faculty of Medicine, Institute for Exercise and Occupational Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Vera Peters
- Department of Medicine, Medical Center University of Freiburg, Faculty of Medicine, Institute for Exercise and Occupational Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Oliver Morath
- Department of Medicine, Medical Center University of Freiburg, Faculty of Medicine, Institute for Exercise and Occupational Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Oliver Krumnau
- Department of Medicine, Medical Center University of Freiburg, Faculty of Medicine, Institute for Exercise and Occupational Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Philipp Maier
- Department of Medicine, Medical Center University of Freiburg, Faculty of Medicine, Institute for Exercise and Occupational Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Daniela Huzly
- Freiburg University Medical Center, Faculty of Medicine, Institute of Virology, University of Freiburg, Freiburg im Breisgau, Germany
| | - Stephan Prettin
- Department of Medicine, Medical Center University of Freiburg, Faculty of Medicine, Institute for Exercise and Occupational Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Peter Deibert
- Department of Medicine, Medical Center University of Freiburg, Faculty of Medicine, Institute for Exercise and Occupational Medicine, University of Freiburg, Freiburg im Breisgau, Germany
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Rudin C, Bollen N, Hong SL, Wegner F, Politi L, Mellou K, Geenen C, Gorissen S, Verhasselt B, Durkin K, Henin C, Logist AS, Dellicour S, Resa T, Stadler T, Maes P, Cuypers L, André E, Egli A, Baele G. Investigation of an international water polo tournament in Czechia as a potential source for early introduction of the SARS-CoV-2 Omicron variant into Belgium, Switzerland and Germany, November 2021. Euro Surveill 2023; 28:2300018. [PMID: 37943503 PMCID: PMC10636743 DOI: 10.2807/1560-7917.es.2023.28.45.2300018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 06/28/2023] [Indexed: 11/10/2023] Open
Abstract
BackgroundThe earliest recognised infections by the SARS-CoV-2 Omicron variant (Pango lineage B.1.1.529) in Belgium and Switzerland suggested a connection to an international water polo tournament, held 12-14 November 2021 in Brno, Czechia.AimTo study the arrival and subsequent spread of the Omicron variant in Belgium and Switzerland, and understand the overall importance of this international sporting event on the number of infections in the two countries.MethodsWe performed intensive forward and backward contact tracing in both countries, supplemented by phylogenetic investigations using virus sequences of the suspected infection chain archived in public databases.ResultsThrough contact tracing, we identified two and one infected athletes of the Belgian and Swiss water polo teams, respectively, and subsequently also three athletes from Germany. In Belgium and Switzerland, four and three secondary infections, and three and one confirmed tertiary infections were identified. Phylogenetic investigation demonstrated that this sporting event played a role as the source of infection, but without a direct link with infections from South Africa and not as a superspreading event; the virus was found to already be circulating at that time in the countries involved.ConclusionThe SARS-CoV-2 Omicron variant started to circulate in Europe several weeks before its identification in South Africa on 24 November 2021. Accordingly, it can be assumed that travel restrictions are usually implemented too late to prevent the spread of newly detected SARS-CoV-2 variants to other regions. Phylogenetic analysis may modify the perception of an apparently clear result of intensive contact tracing.
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Affiliation(s)
| | - Nena Bollen
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - Samuel L Hong
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - Fanny Wegner
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Lida Politi
- Department of Microbial Resistance and Infections in Health Care Settings, Directorate of Surveillance and Prevention of Infectious Diseases, Hellenic National Public Health Organization (EODY), Athens, Greece
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Kassiani Mellou
- Directorate of Epidemiological Surveillance and Intervention for Infectious Diseases, Hellenic National Public Health Organization (EODY), Athens, Greece
| | - Caspar Geenen
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, KU Leuven, Leuven, Belgium
| | - Sarah Gorissen
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, KU Leuven, Leuven, Belgium
| | - Bruno Verhasselt
- Department of Diagnostic Sciences, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Keith Durkin
- Laboratory of Human Genetics, GIGA Research Institute, Liège, Belgium
| | - Coralie Henin
- Federal testing platform COVID-19, Université libre de Bruxelles, Bruxelles, Belgium
| | - Anne-Sophie Logist
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - Simon Dellicour
- Spatial Epidemiology Lab (SpELL), Université Libre de Bruxelles, Bruxelles, Belgium
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - Tobias Resa
- Cantonal Office of Public Health Basel-Landschaft, Liestal, Switzerland
| | - Tanja Stadler
- SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland
| | - Piet Maes
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - Lize Cuypers
- Department of Laboratory Medicine, National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, KU Leuven, Leuven, Belgium
| | - Emmanuel André
- Department of Laboratory Medicine, National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, KU Leuven, Leuven, Belgium
| | - Adrian Egli
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
- Swiss Pathogen Surveillance Platform (https://spsp.ch)
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
- Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland
| | - Guy Baele
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
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Mjøsund K, Ghaleb M, Kolsrud L, Carrabre J, Kainzinger F, Boehm D, Bitterling F, Wolfarth B. International biathlon season during the COVID-19 pandemic was based on frequent on-site PCR-testing protocol with rapid result management. Front Sports Act Living 2023; 5:1217463. [PMID: 37720078 PMCID: PMC10500065 DOI: 10.3389/fspor.2023.1217463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/17/2023] [Indexed: 09/19/2023] Open
Abstract
The resumption of professional sports during the COVID-19 pandemic has been described in team sports but less in individual sports. The International Biathlon Union implemented a COVID-19 concept for the 2020-2021 season aimed to mitigate the risks of transmission by rules designated for the professional biathlon environment. The "bubble" model was based on regular reverse transcript polymerase chain reaction (PCR) testing with rapid results and efficient result management protocol. The objective of this study was report incidence and transmission of SARS-CoV-2 among professional biathletes and staff undergoing frequent PCR testing and risk reduction measures during the international season 2020-2021. The efficiency of risk mitigation measures was also evaluated based on the incidence data. During the 4-month season, altogether 22,182 SARS-CoV-2 PCR tests were conducted on all individuals participating in international biathlon season (athletes, team staff and organizing committee). Ninety-six (0.4%) PCR tests were positive and 30% of the positive PCR tests were considered "persistent positive" following recovery from a recent COVID-19 infection. No transmission events were detected following contact with "persistent positive" cases during the season. A great majority of the positive PCR tests were recorded during the first days after arrival in the "bubble", often in the first entry test taken by the on-site laboratory. In conclusion, a "bubble model" based on frequent PCR testing and hygiene rules was efficient in keeping the infection rate low. The competition activity including international travel was safe, and most of the infections seemed to originate from outside of the "bubble".
