2021 Fall Sports COVID-19 Guidance August 12, 2021

QUICK FACTS:

• Everyone aged 12 and older is now eligible for vaccination. https://www.cdc.gov/coronavirus/2019- ncov/vaccines/recommendations/adolescents.html

• The Pfizer vaccine is currently approved for youth aged 12 and older. It requires two shots, scheduled 3 weeks apart, which means athletes and coaches should get vaccinated now to be ready for the Fall sport season

• COVID-19 vaccines are safe, very effective, readily available, and free! Find the vaccine location nearest to you: https://portal.ct.gov/vaccine-portal?language=en_US

• Remember: Fully vaccinated people do not have to quarantine or test after a known exposure to COVID-19, as long as they remain asymptomatic. For more information on COVID-19 vaccination, including how to schedule a clinic for your participants, please visit: https://portal.ct.gov/Vaccine-Portal or COVID19.DPH@ct.gov.”

Masks Fall 2021 Interim recommendations for COVID-19 prevention in Connecticut’s PreK -12 schools were issued by the Connecticut State Department of Education (CSDE) and CT DPH on July 25, 2021. In alignment with those recommendations, the CIAC policy will follow current Executive Order 13A, which provides that everyone must wear masks regardless of vaccination status while inside certain settings, such as schools, pursuant to an order from the commissioner of the Department of Public Health. Federal Order (CDC) requires mask use on public transportation, including school buses. The CIAC will continue to collaborate with the CSMS Sports Medicine Committee and the CT DPH on mask requirements as back-to-school recommendations are finalized by the CSDE.

• Volleyball – In alignment with current executive orders pertaining to mask requirements in school buildings, athletes, regardless of vaccination status, will wear masks for all indoor activities including active competition, practice, and all events around active play. If volleyball practices/training sessions occur outdoors, masks may be removed while in the outdoor setting. This follows practices implemented in the 2020-2021 school year for both girls’ and boys’ volleyball.

• Swimming – Athletes, regardless of vaccination status, will wear masks for all activities around active practice and competition, however, will not wear masks while in the water. Masks may be removed for outdoor dry-land training while athletes are actively conditioning.

• Cross Country, Field Hockey, Football, Golf, Soccer – In alignment with current youth sport recommendations, athletes, regardless of vaccination status, will not be required to wear masks during outdoor activities, practice, or competition. When indoors (e.g. locker rooms, indoor practice, classroom team/film session, weight room, etc.), mask should be worn in alignment with current executive orders pertaining to mask requirements in schools.

• Sideline/Exhibition Cheerleading and Dance – In alignment with current youth sport recommendations, athletes, regardless of vaccination status, will masks indoors. For safety purposes, masks may be removed indoors when performing stunts and put back on after the stunt sequence is completed. Outdoors, masks are not required while actively cheering, dancing, or stunting during halftime performances. Masks are not required while cheerleading on the sideline.

• Officials – Swim and volleyball officials will wear masks in alignment in Connecticut mask requirements inside school buildings. Cross country, field hockey, football, and soccer officials are not required to wear masks while officiating outdoor competitions.

Quarantine, Contacts, Isolation Fully vaccinated students/staff who are a close contact with a known COVID-19 case do not have to quarantine from sports or other activities, provided they remain asymptomatic after close contact with a known COVID-19 case (Interim Recommendations for COVID-19 Prevention in Connecticut’s PreK-12 Schools, July 2021), and wear a mask until receiving a negative COVID-19 test (taken between days 3 and 5 from the date of contact) or 14 days without a test.

Unvaccinated asymptomatic students who are a close contact of a known COVID-19 case will quarantine for 10 days (with a negative test between days 7 and 10) or 14 days without a test.

Vaccinated and unvaccinated students who experience COVID-19 symptoms after close contact with a known COVID-19 case will quarantine for 10 days (with a negative test between days 7 and 10) or 14 days without a test. Weekly testing for unvaccinated athletes / coaches is recommended (Interim Recommendations for COVID-19 Prevention in Connecticut’s PreK-12 Schools, July 2021).

