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Updated Nov. 24, 2020

Because of the COVID-19 pandemic, many high schools have delayed, postponed, or canceled sports practices and competitions.

As restrictions begin to ease across the U.S., some schools are preparing for a return to play.

To help reduce the risk of COVID-19 spread in high school athletics, a multidisciplinary team of experts at UPMC developed a Return to Sports Playbook. The playbook sets guidelines for high schools to bring back sports while keeping athletes, coaches, fans, and other participants safe.

While we believe these guidelines will help reduce the risk of COVID-19 spread, we cannot guarantee prevention of illness or injury. High school sports officials should also follow guidelines from the Centers for Disease Control and Prevention (CDC) and state health departments.

As of Nov. 18, 2020, Pennsylvania requires all sports participants — athletes (including cheerleaders), coaches, and spectators over 2 years old — to wear face coverings at all times indoors and at all times outdoors when they cannot consistently maintain 6 feet of physical distancing. This requirement includes people who are actively participating, with few exceptions. See below for further details.

The following steps include some, but not all, of the guidelines included in the Return to Sports Playbook for high school athletes. They are subject to change as we learn more about COVID-19. The full playbook can be viewed on our website.

Step 1: Create a COVID-19 Safety Task Force

We recommend that high schools create a task force to implement COVID-19 safety guidelines in athletics. This group is responsible for communicating its plans to everyone at the school. The creation of this group also provides structure so everyone is aware of how athletes will be screened each day, ensuring that the steps do not become redundant.

The task force can include officials such as athletic directors, athletic trainers, team doctors, and school nurses. Schools also could consider head coaches, strength and conditioning coaches, facilities managers, counselors, and nutritionists for the task force.

Step 2: Bring Back High School Sports in Phases

The NCAA suggests a six-week “warm-up” period to help athletes regain conditioning they may have lost during quarantine. This should be done in phases to limit the risk of COVID-19 spread.

During all phases, coaches, players, and officials should follow COVID-19 prevention procedures like social distancing and sanitizing.

• Phase one: High school sports participants usually come from the same community and are presumed to have followed government-mandated social distancing. Because of this, a 14-day isolation period is not required — however, it can help prevent disease spread if done properly. We recommend COVID-19 education to teach athletes, parents, coaches, and staff about COVID-19 symptoms, spread, and prevention.
• Phase two: If, after 14 days of self-isolation, the number of COVID-19 cases in the community is not rising, teams should be broken up into groups of 10 student-athletes or fewer. These groups can participate in non-contact workouts for two weeks. The groups should remain constant over the two-week period. They should wear masks, and all meetings should be done over a virtual platform.
• Phase three: If the number of COVID-19 cases is not on the rise after 14 days of small groups, the groups can be combined into larger groups — with a maximum of 50 student-athletes. These groups now can practice with full contact. Social distancing should be followed at all other times, including in weight rooms and locker rooms.
• Phase four: If the number of COVID-19 cases in the community is falling after two weeks in phase three, teams can return to full groups for practice and competition. They should continue to follow social distancing and other COVID-19 prevention methods.

Step 3: Follow Social Distancing Guidelines

All teams should follow social distancing guidelines at all times. Athletes, coaches, and other staff should maintain 6 feet of distance unless actively participating. Masks should be worn at all times indoors, and at all times outdoors if participants cannot maintain 6 feet of distancing consistently.

Other possibilities for following proper social distancing include:

• Limiting staff at practices, competitions, and workouts to essential personnel.
• Reducing the amount of people in rooms/buildings to less than capacity.
• Avoiding large social gatherings.
• Analyzing facilities — cafeterias, classrooms, weight rooms, locker rooms, stadiums, gymnasiums, and more venues — and considering spacing. Mark out 6 feet of distance where appropriate. Participants should sit at least 6 feet apart in all common areas.
• Avoiding using dugouts if possible, and maintaining 6 feet of distance on benches.
• Asking athletes to stand at least 6 feet apart when not participating in drills or activities that require close contact.
• Holding team meetings virtually, if possible.
• Avoiding unnecessary contact like handshakes, high-fives, fist bumps, and elbow bumps.

Step 4: Follow Sanitation Recommendations

To help prevent the spread of COVID-19, coaches, athletes, staff, and others should keep equipment and facilities as sanitary as possible.

• Do not share equipment, if possible. Athletes should use their own equipment.
• If equipment is shared, it should be cleaned after each person uses it.
• Athletes should not share hydration containers (such as water bottles) or food.
• Hand sanitizer should be readily available throughout athletic facilities for use before, during, and after workouts.
• Staff should frequently clean common areas like classrooms, weight rooms, and restrooms.

Step 5: Wear Personal Protective Equipment

Per Pennsylvania’s updated order on face coverings, players, coaches, and staff should wear facemasks at all times indoors, including training rooms and weight rooms. They should wear facemasks at all times outdoors if they cannot consistently maintain 6 feet of social distancing. Exceptions include if wearing a facemask could cause a medical condition or exacerbate an existing one, such as respiratory trouble.

• Cloth face coverings are sufficient, but surgical or N95 masks also can be used.
• Masks should cover the nose and mouth while still allowing for steady, unrestricted breathing.
• Gloves have not been proven to prevent spread of COVID-19. Instead, we recommend people wash their hands frequently and avoid touching their face.

Step 6: Hold Pre-Participation Screenings for COVID-19

Schools should check for COVID-19 symptoms and exposure in pre-participation physicals. Screenings should be spaced out over several different times or days to prevent large gatherings of people.

COVID-19 questions should be included in the screening, including:

1. Have you tested positive for COVID-19?
2. Have you had a known exposure to COVID-19?
3. Have you been tested for COVID-19?
4. Have you experienced cough, shortness of breath, or a fever above 99.5 degrees Fahrenheit?

If an athlete has tested positive for COVID-19, recent medical evidence recommends that a heart screening be considered. This should be discussed with a team physician on a case-by-case basis.

Step 7: Have Daily Screenings

Athletes, coaches, and staff should be screened daily for COVID-19 exposure and symptoms. This can be accomplished with no-touch temperature checks and a series of COVID-19 screening questions:

1. Do you have a new cough or shortness of breath?
2. Have you had a fever or felt feverish?
3. Have you had known exposure to someone with COVID-19?

If someone answers yes to any of the above questions, or has a temperature above 99.5 degrees Fahrenheit, more investigation and/or testing is needed. That person should be removed from the group immediately. If it’s a student-athlete, his or her parents should be notified because of the concern for illness.

For more information about the Return to Sports Playbook for high school sports, visit UPMC Sports Medicine or email ReturnToSports@upmc.edu.