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Affiliation(s)
- Katja Mjøsund
- The International Biathlon Union (IBU), Salzburg, Austria
- Paavo Nurmi Centre and Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | | | - Lars Kolsrud
- The International Biathlon Union (IBU), Salzburg, Austria
- Norges SkiskytterforbundOslo, Norway
| | - Jim Carrabre
- The International Biathlon Union (IBU), Salzburg, Austria
| | | | - Daniel Boehm
- The International Biathlon Union (IBU), Salzburg, Austria
| | | | - Bernd Wolfarth
- The International Biathlon Union (IBU), Salzburg, Austria
- Department of Sports Medicine, Humboldt University and Charité University School of Medicine, Berlin, Germany
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Carmola LR, Turcinovic J, Draper G, Webner D, Putukian M, Silvers-Granelli H, Bombin A, Connor BA, Angelo KM, Kozarsky P, Libman M, Huits R, Hamer DH, Fairley JK, Connor JH, Piantadosi A, Bourque DL. Genomic Epidemiology of a Severe Acute Respiratory Syndrome Coronavirus 2 Outbreak in a US Major League Soccer Club: Was It Travel Related? Open Forum Infect Dis 2023; 10:ofad235. [PMID: 37323423 PMCID: PMC10264064 DOI: 10.1093/ofid/ofad235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/03/2023] [Indexed: 06/17/2023] Open
Abstract
Background Professional soccer athletes are at risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). United States Major League Soccer (MLS) uses protocol-based SARS-CoV-2 testing for identification of individuals with coronavirus disease 2019. Methods Per MLS protocol, fully vaccinated players underwent SARS-CoV-2 real-time polymerase chain reaction testing weekly; unvaccinated players were tested every other day. Demographic and epidemiologic data were collected from individuals who tested positive, and contact tracing was performed. Whole genome sequencing (WGS) was performed on positive specimens, and phylogenetic analyses were used to identify potential transmission patterns. Results In the fall of 2021, all 30 players from 1 MLS team underwent SARS-CoV-2 testing per protocol; 27 (90%) were vaccinated. One player who had recently traveled to Africa tested positive for SARS-CoV-2; within the following 2 weeks, 10 additional players and 1 staff member tested positive. WGS yielded full genome sequences for 10 samples, including 1 from the traveler. The traveler's sample was Delta sublineage AY.36 and was closely related to a sequence from Africa. Nine samples yielded other Delta sublineages including AY.4 (n = 7), AY.39 (n = 1), and B.1.617.2 (n = 1). The 7 AY.4 sequences clustered together; suggesting a common source of infection. Transmission from a family member visiting from England to an MLS player was identified as the potential index case. The other 2 AY.4 sequences differed from this group by 1-3 nucleotides, as did a partial genome sequence from an additional team member. Conclusions WGS is a useful tool for understanding SARS-CoV-2 transmission dynamics in professional sports teams.
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Affiliation(s)
- Ludy R Carmola
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jacquelyn Turcinovic
- Department of Microbiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- National Emerging Infectious Diseases Laboratory, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Program in Bioinformatics, Boston University, Boston, Massachusetts, USA
| | - Garrison Draper
- Department of Sport and Exercise Science, School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
- Player and Health Performance, 6 Philadelphia Union, Chester, Pennsylvania, USA
| | - David Webner
- Player and Health Performance, 6 Philadelphia Union, Chester, Pennsylvania, USA
- Crozer Health, Sports Medicine, Springfield, Pennsylvania, USA
| | | | | | - Andrei Bombin
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Bradley A Connor
- Deparment of Medicine, Weill Cornell Medicine and the New York Center for Travel and Tropical Medicine, New York, New York, USA
| | - Kristina M Angelo
- Travelers’ Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Phyllis Kozarsky
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michael Libman
- J.D. MacLean Centre for Tropical Diseases, McGill University, Montreal, Canada
| | - Ralph Huits
- Department of Infectious Tropical Diseases and Microbiology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy
| | - Davidson H Hamer
- National Emerging Infectious Diseases Laboratory, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Section of Infectious Diseases, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Department of Global Health, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Jessica K Fairley
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | - John H Connor
- Department of Microbiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- National Emerging Infectious Diseases Laboratory, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Program in Bioinformatics, Boston University, Boston, Massachusetts, USA
| | - Anne Piantadosi
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Daniel L Bourque
- Section of Infectious Diseases, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
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Alhussaini NWZ, Elshaikh UAM, Hamad NA, Nazzal MA, Abuzayed M, Al-Jayyousi GF. A scoping review of the risk factors and strategies followed for the prevention of COVID-19 and other infectious diseases during sports mass gatherings: Recommendations for future FIFA World Cups. Front Public Health 2023; 10:1078834. [PMID: 36726622 PMCID: PMC9885104 DOI: 10.3389/fpubh.2022.1078834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/28/2022] [Indexed: 01/17/2023] Open
Abstract
Objective Sports mass gatherings of people pose particular concerns and place an additional burden on the host countries and the countries of origin of the travelers. It is imperative to identify how countries dealt with various communicable diseases in the context of previous world cups and identify possible advice for protection from outbreaks. Methods A scoping review was employed in this study and a PRISMA extension for scoping reviews was employed to guide the reporting of this study. A systematic search was performed using PubMed, Embase, Web of Science, SCOPUS, SportDiscus, and Google scholar. The search strategy included two main strings viz "communicable disease" AND "sport" AND "setting" as keywords for each string. A total of 34 studies were included in this review. Results Information on risk factors for infectious diseases during FIFA, and recommendations for disease prevention in various stages of the event: pre-event, during, and post-event were charted. These strategies can be achieved with the empowerment of the public by enhancing their social responsibility and the coordination between the healthcare system, the ministry of public health, and other stakeholders. Conclusion The findings will support planning for protection strategies to prevent any outbreak while having the FIFA World Cup or any other sports gatherings. A model was constructed to present the findings and recommendations from this review.
