Sport makes an important contribution to the physical, psychological and emotional well-being of Australians. The economic contribution of sport is equivalent to 2–3% of Gross Domestic Product (GDP). The COVID-19 pandemic has had devastating effects on communities globally, leading to significant restrictions on all sectors of society, including sport. Resumption of sport can significantly contribute to the re-establishment of normality in Australian society.
The Australian Institute of Sport (AIS), in consultation with sport partners (National Institute Network (NIN) Directors, NIN Chief Medical Officers (CMOs), National Sporting Organisation (NSO) Presidents, NSO Performance Directors and NSO CMOs), has developed a framework to inform the resumption of sport. National Principles for Resumption of Sport were used as a guide in the development of ‘the AIS Framework for Rebooting Sport in a COVID-19 Environment’ (the AIS Framework); and based on current best evidence, and guidelines from the Australian Federal Government, extrapolated into the sporting context by specialists in sport and exercise medicine, infectious diseases and public health.
The principles outlined in this document apply equally to high performance/professional level, community competitive and individual passive (non-contact) sport. The AIS Framework is a timely tool for ‘how’ reintroduction of sport activity will occur in a cautious and methodical manner, to optimise athlete and community safety. Decisions regarding the timing of resumption of sporting activity (the ‘when’) must be made in close consultation with Federal, State/Territory and Local Public Health Authorities. The priority at all times must be to preserve public health, minimising the risk of community transmission.
The resumption of sport and recreation activities will be a complex process. A careful stepwise process needs to be implemented to ensure the safety of athletes and other personnel and the wider community.
High level descriptors of three levels (Levels A, B, C) of activities and associated hygiene measures are recommended. More detailed descriptions of recommended sport specific activities at each level are outlined in Appendices A and B.
Preparation for resumption includes education of the athletes and other personnel, assessment of the sport environment and agreement on training scheduling to accommodate social distancing. The approach to training should focus on ‘get in, train, get out’, minimising unnecessary contact in change rooms, bathrooms and communal areas. Prior to resumption, sporting organisations should have agreed protocols in place for management of illness in athletes and other personnel. Special consideration should be made for para-athletes and others with medical conditions as they may be more vulnerable to COVID-19 infection. Clubs and individuals should apply a graded return to mitigate injury risk, understanding that sudden increase in training load will predispose to injury.
The timing of progression between levels may be influenced by any evidence of transmission issues within the local community or sporting cohort.
Individuals should not return to sport if in the last 14 days they have been unwell or had contact with a known or suspected case of COVID-19. Any individual with respiratory symptoms (even if mild) should be considered a potential case and must immediately self-isolate, have COVID-19 excluded and be medically cleared by a doctor to return to the training environment.
Athletes returning to sport after COVID-19 infection require special consideration prior to resumption of high intensity physical activity. While there is increasing research on the multi-organ nature of COVID-19 in the acute phase, there is currently limited research on medium to long-term complications. Long-term decreased exercise capacity has been noted following previous related coronavirus infections (SARS and MERS). Sudden increase in training load predispose to injury and a graded return should be considered.
Resumption of sporting activity may not be linear. Increasing restrictions may be required in response to fluctuating numbers of COVID-19 cases. Sporting organisations need to be flexible to accommodate and respond to changes in community transmission rates and the associated changes in advice from Public Health Authorities.
To Download the Executive Summary and the full framework go here.