End-to-end SARS-CoV-2 transmission risks in sport: Current evidence and practical recommendations

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has caused disruption to professional and recreational sports across the world. The SARS-CoV-2 virus  can be transmitted by relatively large respiratory droplets that behave ballistically, and exhaled aerosol droplets, which potentially pose a greater risk.  This review provides a summary of end-to-end SARS-CoV-2 transmission risk factors for sport and an overview of transmission mechanisms to be  considered by all stakeholders. The risk of SARS-CoV-2 transmission is greatest indoors, and primarily influenced by the ventilation of the environment  and the close proximity of individuals. The SARS-CoV-2 transmission risks outdoors, e.g. via water, and from fomites, appear less than initially thought.  Mitigation strategies include good end-to-end scenario planning of activities to optimise physical distancing, face mask wearing and hygiene practice of  individuals, the environment and equipment. The identification and removal of infectious individuals should be undertaken by means of the taking of  temperature and COVID-19 symptom screening, and the use of diagnostic monitoring tests to identify asymptomatic individuals. Using adequate video  footage, data from proximity technology and subject interviews, the identification and isolation of ‘close contacts’ should also be undertaken to limit  SARS-CoV-2 transmission within sporting environments and into the wider community. Sports should aim to undertake activities outdoors where  possible, given the lower SARS-CoV-2 transmission risk, in comparison to indoor environments.