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Affiliation(s)
| | | | - Noor Ahmed Hamad
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Maisa Ayman Nazzal
- Department of Infection Control Unit, Ibn Sina Specialized Hospital, West Bank, Palestine
| | - Manal Abuzayed
- Health Promotion Division, Department of Public Health, Ministry of Public Health, Doha, Qatar
| | - Ghadir Fakhri Al-Jayyousi
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar,*Correspondence: Ghadir Fakhri Al-Jayyousi ✉
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7
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Purves RI, Maclean J, Rocha C, Philpott M, Fitzgerald N, Piggin J, Hunt K. Attending sporting mega events during COVID-19: mitigation and messaging at UK EURO 2020 matches. Health Promot Int 2023; 38:6974790. [PMID: 36617291 PMCID: PMC9825819 DOI: 10.1093/heapro/daac176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The UEFA EURO 2020 football tournament was one of the largest Sporting Mega Events (SMEs) to take place during the COVID-19 pandemic. Mitigating the risk of virus transmission requires a multi-layered approach for any large event, more so in this case due to staging the tournament across eleven host countries. Yet, little is known about COVID-19 risks and mitigation from attending an event of this scale and nature. We examined the implementation of mitigation and messaging at EURO 2020 matches hosted at venues in the UK. The tournament was postponed from the summer of 2020 and played in June and July of 2021. Structured observations were conducted by 11 trained fieldwork-supporters at 10 matches played at Wembley Stadium, London, or Hampden Park, Glasgow. Fieldwork-supporters observed one-way systems and signage, and hand sanitizing stations inside the stadia, but reported significant variation in the implementation of staggered timeslots, testing upon entry, and procedures for exit. Adherence to planned measures by ticket holders and implementation by stewards waned as the tournament progressed culminating in an absence of enforced measures at the final. The non-compliance with COVID-19 mitigation measures was likely to have led to a significantly increased risk of transmission. Future events should consider how COVID-19 mitigation measures could become 'new norms' of fan behaviour, learning from what is already known about football fandom. Tournament organizers of SMEs can use these findings to promote clearer messaging on pandemic-driven changes in fan behaviour and best practices in mitigating risk at future sporting and cultural events.
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Affiliation(s)
| | - Jordan Maclean
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Claudio Rocha
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | | | - Niamh Fitzgerald
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Joe Piggin
- Loughborough University, Loughborough, UK
| | - Kate Hunt
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
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O'Donnell C, Brownlee K, Martin E, Suyama J, Albert S, Anderson S, Bhatte S, Bonner K, Burton C, Corn M, Eng H, Flage B, Frerotte J, Balasubramani GK, Haggerty C, Haight J, Harrison LH, Hartman A, Hitter T, King WC, Ledger K, Marsh JW, McDonald MC, Miga B, Moses K, Newman A, Ringler M, Roberts M, Sax T, Shekhar A, Sterne M, Tenney T, Vanek M, Wells A, Wenzel S, Williams J. SARS-CoV-2 control on a large urban college campus without mass testing. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 36595575 DOI: 10.1080/07448481.2022.2153600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 06/22/2022] [Accepted: 09/19/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE A small percentage of universities and colleges conducted mass SARS-CoV-2 testing. However, universal testing is resource-intensive, strains national testing capacity, and false negative tests can encourage unsafe behaviors. PARTICIPANTS A large urban university campus. METHODS Virus control centered on three pillars: mitigation, containment, and communication, with testing of symptomatic and a random subset of asymptomatic students. RESULTS Random surveillance testing demonstrated a prevalence among asymptomatic students of 0.4% throughout the term. There were two surges in cases that were contained by enhanced mitigation and communication combined with targeted testing. Cumulative cases totaled 445 for the term, most resulting from unsafe undergraduate student behavior and among students living off-campus. A case rate of 232/10,000 undergraduates equaled or surpassed several peer institutions that conducted mass testing. CONCLUSIONS An emphasis on behavioral mitigation and communication can control virus transmission on a large urban campus combined with a limited and targeted testing strategy.
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Affiliation(s)
- Christopher O'Donnell
- Department of Medicine, University of Pittsburgh School of Medicine (UPSOM), Pittsburgh, Pennsylvania, USA
| | | | - Elise Martin
- Department of Medicine, University of Pittsburgh School of Medicine (UPSOM), Pittsburgh, Pennsylvania, USA
| | - Joe Suyama
- Department of Emergency Medicine, UPSOM, Pittsburgh, Pennsylvania, USA
| | - Steve Albert
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health (GSPH), Pittsburgh, Pennsylvania, USA
| | - Steven Anderson
- Office of the Dean, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sai Bhatte
- Kenneth P. Dietrich School of Arts & Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kenyon Bonner
- Office of the Dean, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Chad Burton
- University of Pittsburgh Information Technology, Pittsburgh, Pennsylvania, USA
| | - Micaela Corn
- Office of University Communications & Marketing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Heather Eng
- Department of Epidemiology, GSPH, Pittsburgh, Pennsylvania, USA
| | - Bethany Flage
- Department of Infectious Disease and Microbiology, GSPH, Pittsburgh, Pennsylvania, USA
| | - Jay Frerotte
- Environmental Health and Safety, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | | | - Joel Haight
- Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lee H Harrison
- Department of Medicine, University of Pittsburgh School of Medicine (UPSOM), Pittsburgh, Pennsylvania, USA
| | - Amy Hartman
- Department of Infectious Disease and Microbiology, GSPH, Pittsburgh, Pennsylvania, USA
| | - Thomas Hitter
- Office of Policy Development and Management, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Wendy C King
- Department of Epidemiology, GSPH, Pittsburgh, Pennsylvania, USA
| | - Kate Ledger
- Office of University Communications & Marketing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jane W Marsh
- Department of Medicine, University of Pittsburgh School of Medicine (UPSOM), Pittsburgh, Pennsylvania, USA
| | | | - Bethany Miga
- Office of the Chancellor, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kimberly Moses
- Office of University Counsel, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Anne Newman
- Department of Epidemiology, GSPH, Pittsburgh, Pennsylvania, USA
| | - Meg Ringler
- Office of University Communications & Marketing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mark Roberts
- Department of Health Policy and Management, GSPH, Pittsburgh, Pennsylvania, USA
| | - Theresa Sax
- Department of Epidemiology, GSPH, Pittsburgh, Pennsylvania, USA
| | | | - Matthew Sterne
- Office of Business and Auxiliary Services, GSPH, Pittsburgh, Pennsylvania, USA
| | - Tyler Tenney
- Office of Policy Development and Management, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Marian Vanek
- Office of the Dean, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alan Wells
- Department of Pathology, UPSOM, Pittsburgh, Pennsylvania, USA
| | - Sally Wenzel
- Department of Environmental and Occupational Health, GSPH, Pittsburgh, Pennsylvania, USA
| | - John Williams
- Department of Pediatrics, UPSOM, Pittsburgh, Pennsylvania, USA
- Institute for Infection, Inflammation, and Immunity in Children, Pittsburgh, Pennsylvania, USA
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Dixon BE, Fadel WF, Duszynski TJ, Caine VA, Meyer JF, Saysana M. Mitigation of COVID-19 at the 2021 National Collegiate Athletic Association Men’s Basketball Tournament. BMC Public Health 2022; 22:2061. [DOI: 10.1186/s12889-022-14547-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/04/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Data are lacking regarding the risk of viral SARS-CoV-2 transmission during a large indoor sporting event involving fans utilizing a controlled environment. We sought to describe case characteristics, mitigation protocols used, variants detected, and secondary infections detected during the 2021 National Collegiate Athletic Association (NCAA) Men’s Basketball Tournament involving collegiate athletes from across the U.S.
