Because of the COVID-19 pandemic, college sports seasons were canceled, postponed, or delayed. But with states beginning to ease their restrictions, college sports teams are preparing for a return to play.

To lower the risk of COVID-19 spread in college sports, a multidisciplinary team of UPMC experts developed the Return to Sports Playbook. The playbook provides guidelines for college sports teams to keep student-athletes, coaches, staff, and others safe from COVID-19. It covers topics like social distancing, sanitation, personal protective equipment, and travel.

Although a team of UPMC experts created the playbook, we cannot guarantee the prevention of injury or illness. Our recommendations also do not supersede any protocols set by the Centers for Disease Control and Prevention (CDC) or state departments of health. Colleges must develop their own safety protocols based on information from national, state, and local health officials.

Our guidelines also are subject to change as we learn more about COVID-19.

College Sports Task Force

We recommend that each college athletic department create a task force to discuss and implement COVID-19 safety protocols. That group of individuals can include:

  • Athletic director
  • Athletic trainers
  • Team physicians
  • Student health representative
  • Head coaches
  • Strength and conditioning coaches
  • Nutritionist
  • Facilities manager
  • Counseling services representative

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COVID-19 Screening in College Sports

Colleges should screen for COVID-19 exposure and symptoms in pre-participation screenings and continue to do so daily.

  • Pre-participation exams should be spaced out by teams and players. The only people in the testing space at one time should be the practitioner and person getting screened. This can be accomplished by reducing the number of teams screened in one day and scheduling screening appointments. No large groups of people should be waiting for screening at any time.
  • The pre-participation exam should include COVID-19-specific questions:
    • Have you tested positive for COVID-19?
    • Have you had known exposure to someone diagnosed with COVID-19?
    • Have you been tested for COVID-19?
    • Have you experienced a recent cough or shortness of breath?
    • Have you had a fever of over 99.5 degrees Fahrenheit recently?
  • Cardiac testing should be considered on a case-by-case basis if a student-athlete has previously tested positive for COVID-19.

Student-athletes, coaches, and staff should be screened daily for COVID-19 exposure and symptoms. It should include a no-touch temperature check and COVID-19 screening questions:

  • Do you have a new-onset cough or shortness of breath?
  • Have you had a fever or felt feverish?
  • Have you had a known exposure to someone who has tested positive for COVID-19?

Further investigation is needed if an individual has a temperature over 99.5 degrees Fahrenheit or answers “yes” to any of the screening questions.

Collegiate Athletics Acclimatization Phases

The NCAA recommends a six-week acclimatization period to help student-athletes regain conditioning lost during quarantine. This should be done in phases to limit the risk of COVID-19 spread. Team arrivals should be staggered based on competition schedule.

  • Phase one: Student-athletes should socially isolate in their dorms or individual spaces for 14 days. They should limit contact with others.
    • Pre-participation testing and paperwork can take place if all individuals wear masks. No workouts should be held.
    • Teams should hold virtual meetings.
    • COVID-19 educational sessions are recommended for all participants to learn about symptoms, spread, and prevention. Look to the CDC or Pennsylvania Department of Health for information.
    • Asymptomatic testing can be considered but is not mandatory. The 14 days of self-isolation should make sure student-athletes are disease-free at the start of phase two.
    • Meal delivery should be considered.
  • Phase two: If community disease load isn’t rising after two weeks, phase two can begin.
    • Teams should break into groups with a maximum of 10 student-athletes for non-contact workouts. These groups should remain consistent for 14 days.
    • Student-athletes should wear masks indoors.
    • Team meetings should be held virtually.
    • Grab-and-go meals should be considered.
  • Phase three: If community disease load isn’t rising after 14 days in phase two, teams can proceed to phase three.
    • Smaller groups can combine into larger groups, with a maximum of 50 student-athletes. These groups should remain consistent for two weeks.
    • Full-contact practices can be held.
    • Social distancing (6 feet minimum) should be followed when not practicing — i.e. in weight rooms, cafeterias, and locker rooms.
    • Student-athletes should wear masks at all times indoors unless they are actively participating. Masks are recommended outdoors when participants are in close contact and are not actively competing. Coaches and staff should wear masks.
  • Phase four: If community disease load is falling after two weeks in phase three, teams may combine to their full groups.
    • Full practices and competitions can be held.
    • Teams should follow social distancing when not actively participating in practices and competitions.

Social Distancing in Collegiate Athletics

Colleges should encourage social distancing (a minimum of 6 feet) at all times, except when athletes are actively participating in drills or competition that requires close contact.

