Coronavirus and its impact on footballers – a medical insight

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Football, like society, is in limbo. Dr. Rajpal Brar, DPT of 3CB Performance consulted closely with an epidemiologist and infectious disease expert to detail the coronavirus pandemic’s impact on football.

Note: Before I begin, infectious disease is far outside my scope of practice and expertise so I consulted with a trusted epidemiologist for all medical insight in this article.

The football world has been put on delay by the rapidly spreading novel coronavirus aka COVID-19 (CO – corona, VI – virus, D – disease, 19 – year of discovery) with most federations including the FA postponing professional leagues and UEFA delaying both the Champions and Europa League tournaments.

If you want more information on the virus itself, head over to the World Health Organization website and/or you can watch this general FAQ video I created in collaboration with the aforementioned epidemiologist and infectious disease expert:

In the following article, I’ll focus more on the football-specific impact of COVID-19, including if footballers are at higher risk for contracting the virus and when we might see leagues start back up.

 

Are footballers at higher risk?

LIVERPOOL, ENGLAND - Monday, February 17, 2020: Liverpool's Georginio Wijnaldum, Joe Gomez, Joel Matip and Virgil van Dijk during a training session at Melwood Training Ground ahead of the UEFA Champions League Round of 16 1st Leg match between Club Atlético de Madrid and Liverpool FC. (Pic by Paul Greenwood/Propaganda)

Although we have no data on footballer transmission rates (and never will) as it relates to COVID-19, there are multiple reasons why footballers may be at higher risks for becoming infected.

The first reason is that elite footballers are often immunosuppressed during the season due to the high quantity and intensity of physical and mental activity, fatigue, constant changes in sleep patterns due to travel, schedule variability due to games, and generally a very high stress environment – particularly for top tier teams in top markets that come under heavy scrutiny, media coverage, and relentless microscopic over-analysis.

Further, athletes, staff, and team personnel are potentially at higher risk simply due to a higher quantity of exposure to potential vectors for COVID-19.

Examples include interactions with fans, media members, and even players’ families may have more interaction with the community at large which results in potential transmission risk back to the player.

Additionally, players, staff, and personnel are often in confined group settings such as team meetings, locker rooms, training, travelling, and partake in meals together which further exacerbates potential exposures.

LIVERPOOL, ENGLAND - Sunday, January 19, 2020: Liverpool's Mohamed Salah celebrates scoring the second goal with team-mate goalkeeper Alisson Becker during the FA Premier League match between Liverpool FC and Manchester United FC at Anfield. (Pic by David Rawcliffe/Propaganda)

All that being said, elite athletes still typically have robust immune systems due to their fitness, overall health, and younger age which means even though they may be infected, it’s highly unlikely they’ll have severe symptoms.

Additionally, athletes, staff, and personnel have access to early COVID-19 testing and elite, concierge medical care which further limits any probability of developing severe symptoms.

To that point, Arsenal manager Mikel Arteta – the first confirmed COVID-19 case in the Premier League which set off a chain of emergency meetings that rightfully resulted in delaying the league – was able to undertake a COVID-19 test with only very mild symptoms – a luxury not available to most of the populous – and is faring quite well according to all reports.

 

When will sporting events and leagues be back?

LIVERPOOL, ENGLAND - Saturday, August 24, 2019: A Liverbird on the Paisley Gates pictured before the FA Premier League match between Liverpool FC and Arsenal FC at Anfield. (Pic by David Rawcliffe/Propaganda)

There’s no good answer here other than “we don’t know” because there are so many variables at play.

For example, lets say Premier League players, staff, personnel, and close contacts all go through an extended quarantine, come back with negative COVID-19 tests and all touch points – stadiums, training grounds, homes, transport, etc – are thoroughly disinfected.

If that’s the case, you still have to wait for COVID-19 to play its course in the general population; otherwise, you again risk league personnel becoming infected.

That timeline for the general population depends on the availability of testing and government mandates on quarantine and isolation.

To use the United States as an example, the CDC is now recommending eight more weeks of no events with greater than 10 individuals, with multiple states and cities currently shuttering all non-essential establishments and mandating isolation protocols with nightly curfews and only necessary travel like grocery shopping and doctor’s visits allowed.

If the UK and other European countries follow a similar two-month timeline, that essentially places the rest of the football club season into late May and the summer.

That reality may be setting in with reports that Euro 2020 and Copa America are on the verge of being pushed to the summer of 2021.

If the club season does return when it’s deemed relatively safe to come back, I imagine the leagues will continue to monitor and mandate strict distancing measures for players, staff, and personnel – possibly with family as well – with only essential personnel and no fans attending games until COVID-19 has completely run its course in the general population, just to be safe and avoid a further shutdown.

Unfortunately – like many things when it comes to medicine and disease – this is truly a fluid “wait and see” scenario. Assume nothing and take this one step at a time. There are no easy answers.

 

The Upshot

COVID-19 aka novel coronavirus has placed football on the backburner and the safety and health of the world population at the forefront. It’s a situation that needs to be taken very seriously and we’re seeing sports administration and federations now do just that.

We’ll assuredly hear of a number of athletes who become infected with COVID-19 but they’re more than likely to have only mild symptoms and recover well.

The larger concern is if any of these athletes came or come into contact with others and increase the spread, especially with high-risk populations.

I know we’re all bummed about the sports hiatus and re-arrangement of calendars but those are small blips in the grand scheme of things.

In the meantime, each and every one of us can follow experts’ advice and limit our own exposure to COVID-19 via social distancing and fundamental sanitation measures and limit its potential spread to others.

Stay safe, stay calm, stay in control of what you can control, and possibly use this relative downtime to reset and work on habits such as sleep hygiene, fitness, nutrition, reading, reaching out to family and friends, and so on.

These are difficult times full of change but it’s a short-term sacrifice for the long-term good.

We’ll get through this and perhaps be better for it with a deeper appreciation of football due to the forced perspective that comes from having it taken away.

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