Methods
This retrospective cohort study used data collected from March 16 to April 3, 2021, as part of a closed environment which required daily reverse transcription-polymerase chain reaction (RT-PCR) testing, social distancing, universal masking, and limited contact between tiers of participants. Nearly 3000 players, staff, and vendors participated in indoor, unmasked activities that involved direct exposure between cases and noninfected individuals. The main outcome of interest was transmission of SARS-CoV-2 virus, as measured by the number of new infections and variant(s) detected among positive cases. Secondary infections were identified through contact tracing by public health officials.
Results
Out of 2660 participants, 15 individuals (0.56%) screened positive for SARS-CoV-2. Four cases involved players or officials, and all cases were detected before any individual played in or officiated a game. Secondary transmissions all occurred outside the controlled environment. Among those disqualified from the tournament (4 cases; 26.7%), all individuals tested positive for the Iota variant (B.1.526). All other cases involved the Alpha variant (B.1.1.7). Nearly all teams (N = 58; 85.3%) reported that some individuals had received at least one dose of a vaccine. Overall, 17.9% of participants either had at least one dose of the vaccine or possessed documented infection within 90 days of the tournament.
Conclusion
In this retrospective cohort study of the 2021 NCAA Men’s Basketball Tournament closed environment, only a few cases were detected, and they were discovered in advance of potential exposure. These findings support the U.S. Centers for Disease Control and Prevention (CDC) guidelines for large indoor sporting events during the COVID-19 pandemic.
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Prisco L, Salesi LA, McElheny KD, Weiss D, Diamond L, Brennan T. Primary Care Considerations for the Baseball Athlete. Curr Rev Musculoskelet Med 2022; 15:570-580. [PMID: 36342649 PMCID: PMC9640801 DOI: 10.1007/s12178-022-09798-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/27/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE OF REVIEW To summarize current guidance and best practices surrounding non-orthopedic medical concerns in baseball. RECENT FINDINGS Discussion of COVID19-related practice changes pertaining to the prevention and screening of communicable respiratory illness, concussion protocol updates, the enhanced role of a multi-disciplinary team of mental health professionals. Prevention, appropriate screening, and early identification remain cornerstones of effective primary care both within the general population as well as for the baseball athlete.
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Affiliation(s)
- Lauren Prisco
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Lauren A. Salesi
- grid.239915.50000 0001 2285 8823Primary Sports Medicine, Hospital for Special Surgery, 535 E 70th. St, New York, NY 10021 USA
| | - Kathryn D. McElheny
- grid.239915.50000 0001 2285 8823Primary Sports Medicine, Hospital for Special Surgery, 535 E 70th. St, New York, NY 10021 USA
| | - Doria Weiss
- grid.260917.b0000 0001 0728 151XNew York Medical College School of Medicine, Valhalla, NY USA
| | - Laura Diamond
- grid.416167.30000 0004 0442 1996The Addiction Institute of Mount Sinai West Hospital, Department of Psychiatry, New York, NY USA
| | - Tim Brennan
- grid.59734.3c0000 0001 0670 2351Addiction Institute of Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY USA
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11
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Bhatia R, Sledge I, Baral S. Missing science: A scoping study of COVID-19 epidemiological data in the United States. PLoS One 2022; 17:e0248793. [PMID: 36223335 PMCID: PMC9555641 DOI: 10.1371/journal.pone.0248793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 09/12/2022] [Indexed: 11/06/2022] Open
Abstract
Systematic approaches to epidemiologic data collection are critical for informing pandemic responses, providing information for the targeting and timing of mitigations, for judging the efficacy and efficiency of alternative response strategies, and for conducting real-world impact assessments. Here, we report on a scoping study to assess the completeness of epidemiological data available for COVID-19 pandemic management in the United States, enumerating authoritative US government estimates of parameters of infectious transmission, infection severity, and disease burden and characterizing the extent and scope of US public health affiliated epidemiological investigations published through November 2021. While we found authoritative estimates for most expected transmission and disease severity parameters, some were lacking, and others had significant uncertainties. Moreover, most transmission parameters were not validated domestically or re-assessed over the course of the pandemic. Publicly available disease surveillance measures did grow appreciably in scope and resolution over time; however, their resolution with regards to specific populations and exposure settings remained limited. We identified 283 published epidemiological reports authored by investigators affiliated with U.S. governmental public health entities. Most reported on descriptive studies. Published analytic studies did not appear to fully respond to knowledge gaps or to provide systematic evidence to support, evaluate or tailor community mitigation strategies. The existence of epidemiological data gaps 18 months after the declaration of the COVID-19 pandemic underscores the need for more timely standardization of data collection practices and for anticipatory research priorities and protocols for emerging infectious disease epidemics.