  • Consider limiting staff to essential personnel.
  • Evaluate the capacity of rooms and buildings. Set limits that are lower than those numbers.
  • Discourage large social gatherings.
  • Student housing should allow for individual rooms both on and off campus.
  • Evaluate the space in cafeterias, classrooms, weight rooms, training rooms, locker rooms, and other venues. Consider marking off spaces with 6 feet of distance. Space seating 6 feet apart in these areas.
  • Hold team meetings virtually.
  • Avoid unnecessary contact like handshakes, high fives, fist bumps, and elbow bumps.
  • Student-athletes should sit at least 6 feet apart on benches and avoid dugouts whenever possible.

Cleanliness in Collegiate Athletics

Schools should make a concerted effort to keep equipment, athletic facilities, and common areas as sanitized as possible.

  • Student-athletes should use their own equipment, if possible, and avoid sharing gear.
  • Equipment should be sanitized between each individual use.
  • Student-athletes should have their own personal hydration container and not share with teammates or others.
  • Hand sanitizer should be readily available in athletic venues and common areas for use before, during, and after workouts.
  • Facilities and common areas (locker rooms, weight rooms, restrooms) should be regularly cleaned and sanitized.
  • Consider eliminating items such as gaming systems, pool tables, etc. in other common areas.

Personal Protective Equipment (PPE) in Collegiate Athletics

Student-athletes, coaches, and staff should wear masks in all indoor spaces, including locker rooms, training rooms, and weight rooms. Masks also should be considered in outdoor spaces when people are in close contact and are not actively participating in their sport.

  • Cloth face coverings are adequate for use. Surgical or N95 masks can be used but aren’t necessary.
  • The facemask should cover the nose and mouth and allow for steady, unlabored breathing.
  • Because it is difficult to wear a mask while actively participating in an indoor sport, it is not required to wear one at those times. However, athletes should wear masks when not actively participating.
  • Coaches and staff should wear masks at all times.
  • Gloves have not been proven to decrease spread of COVID-19. Instead, we recommend people wash their hands frequently and avoid touching their face.

Collegiate Athletics Travel and Competition Guidelines

Colleges should make plans for competition and travel in advance of the season. School and conference officials, including medical providers, should remain in regular contact. Schools will need to share information about potential positive cases and exposures.

  • All ill athletes should be held from competition, no matter what.
  • Travel should be limited. Consider limiting out-of-conference play.
  • Teams should travel by air or by charter bus whenever possible.
  • Social distancing protocols should be followed during travel. Athletes should not share seats. Colleges should consider limiting the number of people who travel to essential coaches, players, and staff members.
  • Limit the number of stops made during travel.
  • Overnight stays should be avoided when possible. If overnight stays are necessary, no more than two people should share a room, and each person should have an individual sleeping space.

Illness Protocol in Collegiate Athletics

If a student-athlete falls ill with suspected COVID-19 during any phase, he or she should be removed from the group, masked, and physically isolated. Testing for COVID-19 should take place.

If an athlete tests positive for COVID-19, contact tracing should begin. See the CDC for contact tracing details.

  • Contact tracing identifies people who were in close contact (6 feet or closer) with someone with COVID-19 for more than 15 minutes while that person was symptomatic, or in the 48 hours before that person became symptomatic.
  • People identified through contact tracing should self-isolate for 14 days, and they should be monitored for potential symptoms.

Athletes who test positive for COVID-19 can return to social interaction if 72 hours have passed since their symptoms resolved AND at least 10 days have passed since they first experienced symptoms.

  • COVID-19 symptoms include fever, cough, and shortness of breath. A fever must go away without the use of fever-reducing drugs for an athlete to return.
  • A convalescent period lasting 14 days from the start of symptoms is recommended before an athlete returns to strenuous activity. Cardiac testing should also be considered.
  • The designated team physician should evaluate the COVID-19-positive athlete before clearing him or her to return.

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

Sources

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For Journals and Media sources:National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases. Enterovirus D68. Centers for Disease Control and Prevention. Link

For News sources:Dr. Amesh Adalja. A Back to School Victim-Finding Spree for Enterovirus 68. Tracking Zebra. Link

About Sports Medicine

Sports bring with them a potential for injury. And if you are looking to prevent, treat, or rehabilitate a sports injury, UPMC Sports Medicine can help. We serve athletes from a wide variety of sports across every demographic: young or old, male or female, pro or amateur. We partner with the Pittsburgh Steelers, Pittsburgh Penguins, Pitt Panthers, and over 60 high school, college, and regional teams and events. We’re working to build better athletes. We use cutting-edge rehabilitation techniques to help you recover and provide education on how to prevent injuries.