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1.
Int J Environ Res Public Health ; 19(7)2022 Mar 25.
Article in English | MEDLINE | ID: covidwho-1789455

ABSTRACT

The study of the origin and implications of fatigue in exercise has been widely investigated, but not completely understood given the complex multifactorial mechanisms involved. Then, it is essential to understand the fatigue mechanism to help trainers and physicians to prescribe an adequate training load. The present narrative review aims to analyze the multifactorial factors of fatigue in physical exercise. To reach this aim, a consensus and critical review were performed using both primary sources, such as scientific articles, and secondary ones, such as bibliographic indexes, web pages, and databases. The main search engines were PubMed, SciELO, and Google Scholar. Central and peripheral fatigue are two unison constructs part of the Integrative Governor theory, in which both psychological and physiological drives and requirements are underpinned by homeostatic principles. The relative activity of each one is regulated by dynamic negative feedback activity, as the fundamental general operational controller. Fatigue is conditioned by factors such as gender, affecting men and women differently. Sleep deprivation or psychological disturbances caused, for example, by stress, can affect neural activation patterns, realigning them and slowing down simple mental operations in the context of fatigue. Then, fatigue can have different origins not only related with physiological factors. Therefore, all these prisms must be considered for future approaches from sport and clinical perspectives.


Subject(s)
COVID-19 , Sports , Exercise/psychology , Fatigue/etiology , Fatigue/psychology , Female , Humans , Male , SARS-CoV-2
2.
J Orthop Res ; 40(1): 43-54, 2022 01.
Article in English | MEDLINE | ID: covidwho-1787691

ABSTRACT

Anterior cruciate ligament (ACL) injuries are one of the most common and severe knee injuries across sports. As such, ACL injury prevention has been a focus of research and sports medicine practice for the past three-plus decades. Examining the current research and identifying both clinical strategies and research gaps, the aim of this review is to empower clinicians and researchers with knowledge of where the ACL injury prevention literature is currently and where it is going in the future. This paper examines the mechanism of ACL injury prevention, screening, implementation, compliance, adherence, coronavirus, and areas of future research. Clinical significance: The time lag between research and practical implementation in general healthcare settings can be as long as 17 years; however, athletes playing sports today are unable to wait that long. With effective programs already established, implementation and adherence to these programs is essential. Strategies such as coaching education, increasing awareness of free programs, identifying barriers, and overcoming implementation obstacles through creative collaboration are just a few ways that could help improve both ACL injury prevention implementation and adherence.


Subject(s)
Anterior Cruciate Ligament Injuries/prevention & control , Athletic Injuries/prevention & control , Knee Injuries/prevention & control , Athletes , Humans , Sports
3.
Int J Environ Res Public Health ; 19(7)2022 Mar 24.
Article in English | MEDLINE | ID: covidwho-1785629

ABSTRACT

INTRODUCTION: The global rise of urbanization has much triggered scientific interest in how nature impacts on human health. Natural environments, such as alpine landscapes, forests, or urban green spaces, are potential high-impact health resources. While there is a growing body of evidence to reveal a positive influence of these natural environments on human health and well-being, further investigations guided by rigorous evidence-based medical research are very much needed. OBJECTIVE: The present study protocol aims at testing research methodologies in the context of a prospective clinical trial on nature-based interventions. This shall improve the standards of medical research in human-nature interactions. METHODS: The ANKER Study investigates the influence of two novel types of nature-based therapy-mountain hiking and forest therapy-on physiological, psychological, and immunological parameters of couples with a sedentary lifestyle. Two intervention groups were formed and spent a seven-day holiday in Algund, Italy. The "forest therapy group" participated in daily guided low-power nature connection activities. The "hiking group", by contrast, joined in a daily moderate hiking program. Health-related quality of life and relationship quality are defined as primary outcomes. Secondary outcomes include nature connection, balance, cardio-respiratory fitness, fractional exhaled nitric oxide, body composition and skin hydration. Furthermore, a new approach to measure health-related quality of life is validated. The so-called "intercultural quality of life" comic assesses the health-related quality of life with a digitally animated comic-based tool.


Subject(s)
Quality of Life , Sports , Exercise , Forests , Humans , Prospective Studies
4.
Front Public Health ; 10: 843448, 2022.
Article in English | MEDLINE | ID: covidwho-1776052