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Affiliation(s)
- Rajiv Bhatia
- Primary Care and Population Health, Stanford University, Stanford, CA, United States of America
- * E-mail:
| | | | - Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, United States of America
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12
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Schultz EA, Kussman A, Jerome A, Abrams GD, Hwang CE. Comparison of SARS-CoV-2 Test Positivity in NCAA Division I Student Athletes vs Nonathletes at 12 Institutions. JAMA Netw Open 2022; 5:e2147805. [PMID: 35138397 PMCID: PMC8829663 DOI: 10.1001/jamanetworkopen.2021.47805] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
IMPORTANCE The COVID-19 pandemic initially led to the abrupt shutdown of collegiate athletics until guidelines were established for a safe return to play for student athletes. Currently, no literature exists that examines the difference in SARS-CoV-2 test positivity between student athletes and nonathletes at universities across the country. OBJECTIVE To identify the difference in risk of COVID-19 infection between student athlete and nonathlete student populations and evaluate the hypothesis that student athletes may display increased SARS-CoV-2 test positivity associated with increased travel, competition, and testing compared with nonathletes at their respective universities. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional analysis, a search of publicly available official university COVID-19 dashboards and press releases was performed for all 65 Power 5 National Collegiate Athletic Association (NCAA) Division I institutions during the 2020 to 2021 academic year. Data were analyzed at the conclusion of the academic year. Schools that released at least 4 months of testing data, including the fall 2020 football season, for student athletes and nonathlete students were included in the analysis. Power 5 NCAA Division I student athletes and their nonathlete student counterparts were included in the analysis. EXPOSURE Designation as a varsity student athlete. MAIN OUTCOMES AND MEASURES The main outcome was SARS-CoV-2 test positivity for student athletes and nonathlete students at the included institutions for the 2020 to 2021 academic year, measured as a relative risk for student athletes. RESULTS Among 12 schools with sufficient data available included in the final analysis, 555 372 student athlete tests and 3 482 845 nonathlete student tests were performed. There were 9 schools with decreased test positivity in student athletes compared with nonathlete students (University of Arkansas: 0.01% vs 3.52%; University of Minnesota: 0.63% vs 5.96%; Penn State University: 0.74% vs 6.58%; Clemson University: 0.40% vs 1.88%; University of Louisville: 0.75% vs 3.05%; Purdue University: 0.79% vs 2.97%; University of Michigan: 0.40% vs 1.12%; University of Illinois: 0.17% vs 0.40%; University of Virginia: 0.64% vs 1.04%) (P < .001 for each). The median (range) test positivity in these 9 schools was 0.46% (0.01%-0.79%) for student athletes and 1.04% (0.40%-6.58%) for nonathlete students. In 1 school, test positivity was increased in the student athlete group (Stanford University: 0.20% vs 0.05%; P < .001). Overall, there were 2425 positive tests (0.44%) among student athletes and 30 567 positive tests (0.88%) among nonathlete students, for a relative risk of 0.50 (95% CI, 0.48-0.52; P < .001). There was no statistically significant difference in student athlete test positivity between included schools; however, test positivity among nonathlete students varied considerably between institutions, ranging from 133 of 271 862 tests (0.05%) at Stanford University to 2129 of 32 336 tests (6.58%) at Penn State University. CONCLUSIONS AND RELEVANCE This study found that in the setting of SARS-CoV-2 transmission mitigation protocols implemented by the NCAA, participation in intercollegiate athletics was not associated with increased SARS-CoV-2 test positivity. This finding suggests that collegiate athletics may be held without an associated increased risk of infection among student athletes.
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Affiliation(s)
- Emily A. Schultz
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Andrea Kussman
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Alyssa Jerome
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Geoffrey D. Abrams
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Calvin E. Hwang
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
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Mack CD, Wasserman EB, Anderson DJ, Farkas G, Delaney M, Eichner D, Johnston K, Lassiter MK, Myers E, Mayer T, Solomon G, Sills A. Anatomy of an American football game: Player-to-player contact before, during and after an NFL game in context of the 2020 COVID-19 pandemic. PHYSICIAN SPORTSMED 2022; 51:234-239. [PMID: 35040386 DOI: 10.1080/00913847.2022.2028536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To quantify levels of potential exposure to SARS-CoV-2 surrounding a typical professional American football game, with a focus on interactions on-field between teammates and opposing players before, during, and immediately after competition. METHODS We examined across-Club consecutive interactions ≥2 minutes within 6 feet [1.8 meters] between athletes on opposing Clubs for all 2020 NFL regular season games (n = 256). Cumulative interaction was measured for a representative subset (n = 119; 46%) of games. Wearable proximity tracking devices (Kinexon) were used to measure distance and duration of interactions; these data were combined with game schedule and Club rosters for analyses. Frequency and per-game mean, median, interquartile range for consecutive interactions ≥2/≥5 minutes and cumulative interactions ≥5/≥15 were described overall and stratified by pre-game, in-game, and post-game. RESULTS Of the 1964 distinct player-to-opponent contacts ≥2 minutes in NFL regular season games, the majority (n = 1,699; 87%) were fewer than 5 minutes in consecutive length. Among the mean 7.7 distinct contacts ≥2 minutes with opponents each game (median = 4; IQR = 2, 8), very few were ≥5 consecutive minutes at any point (mean = 1.0; median = 0; IQR = 0, 0). Most (n = 849; 43.2%) distinct contacts were pre-game, 546 (27.8%) were during competition, and 569 (29%) were post-game. In games where cumulative interactions were analyzed, there was an average of 17.1 player/opponent interactions with cumulative exposure ≥5 minutes (median = 12; IQR = 4, 30), almost all of which occurred during competition. CONCLUSION There is limited and short contact between and among competing players in professional American football. In the setting of infectious disease such as the COVID-19 pandemic, a robust prevention program integrating masking, distancing, hygiene, and ventilation when off-field can be created to minimize on- and off-field exposures, which effectively reduces transmission risk in outdoors and/or well-ventilated stadium settings.