Guidance on Return-to-Play after COVID-19 Infection (The following recommendations are informed by the AAP COVID- 19 Interim Guidelines: https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinicalguidance/covid-19-interim-guidance-return-to-sports/ )

Returning to play after COVID positive test: COVID 19 can affect the heart and lungs of the person infected. One uncommon but serious complication of COVID 19 is a heart condition called myocarditis. Myocarditis is an inflammation of the heart muscle (myocardium). Myocarditis can affect the heart muscle and the heart's electrical system, reducing the heart's ability to pump and causing rapid, abnormal heart rhythms (arrhythmias) which can cause cardiac arrest. Exercise can increase the likelihood of permanent heart damage in myocarditis and increase the possibility of arrhythmias and sudden cardiac death. Student athletes who have tested positive for COVID 19 should follow the guideline noted below to decrease risk of developing complications from COVID 19 infection.

What to do if a participant had COVID-19 or has it during the season?

In a covid19 positive child who is either asymptomatic or mildly symptomatic (<4 days of fever >100.4°F, short duration of myalgia, chills, and lethargy) should not exercise until they are cleared by a licensed medical provider. The licensed medical provider will perform a history with emphasis on cardiopulmonary symptoms and complete physical examination. If this evaluation was completed and no contraindications to participation were identified, no further testing is warranted. The patient may then begin a gradual return to play after 10 days have passed from date of the positive test result and at least 24 hours without symptoms off-fever reducing medications. If the licensed medical provider identifies any new or concerning history or physical examination findings at this visit, appropriate further testing or consultation should be ordered and participation will not be allowed until that testing is completed and no contraindications to participation are identified. Written documentation of medical clearance for return to sport should be provided by the medical provider. Children with moderate symptoms of COVID-19 (≥4 days of fever >100.4°F, myalgia, chills, or lethargy or were in a hospital not an intensive care unit), should not exercise until they are cleared by a licensed medical provider. In addition to a history and complete physical exam appropriate additional testing should be ordered as determined by examination.

Consultation or referral to a cardiologist is recommended and they may request further, more extensive, testing. If cardiac evaluation is normal, gradual return to physical activity may be allowed after 10 days have passed from the date of the positive test result, and at least 10 days of symptom resolution has occurred off fever-reducing medicine. Written documentation of medical clearance for return to sport should be provided by the medical provider.

For patients with severe COVID-19 symptoms (ICU stay and/or on a ventilator) or multisystem inflammatory syndrome in children (MIS-C), it is recommended they be restricted from exercise for a minimum of 3 months. The student athlete should be evaluated by a licensed medical provider for a history and complete physical examination. In addition, they should be referred to a cardiologist prior to resuming training or competition. In addition to the initial evaluation and work-up student athletes should have a coordinated evaluation at the time of returning to play for final clearance. Written documentation of medical clearance for return to sport should be provided by the medical provider.

A graduated return-to-play protocol can begin once an athlete has been cleared by a licensed medical provider (cardiologist for moderate to severe COVID-19 symptoms) and feels well when performing normal activities of daily living. The progression should be performed over the course of a 7-day minimum. Consideration for extending the progression should be given to student athletes who experienced moderate COVID-19 symptoms as outlined above. If the student athlete experiences any symptoms of chest pain, palpitations, syncope, shortness of breath or exercise intolerance, during this return to play protocol, they should stop exercise and inform their medical provider.

The following progression was adapted from Elliott N, et al, infographic, British Journal of Sports Medicine, 2020:

Stage 1: Day 1 and Day 2 - (2 Days Minimum) - 15 minutes or less: Light activity (walking, jogging, stationary bike), intensity no greater than 70% of maximum heart rate. NO resistance training.

Stage 2: Day 3 - (1 Day Minimum) - 30 minutes or less: Add simple movement activities (eg. running drills) - intensity no greater than 80% of maximum heart rate.

Stage 3: Day 4 - (1 Day Minimum) - 45 minutes or less- Progress to more complex training - intensity no greater than 80% maximum heart rate. May add light resistance training.

Stage 4: Day 5 and Day 6 - (2 Days Minimum) - 60 minutes -Normal training activity - intensity no greater than 80% maximum heart rate. Stage 5:

Day 7 - Return to full activity/participation (i.e., - Contests/competitions).

Spectator/Fan Attendance Allowance for regular season spectator/fan attendance should align with DECD sector rules. The CIAC supports the plans established by school districts that direct the presence of adults on campus at this time. Notwithstanding the above, permissible regular season spectator/fan attendance will be governed by local districts’ current operating plan. The CIAC will determine spectator/ fan attendance protocol for its state championship tournaments.


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