ABSTRACT

During the COVID-19 pandemic, countries took several restrictions to contain the spread of coronavirus. In the second wave of the COVID-19 pandemic, primary schools in Slovenia were closed for a period long time (from October 19th 2020 until January 18th 2021 when they were partially reopened for 6-9 year olds until February 15th 2021 when they were reopened for all children) and organized sport activities for children and adolescents under the age of 15 was not allowed during this period. The aim of the study was to examine how these restrictions were reflected in the amount of different forms of physical activity (PA) of 6-12-year old children (N = 3,936). Data were collected using an online questionnaire (International Physical Activity Questionnaire Short Form) comparing different forms of PA before (BEFORE) and during (DURING) remote schooling. The results show that there has been a decline in children's PA DURING, specifically, only 4.3% of children had their physical education ≥ 45 min (or 77.7% ≤ 30 min), as is the usual duration in Slovenia. There was also a remarkable decline in extracurricular sports activities (p < 0.001), which BEFORE had been participated by 72.2% of children, while DURING remote schooling, as many as 83.5% of children did not participate these activities. 69.7% of children participated in organized sports in clubs at least once a week, while DURING remote schooling, as many as 88.1% (p < 0.001) did not participate in such form of activities. Furthermore, the time spent exercising in moderate to vigorous PA also decreased (BEFORE 8.2% vs. DURING 24.9%; p < 0.001). We found that during lockdown there has been an alarming decrease in the frequency and duration of organized PA at school and at sports clubs. These findings are a good starting point for designing (developing) an effective strategy for promoting health-enhancing PA of children in the event of a future lockdown or similar situations. The strategy should focus on the appropriate implementation of PA curriculum and motivate young people to participate regularly in extracurricular organized and non-organized activities.


Subject(s)
COVID-19 , Sports , COVID-19/epidemiology , COVID-19/prevention & control , Child , Communicable Disease Control , Exercise , Humans , Pandemics
5.
Front Public Health ; 9: 730555, 2021.
Article in English | MEDLINE | ID: covidwho-1775859

ABSTRACT

Background: Organized sport participation (OSP) is considered as one method with the potential to increase overall physical activity (PA) levels in young people. It is essential to understand the correlates of OSP to inform future PA interventions. Purpose: This study aimed to explore the sociodemographic correlates of OSP among middle school students from the Nanjing City of China. Methods: A total of 7,097 adolescents (50.1% girls) aged 12-15 years from Nanjing, China, were recruited in this survey. Self-reported data on sex, grade, race, residence areas, proficient sport skills, and parental highest education were obtained. OSP was assessed by the question asked in the questionnaire on whether participants were involved in any "sports club or team" with the binary answer options of "yes" and "no," for statistical analysis purposes. Generalized linear models were used to determine the correlates of OSP. Results: Only 16.6% reported participating in any organized sport over the past whole year, while boys (OR = 1.34, 95% CI: 1.18-1.53) and 7th graders (OR = 1.40, 95% CI: 1.18-1.65) were more likely to participate in organized sport. Adolescents being Han ethnicity were less likely to either participate in organized sport (OR = 0.60, 95% CI: 0.40-0.92), or masterless (one or two) proficient sport skills [OR (one) = 0.27, 95%CI: 0.20-0.37; OR (two) = 0.43, 95% CI: 0.36-0.50]. Besides, both residence area and parental highest education were not significantly associated with OSP among the participating adolescents. Conclusion: The current study confirmed that only one-sixth of adolescents participate in the organized sport over the past year. At-risk population subgroups include girls, older adolescents, being Han ethnicity, and those proficient in fewer sport skills. Sex, grades, race, and proficient sport skills were significant correlates of OSP. School, community, and families need to provide more resources and support for disadvantaged populations in OSP.


Subject(s)
Sports , Students , Adolescent , Child , Exercise , Female , Humans , Male , Schools
6.
Indian J Pharmacol ; 54(1): 58-62, 2022.
Article in English | MEDLINE | ID: covidwho-1766047

ABSTRACT

The decline in human performance with age at 5000 m, an athletic event requiring high VO2 max, is remarkably precise, and unavoidable, and related to entropy, even at an individual level. Women and men show an identical age-related decline, up to ~100 years old. The precision of the decline shows the limitations for therapy of aging. Mortality incidence for COVID-19 shows a similar relationship. We propose that initial VO2 max has a critical role in COVID sensitivity because of the direct relationship of disease severity with oxygen use, and the parallel decline in aging.


Subject(s)
COVID-19 , Sports , Aged, 80 and over , Aging , Entropy , Female , Humans , Male , Oxygen Consumption
7.
PLoS One ; 17(3): e0266197, 2022.
Article in English | MEDLINE | ID: covidwho-1765545

ABSTRACT

In this study, we quantitatively assessed the effectiveness of systems for COVID-19 testing in small groups of sport teams that are semi-isolated from the general population by countermeasures against infection. Two types of group were assumed, and the dynamics of infection within each group was modeled by using a compartment model of infectious disease. One group (Group A) comprised domestic professional sports teams that play many games over a season while remaining within a relatively small region. Polymerase chain reaction (PCR) tests were routinely conducted once every 2 weeks, and the number of infected individuals that could not be quarantined after identification by testing or checking for symptoms was defined as the risk. The other group (Group B) comprised teams that travel across borders for mass-gathering events like the Olympic and Paralympic Games. The teams were isolated for 2 weeks at their destination; frequent testing and checking for symptoms was conducted, and any infected individuals were quarantined. The number of infected individuals participating in games after the isolation period was defined as the risk. In Group A, the number of infected individuals detected by routinely conducted PCR testing was lower than the number of infected individuals detected by checking for symptoms, indicating that routine testing every 2 weeks was not very effective. In Group B, daily PCR testing was the most effective, followed by daily antigen testing. Dual testing, in which individuals with a positive antigen test were given an additional PCR test, was the least effective with an effect equal to PCR testing every other day. These results indicate that repeated testing does not necessarily increase the detection of infected individuals.