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Affiliation(s)
- Christina D Mack
- IQVIA Real-World Solutions, Research Triangle Park, North Carolina, USA
| | - Erin B Wasserman
- IQVIA Real-World Solutions, Research Triangle Park, North Carolina, USA
| | - Deverick J Anderson
- Department of Medicine, Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina, USA
| | - Gabriel Farkas
- IQVIA Real-World Solutions, Research Triangle Park, North Carolina, USA
| | - Molly Delaney
- Player Health and Safety Department, National Football League, New York, NY, USA
| | - Daniel Eichner
- Sports Medicine Research and Testing Laboratory, Salt Lake City, UT, USA
| | | | | | - Emily Myers
- Player Health and Safety Department, National Football League, New York, NY, USA
| | - Thom Mayer
- National Football League Players Association, Washington, DC, USA
| | - Gary Solomon
- Player Health and Safety Department, National Football League, New York, NY, USA
| | - Allen Sills
- Player Health and Safety Department, National Football League, New York, NY, USA
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Guo X, Gupta A, Sampat A, Zhai C. A stochastic contact network model for assessing outbreak risk of COVID-19 in workplaces. PLoS One 2022; 17:e0262316. [PMID: 35030206 PMCID: PMC8759694 DOI: 10.1371/journal.pone.0262316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 12/20/2021] [Indexed: 12/19/2022] Open
Abstract
The COVID-19 pandemic has drastically shifted the way people work. While many businesses can operate remotely, a large number of jobs can only be performed on-site. Moreover as businesses create plans for bringing workers back on-site, they are in need of tools to assess the risk of COVID-19 for their employees in the workplaces. This study aims to fill the gap in risk modeling of COVID-19 outbreaks in facilities like offices and warehouses. We propose a simulation-based stochastic contact network model to assess the cumulative incidence in workplaces. First-generation cases are introduced as a Bernoulli random variable using the local daily new case rate as the success rate. Contact networks are established through randomly sampled daily contacts for each of the first-generation cases and successful transmissions are established based on a randomized secondary attack rate (SAR). Modification factors are provided for SAR based on changes in airflow, speaking volume, and speaking activity within a facility. Control measures such as mask wearing are incorporated through modifications in SAR. We validated the model by comparing the distribution of cumulative incidence in model simulations against real-world outbreaks in workplaces and nursing homes. The comparisons support the model's validity for estimating cumulative incidences for short forecasting periods of up to 15 days. We believe that the current study presents an effective tool for providing short-term forecasts of COVID-19 cases for workplaces and for quantifying the effectiveness of various control measures. The open source model code is made available at github.com/abhineetgupta/covid-workplace-risk.
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Affiliation(s)
- Xi Guo
- One Concern, Inc., Menlo Park, CA, United States of America
| | - Abhineet Gupta
- One Concern, Inc., Menlo Park, CA, United States of America
| | - Anand Sampat
- One Concern, Inc., Menlo Park, CA, United States of America
| | - Chengwei Zhai
- One Concern, Inc., Menlo Park, CA, United States of America
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15
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Return to Play Following COVID-19 Infection-A Systematic Review of Current Evidence. J Sport Rehabil 2021; 31:218-223. [PMID: 34564071 DOI: 10.1123/jsr.2021-0028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT The COVID-19 pandemic has had catastrophic impact on a global scale, affecting people from all walks of life including elite athletes. OBJECTIVES The purpose of this study was to evaluate the reported rates of return to play (RTP) in conjunction with the expert-derived guidelines previously recommended to enable safe RTP post COVID-19 infection. EVIDENCE ACQUISITION Two independent reviewers searched the literature based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, utilizing the MEDLINE, Embase, and Scopus databases. Only studies that reported rates of RTP and/or recommended guidelines for safe RTP were included. EVIDENCE SYNTHESIS Overall, 17 studies (3 level III and 14 level V) were included. A total of 3 studies reported rates of RTP in a total of 1255 athletes and 623 officials; 72 (30 symptomatic) were infected with COVID-19, 100% of whom were able to RTP post COVID-19 infection. Of the 14 studies recommending guidelines for safe RTP, 3 and 9 studies recommended 7 and 14 days of rest in isolation respectively for asymptomatic patients with COVID-19 infection, prior to safe RTP. In contrast, 7 studies recommended 3 to 6 months of rest (following 14 d isolation) in cases of COVID-19-induced myocarditis as a safe timeframe for safe RTP. Of the 11 studies reporting on whether blanket testing prior to RTP was recommended, only 7 studies recommended a negative test result as mandatory prior to RTP for athletes previously infected with COVID-19. CONCLUSIONS Although excellent rates of RTP have been reported for elite athletes post COVID-19 infection, discrepancies in recommended rest periods, requirement for mandatory negative test results, and the magnitude of screening investigations required continue to exist in the literature, with a need for further standardized international guidelines required in future. LEVEL OF EVIDENCE Level V; systematic review of all forms of evidence.
