As some states and communities return to youth sports during the COVID-19 pandemic, many parents are trying to navigate this new experience on their own. Project Play is here to help. While some questions are best answered by public health experts based on local conditions, there are guidelines and best practices that are very useful. We will periodically answer youth sports parents’ questions in this Project Play Parent Mailbag. Got a question? Submit it in the space on the right side of this page or email jon.solomon@aspeninstitute.org.
I’m torn about whether my son should play high school football this fall given the situation. He wants to play and I want him to play. I know there are risks. He’s on the larger size and plays offensive line. What factors do we need to be thinking about?
Kevin Benson
Increasingly, doctors and researchers are concerned about possible long-term heart damage to athletes who test positive for COVID-19. Boston Red Sox pitcher Eduardo Rodriguez is sitting out this season after he tested positive for COVID-19 and an MRI exam showed he had myocarditis, an inflammation of the heart muscle.
“(Younger athletes) think, ‘If I get (COVID-19), it’s not a big deal; it’s going to be like having a cold,’” Jay Schneider, a leading researcher at the Mayo Clinic about how COVID-19 impacts the heart, told The Washington Post. “It may not just be a cold. It may end your sports career. Hopefully not, but there is a sense it’s much more serious than we are thinking, or in particular our young athletes are thinking.”
Multiple published papers from cardiological experts agree there should be a heightened level of concern regarding cardiac involvement in athletes. There is not specific research looking at athletes. But some research has shown as many as 20% of people who recover from COVID-19 show cardiac abnormalities.
One of the biggest and rarest heart concerns is myocarditis. Myocarditis causes about 75 deaths per year in athletes from 13 and 25 years old, according to the Myocarditis Foundation. Most deaths occur during or immediately after exercise. Heart screenings are going to be important for athletes who test positive for COVID-19 and want to return. Myocarditis has been found in at least five Big Ten Conference college athletes and athletes from several other conferences, according to ESPN.com. Left undiagnosed and untreated, it can cause heart damage and sudden cardiac arrest, which can be fatal.
The Journal of the American Medical Association recently published a study out of Germany showing that 78% of COVID-19 patients had some kind of cardiac abnormality, and 60% showed inflammation consistent with myocarditis. The researchers provided cardiac MRI exams to 100 patients who had recovered from COVID-19, including two-thirds who had suffered mild or no symptoms. The study was composed of middle-aged people, and Emory University cardiologist Jonathan Kim told The Washington Post that he would expect athletes as a group to fare better. Still, the results startled him. The researchers concluded, “These findings indicate the need for ongoing investigation of the long-term cardiovascular consequences of COVID-19.”
The physical health of your child, including his size, should also be part of the consideration. According to the Centers for Disease Control and Prevention, people with a body mass index of 30 or higher are considered obese and more likely to become seriously ill if they contract COVID-19. High blood pressure, obesity and diabetes are among the most common factors found in COVID-19 patients. Of course, football players of that size tend to be more physically active than non-athletes of that size.
However, in a letter to player agents that addressed risk factors for the virus, the NFL Players Association noted that a BMI of over 30 was considered an underlying condition. Some experts consider body fat percentage a more accurate metric for athletes. According to the American Council on Exercise, men with a body fat percentage over 25% are considered obese.
Of the 67 NFL players sitting out 2020, 20 are offensive linemen and 12 are defensive linemen. While linemen constitute nearly one-third of NFL rosters, they accounted for nearly half of all opt-outs.
As many kids go to remote learning for the fall, how do we make sure PE is still part of the curriculum? My child’s school did no PE in the spring. I’d like him to be active again.
Heather Graham
Really good question. This is a topic that Axios Sports wrote about this week. Online-only classes unfortunately mean that physical education could be severely limited or suspended. Even before the pandemic, the data were troubling about physical inactivity among youth.
Only 24% of children ages 6 to 17 participated in 60 minutes of physical activity per day – the standard set by the Centers for Disease Control and Prevention. In 2019, 32% of kids ages 6-12 and 46% of youth ages 13-17 regularly participated in high-calorie-burning sports, according to the Sports and Fitness Industry Association – an increase from 2018, but still below the figures from 2012 (38% for ages 6-12, 48% ages 13-17).
Now imagine no PE for many kids this fall. “If schools fail to encourage some sort of physical outlet, America’s youth – most of whom don’t play organized sports, and almost all of whom are currently unable to participate in them – will suffer,” Axios wrote.
SHAPE America created resources to help health and PE teachers provide high-quality, standards-based lessons through remote learning. Among the resources: SHAPE America’s Ready-to-Go Take Home Packet designed for teachers to download so they have a collection of ready to use activities. The activities are designed to be done over the course of a week.
The Hospital for Special Surgery Sports Safety Program has turned its Learning Center into a virtual PE platform. Free PE classes are available for teachers to use in grades 3-12.
No one’s saying this will be easy. Getting kids to be physically active through a computer or phone screen will be challenging. Parents can play a role by participating with their child before, during or after PE class, and by following up that their child is being active. Tip for parents: The more fun the activity, the more likely the child will do it.
Why are youth sports being singled out to ban activities when other businesses are allowed to return? It doesn’t make sense. The kids need sports. Leagues need money.
Bob Thornton
These are challenging times for municipalities on what should and shouldn’t be open. The general rule of thumb: Follow the science, wear masks and practice social distancing. As mentioned previously in the mailbag, there are some reports of COVID-19 outbreaks connecting to youth sports activities. As some kids return to in-person school, the potential for spread may increase, as we’re seeing in Georgia.
In Philadelphia, Montgomery County officials say they’re seeing two major sources of spread for the virus: private social gatherings and youth sports. Montgomery County Commissioner Dr. Val Arkoosh said there are several sports leagues where entire teams are out on quarantine. Since July 1, 13 people associated with youth sports have tested positive, according to the county. Seven of those played while they might have been contagious, and 93 people were potentially exposed.
“It is very hard for transmission to be avoided in settings where people are close together and not wearing masks,” Arkoosh said. “We just know how contagious this virus is and that’s how it spreads.”
Yes, leagues are hurting financially. But that can’t be the main reason to resume play, as it appears to be in Ohio. Gov. Mike DeWine has not permitted competition in contact sports (football, soccer, field hockey, basketball) based on an Ohio Department of Health Order.
The Southwestern Ohio Basketball League and Warren County Sports Park and Kingdom Sports Center filed an injunction against the state to allow contact sports at their facilities, arguing that the restrictions would cause “irreparable harm” to their businesses. Last week, a county judge allowed contact sports to be played at those facilities, according to Cincinnati.com.
Tourism accounts for one of every 10 jobs in Warren County. Many of the 12 million annual visitors come to the area for tournaments at those facilities. Organizers are immediately looking at holding tournaments.
While we all want kids playing sports again, it has to be done in a safe and responsible manner. Many public health experts say travel sports should be the last phase to return to youth sports. Tournaments possibly spread the virus within different communities, states and regions.
We will periodically answer youth sports parents’ questions in this Project Play Parent Mailbag. Got a question? Submit it in the form in this page’s sidebar or email jon.solomon@aspeninstitute.org.