Subject(s)
COVID-19 , Sports , COVID-19/diagnosis , COVID-19 Testing , Humans , Quarantine , SARS-CoV-2
10.
Front Public Health ; 9: 547634, 2021.
Article in English | MEDLINE | ID: covidwho-1760270

ABSTRACT

The number of children dealing with behavioural problems is increasing. A major challenge in many health-supportive programmes is the recruitment and retention of these children. In the current study, Sport Mix Club (SMC), an approach to enhance socioemotional disorders of 4- to 12-year-old children through sport classes in municipality Vaals, the Netherlands, is used as an illustration. Where many studies faced difficulties getting and keeping children in their interventions, SMC overcame this challenge. Therefore, we decided to explore "What factors contribute to enhanced recruitment and retention procedures among children with behavioural problems in Sport Mix Club?" A qualitative case study design using the analysis of the administrative logbook of the SMC coach and trainees, individual interviews with the SMC coach, trainees (n = 2), school teachers (n = 3) and parents of participating children (n = 9), and four focus group interviews with children (n = 13) were carried out. During the recruitment and retention of SMC, the human psychological need of relatedness seemed to be of crucial value. The fact that the SMC coach: (1) made efforts to become a familiar face for children, parents and community partners beforehand; (2) showed enthusiasm; and (3) placed her focus on having fun as opposed to the children's problems, seemed to be decisive in the process of getting children to participate in SMC and retaining their participation.


Subject(s)
Problem Behavior , Sports , Child , Child, Preschool , Humans , Parents/psychology , Schools , Sports/psychology
11.
Curr Sports Med Rep ; 21(3): 100-104, 2022 Mar 01.
Article in English | MEDLINE | ID: covidwho-1731573

ABSTRACT

ABSTRACT: Coronavirus disease (COVID) has become a global pandemic that has widely impacted athletes at all levels of competition. For many athletes infected with COVID, the course is mild or asymptomatic, and most athletes are able to return to play in a matter of weeks. However, 10% to 15% of people infected with COVID will go on to have prolonged COVID symptoms that last for weeks to months and impact their ability to function and exercise. Not much is known about why certain people become "COVID long-haulers," nor are there any predictive tools to predetermine who may have prolonged symptoms. However, many athletes will suffer from prolonged symptoms that may require further evaluation and may prolong their return to exercise, training, and competition. The purpose of this article is to discuss a framework in which sports medicine and primary care physicians can use to evaluate COVID long-haulers and help them return to sport.


Subject(s)
COVID-19 , Sports , Athletes , Humans , Pandemics , Return to Sport , SARS-CoV-2
12.
Epidemiol Infect ; 150: e42, 2022 01 31.
Article in English | MEDLINE | ID: covidwho-1721341

ABSTRACT

A subset of events within the UK Government Events Research Programme (ERP), developed to examine the risk of transmission of COVID-19 from attendance at events, was examined to explore the public health impact of holding mass sporting events. We used contact tracing data routinely collected through telephone interviews and online questionnaires, to describe the potential public health impact of the large sporting and cultural events on potential transmission and incidence of COVID-19. Data from the EURO 2020 matches hosted at Wembley identified very high numbers of individuals who tested positive for COVID-19 and were traced through NHS Test & Trace. This included both individuals who were potentially infectious (3036) and those who acquired their infection during the time of the Final (6376). This is in contrast with the All England Lawn Tennis Championships at Wimbledon, where there were similar number of spectators and venue capacity but there were lower total numbers of potentially infectious cases (299) and potentially acquired cases (582). While the infections associated with the EURO 2020 event may be attributed to a set of socio-cultural circumstances which are unlikely to be replicated for the forthcoming sporting season, other aspects may be important to consider including mitigations for spectators to consider such as face coverings when travelling to and from events, minimising crowding in poorly ventilated indoor spaces such as bars and pubs where people may congregate to watch events, and reducing the risk of aerosol exposure through requesting that individuals avoid shouting and chanting in large groups in enclosed spaces.