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16
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Asymptomatic infection is the pandemic's dark matter. Proc Natl Acad Sci U S A 2021; 118:2114054118. [PMID: 34526404 PMCID: PMC8463787 DOI: 10.1073/pnas.2114054118] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 01/02/2023] Open
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17
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Kubosch EJ, Meidl V, Bretthauer B, Busch A, Leonhart R, Dallmann P, Wrobel N, Hirschmüller A. Impact of the COVID-19 Pandemic on German Paralympic Athletes. SPORTS ORTHOPAEDICS AND TRAUMATOLOGY 2021. [PMCID: PMC8830906 DOI: 10.1016/j.orthtr.2021.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Background The purpose of this study was to bring the impact of the COVID-19 pandemic on competitive sports of german para-athletes into focus. We aimed to identify special aspects of disabled athletes during the pandemic, and their mental health. Material and Methods All german candidate athletes preparing for the Tokyo Summer Paralympic Games were asked to complete a questionnaire, which consisted of questions about sports participation, physical and mental health, and the occupational and personal impact of the COVID-19 pandemic. Results A total of 109 athletes (52 men, 57 women, mean age 29.2 (±10.4) years) completed the questionnaire between May 17th and August 30th 2020. 70% of the athletes felt that organizing their training was difficult, two-thirds of the athletes trained less than before. Half of the participants worried about their own well-being, 25% about their career, only 8% about their finances. Conclusions The COVID-19 pandemic has a huge impact on sports of elite para athletes. Many athletes worried about the social impact and half of the respondents were of the opinion that people with disabilities were specially affected by the COVID-19 pandemic. Level of evidence: IV
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18
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Shenoy ES, Weber DJ. Routine surveillance of asymptomatic healthcare personnel for severe acute respiratory coronavirus virus 2 (SARS-CoV-2): Not a prevention strategy. Infect Control Hosp Epidemiol 2021; 42:592-597. [PMID: 33427148 PMCID: PMC7870911 DOI: 10.1017/ice.2020.1428] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 11/22/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Erica S. Shenoy
- Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - David J. Weber
- Division of Infectious Disease, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Hospital Epidemiology, UNC Medical Center, Chapel Hill, North Carolina
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19
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Johansson MA, Wolford H, Paul P, Diaz PS, Chen TH, Brown CM, Cetron MS, Alvarado-Ramy F. Reducing travel-related SARS-CoV-2 transmission with layered mitigation measures: symptom monitoring, quarantine, and testing. BMC Med 2021; 19:94. [PMID: 33849546 PMCID: PMC8043777 DOI: 10.1186/s12916-021-01975-w] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/25/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Balancing the control of SARS-CoV-2 transmission with the resumption of travel is a global priority. Current recommendations include mitigation measures before, during, and after travel. Pre- and post-travel strategies including symptom monitoring, antigen or nucleic acid amplification testing, and quarantine can be combined in multiple ways considering different trade-offs in feasibility, adherence, effectiveness, cost, and adverse consequences. METHODS We used a mathematical model to analyze the expected effectiveness of symptom monitoring, testing, and quarantine under different estimates of the infectious period, test-positivity relative to time of infection, and test sensitivity to reduce the risk of transmission from infected travelers during and after travel. RESULTS If infection occurs 0-7 days prior to travel, immediate isolation following symptom onset prior to or during travel reduces risk of transmission while traveling by 30-35%. Pre-departure testing can further reduce risk, with testing closer to the time of travel being optimal even if test sensitivity is lower than an earlier test. For example, testing on the day of departure can reduce risk while traveling by 44-72%. For transmission risk after travel with infection time up to 7 days prior to arrival at the destination, isolation based on symptom monitoring reduced introduction risk at the destination by 42-56%. A 14-day quarantine after arrival, without symptom monitoring or testing, can reduce post-travel risk by 96-100% on its own. However, a shorter quarantine of 7 days combined with symptom monitoring and a test on day 5-6 after arrival is also effective (97--100%) at reducing introduction risk and is less burdensome, which may improve adherence. CONCLUSIONS Quarantine is an effective measure to reduce SARS-CoV-2 transmission risk from travelers and can be enhanced by the addition of symptom monitoring and testing. Optimal test timing depends on the effectiveness of quarantine: with low adherence or no quarantine, optimal test timing is close to the time of arrival; with effective quarantine, testing a few days later optimizes sensitivity to detect those infected immediately before or while traveling. These measures can complement recommendations such as social distancing, using masks, and hand hygiene, to further reduce risk during and after travel.
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Affiliation(s)
- Michael A Johansson
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA.
| | - Hannah Wolford
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Prabasaj Paul
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Pamela S Diaz
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Tai-Ho Chen
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Clive M Brown
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Martin S Cetron
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
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20
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Fox-Harding C, Harris SA, Rogers SL, Vial S, Beranek P, Turner M, Cruickshank T. A Survey to Evaluate the Association of COVID-19 Restrictions on Perceived Mood and Coping in Australian Community Level Athletes. Front Sports Act Living 2021; 3:624267. [PMID: 33829154 PMCID: PMC8021018 DOI: 10.3389/fspor.2021.624267] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 01/14/2021] [Indexed: 01/07/2023] Open
Abstract
Highlights: No differences in coping or well-being in Australian community athletes based on the level of support received during COVID-19 restrictions.Community level athletes had better coping when a training program was provided.No difference between individual or team community athletes for well-being or coping scores. Australian community level athletes faced unprecedented changes to their training and competition options as the global COVID-19 pandemic took a stronghold. This disruption was predicted to have a negative impact on emotional well-being as communities braced through periods of social isolation and physical distancing requirements. This study provides an Australian perspective on the emotional well-being of community level athletes and the extent to which they coped during the COVID-19 pandemic. Emotional well-being and coping were measured using the Brief Emotional Experience Scale and the 28-item Brief Cope Scale. Both instruments were administered along with other questions pertaining to participant demographics and training status via an online survey between April and June 2020. The survey was disseminated to community athletes through word-of-mouth and social media platforms. No significant differences in emotional well-being were observed between athlete groups as a result of COVID-19 and its associated restrictions. Coping scores also appeared to be preserved in Australian community athletes, which contrasts the impact expected as a result of the COVID-19 pandemic. While tentative, the observed preservation in coping may have buffered potential declines in emotional well-being, which has been documented in professional and semi-professional athletes and the general population. These unexpected findings and tentative suppositions warrant further investigation and highlight the importance of conducting a country- or region-specific approach to examining the impact of COVID-19 on community athletes, as responses to COVID-19 are undoubtedly not consistent throughout the world.
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Affiliation(s)
- Caitlin Fox-Harding
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia,*Correspondence: Caitlin Fox-Harding
| | - Sarah Ann Harris
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia,Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Shane L. Rogers
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Shayne Vial
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Philipp Beranek
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Mitchell Turner
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Travis Cruickshank
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia,Centre for Precision Health, ECU Strategic Research Centre, Edith Cowan University, Perth, WA, Australia,Perron Institute, QE II Medical Centre, Perth, WA, Australia
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21
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Platt BN, Uhl TL, Sciascia AD, Zacharias AJ, Lemaster NG, Stone AV. Injury Rates in Major League Baseball During the 2020 COVID-19 Season. Orthop J Sports Med 2021; 9:2325967121999646. [PMID: 33796594 PMCID: PMC7970198 DOI: 10.1177/2325967121999646] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 02/08/2021] [Indexed: 12/26/2022] Open
Abstract
Background: The 2020 Major League Baseball (MLB) season was drastically altered because
of the COVID-19 pandemic. The changes included an extended layoff between
March and July as well as a shortened preseason. Purpose/Hypothesis: To determine the incidence and epidemiology of MLB injuries in the
abbreviated 2020 season compared with prior seasons. We hypothesized that
there was an increase in the overall injury rate in the 2020 season compared
with the 2018-2019 seasons and that it equally affected all body
regions. Study Design: Descriptive epidemiology study. Methods: The MLB transactions database was queried to find players who had been placed
on the injury list between 2018 and 2020. Injuries were categorized into
upper extremity, lower extremity, spine/core, and other injuries. Incidence
per 1000 athlete-exposures was calculated for the prior 2 seasons
(2018-2019) and for the 2020 season separately. Incidence for each category
was also calculated separately for pitchers and fielders. Incidence rate
ratios (IRRs) and confidence intervals were used to compare injury rates in
2018-2019 versus 2020. The z test for proportions was used
to determine significant differences between injury incidences. Results: In 2020, the overall incidence rate per 1000 athlete-exposures was almost
twice the rate compared with the 2 seasons before COVID-19 (8.66 vs 5.13;
IRR, 1.69 [95% CI, 1.53-1.87]; P < .001). Injury
incidence increased similarly in 2020 for both pitchers (IRR, 1.68 [95% CI,
1.47-1.91]; P < .001) and fielders (IRR, 1.68 [95% CI,
1.45-1.96]; P < .001). Increases in injury incidence
were seen in the upper extremity, spine/core, and other injury categories;
however, the incidence of the lower extremity did not change
significantly. Conclusion: There was a significant increase in injury incidence for both pitchers and
fielders in 2020. Injury rates increased in anatomic zones of the upper
extremity and spine/core but were not significantly changed in the lower
extremity. The overall increase in injury rate suggests that irregular or
insufficient sport-specific preparation prior to the start of the season
placed athletes at a greater risk of injury when play resumed.
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Affiliation(s)
- Brooks N Platt
- Division of Sports Medicine, Department of Orthopaedic Surgery & Sports Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Timothy L Uhl
- Division of Sports Medicine, Department of Physical Therapy, University of Kentucky, Lexington, Kentucky, USA
| | - Aaron D Sciascia
- Department of Exercise and Sport Science, Eastern Kentucky University, Richmond, Kentucky, USA
| | - Anthony J Zacharias
- Division of Sports Medicine, Department of Orthopaedic Surgery & Sports Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Nicole G Lemaster
- Division of Sports Medicine, Department of Orthopaedic Surgery & Sports Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Austin V Stone
- Division of Sports Medicine, Department of Orthopaedic Surgery & Sports Medicine, University of Kentucky, Lexington, Kentucky, USA
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22
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Folkerts ML, Lemmer D, Pfeiffer A, Vasquez D, French C, Jones A, Nguyen M, Larsen B, Porter WT, Sheridan K, Bowers JR, Engelthaler DM. Methods for sequencing the pandemic: benefits of rapid or high-throughput processing. F1000Res 2021; 10:ISCB Comm J-48. [PMID: 35342619 PMCID: PMC8921685 DOI: 10.12688/f1000research.28352.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2022] [Indexed: 12/21/2022] Open
Abstract
Genomic epidemiology has proven successful for real-time and retrospective monitoring of small and large-scale outbreaks. Here, we report two genomic sequencing and analysis strategies for rapid-turnaround or high-throughput processing of metagenomic samples. The rapid-turnaround method was designed to provide a quick phylogenetic snapshot of samples at the heart of active outbreaks, and has a total turnaround time of <48 hours from raw sample to analyzed data. The high-throughput method, first reported here for SARS-CoV2, was designed for semi-retrospective data analysis, and is both cost effective and highly scalable. Though these methods were developed and utilized for the SARS-CoV-2 pandemic response in Arizona, U.S, we envision their use for infectious disease epidemiology in the 21 st Century.
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Affiliation(s)
- Megan L. Folkerts
- Pathogen Genomics Division, Translational Genomics Research Institute, Flagstaff, AZ, 86005, USA
| | - Darrin Lemmer
- Pathogen Genomics Division, Translational Genomics Research Institute, Flagstaff, AZ, 86005, USA
| | - Ashlyn Pfeiffer
- Pathogen Genomics Division, Translational Genomics Research Institute, Flagstaff, AZ, 86005, USA
| | - Danielle Vasquez
- Pathogen Genomics Division, Translational Genomics Research Institute, Flagstaff, AZ, 86005, USA
| | - Chris French
- Pathogen Genomics Division, Translational Genomics Research Institute, Flagstaff, AZ, 86005, USA
| | - Amber Jones
- Pathogen Genomics Division, Translational Genomics Research Institute, Flagstaff, AZ, 86005, USA
| | - Marjorie Nguyen
- Pathogen Genomics Division, Translational Genomics Research Institute, Flagstaff, AZ, 86005, USA
| | - Brendan Larsen
- Department of Ecology and Evolutionary Biology, University of Arizona, Tucson, AZ, 85721, USA
| | - W. Tanner Porter
- Pathogen Genomics Division, Translational Genomics Research Institute, Flagstaff, AZ, 86005, USA
| | - Krystal Sheridan
- Pathogen Genomics Division, Translational Genomics Research Institute, Flagstaff, AZ, 86005, USA
| | - Jolene R. Bowers
- Pathogen Genomics Division, Translational Genomics Research Institute, Flagstaff, AZ, 86005, USA
| | - David M. Engelthaler
- Pathogen Genomics Division, Translational Genomics Research Institute, Flagstaff, AZ, 86005, USA
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23
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Coronado F, Blough S, Bergeron D, Proia K, Sauber-Schatz E, Beltran M, Rau KT, McMichael A, Fortin T, Lackey M, Rohs J, Sparrow T, Baldwin G. Implementing Mitigation Strategies in Early Care and Education Settings for Prevention of SARS-CoV-2 Transmission - Eight States, September-October 2020. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2020; 69:1868-1872. [PMID: 33301431 PMCID: PMC7737684 DOI: 10.15585/mmwr.mm6949e3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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