Subject(s)
COVID-19/epidemiology , Public Health , Sports , COVID-19/transmission , Contact Tracing , England/epidemiology , Humans , SARS-CoV-2
13.
Brain Behav Immun ; 102: 206-208, 2022 May.
Article in English | MEDLINE | ID: covidwho-1719357

ABSTRACT

Just weeks away from the Opening Ceremony of the Beijing 2022 Winter Olympics, the United States, followed by Australia, the United Kingdom, and Canada, has declared a diplomatic boycott of the Games. A diplomatic boycott stipulates that while government officials of these countries will not attend the event, the athletes' scheduled attendance will largely remain intact. An unintended consequence of the boycotts is that they force the attending athletes to cope with the stress and distress associated with the 2022 Winter Olympics in an unfamiliar environment on their own. It is important to underscore that many of the challenges the athletes could face amid the Games are either deep-rooted or unprecedented, ranging from stressors fuelled by the nonstop media reports, the competitions, to the Omicron scares. These insights combined, in turn, underscore the imperative for effective and preemptive mental health support for Olympic athletes. To shed light on the issue, this paper highlights the reasons why timely solutions are needed to adequately safeguard Olympic athletes' mental health and overall wellbeing, and underlines promising technology-based solutions that can be cost-effectively designed and developed for the athletes.


Subject(s)
Psychoneuroimmunology , Sports , Athletes , Humans , Seasons , United Kingdom
14.
J Sci Med Sport ; 23(7): 664-669, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-1720500

ABSTRACT

The purpose of testing for any communicable disease is to support clinicians in the diagnosis and management of individual patients and to describe transmission dynamics. The novel coronavirus is formally named SARS-CoV-2 and the clinical disease state resulting from an infection is known as COVID-19. Control of the COVID-19 pandemic requires clinicians, epidemiologists, and public health officials to utilise the most comprehensive, accurate and timely information available to manage the rapidly evolving COVID-19 environment. High performance sport is a unique context that may look towards comprehensive testing as a means of risk mitigation. Characteristics of the common testing options are discussed including the circumstances where additional testing may be of benefit and considerations for the associated risks. Finally, a review of the available technology that could be considered for use by medical staff at the point of care (PoC) in a high-performance sporting context is included.


Subject(s)
Clinical Laboratory Techniques/standards , Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Sports , Australia , Betacoronavirus , COVID-19 , COVID-19 Testing , Humans , Pandemics , Point-of-Care Testing , SARS-CoV-2
15.
J Sci Med Sport ; 23(7): 639-663, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-1720499

ABSTRACT

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 to high performance/professional, community and individual passive (non-contact) sport. The AIS Framework is a timely tool of minimum baseline of standards, for 'how' reintroduction of sport activity will occur in a cautious and methodical manner, based on the best available evidence to optimise athlete and community safety. Decisions regarding the timing of resumption (the 'when') of sporting activity must be made in close consultation with Federal, State/Territory and/or Local Public Health Authorities. The priority at all times must be to preserve public health, minimising the risk of community transmission.


Subject(s)
Coronavirus Infections , Pandemics , Pneumonia, Viral , Return to Sport/standards , Sports , Australia , Basic Reproduction Number , Betacoronavirus , COVID-19 , Communicable Disease Control , Decision Making , Guidelines as Topic , Humans , Public Health , SARS-CoV-2
16.
J Athl Train ; 57(2): 136-139, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1708768

ABSTRACT

OBJECTIVE: To define and discuss the role of population health as a framework to improve care and clinical decision making in athletic training practice. BACKGROUND: Athletic trainers (ATs) are allied health professionals who are uniquely suited to provide preventive and educational health and wellness programs to improve health outcomes across a physically active population. Athletic trainers are often the first contacts for high school athletes seeking health and wellness education, which may allow ATs to be the first intervention or prevention point for reducing or eliminating negative health behaviors and outcomes among their patients. CONCLUSIONS: Integrating a population-health framework into the athletic training setting prepares ATs to address complex health concerns in communities that result from factors that influence determinants of health. The field of athletic training could benefit from a population-health approach to care by broadening consideration of the factors that affect the health of homogeneous populations that are served by ATs.


Subject(s)
Population Health , Sports , Athletes , Humans , Schools
17.
Int J Environ Res Public Health ; 19(3)2022 01 20.
Article in English | MEDLINE | ID: covidwho-1686718

ABSTRACT

Sport participation and physical activity promotion have been intensively studied, especially regarding large cities. However, in many cases, rural municipalities have comparatively reduced services, including health care, due to the low profitability that these have for companies and entities. In this sense, the purpose of this article was to describe a case study of the promotion of physical activity in rural areas based on the results of a European project. Carried out in a rural municipality of around 8500 inhabitants with a population density of less than 25 inhabitants/km2, the project's purpose was the promotion of autonomous physical activity among its inhabitants. For this, a diagnostic analysis of the sports areas of the environment and a survey of physical activity habits among the population were carried out. A series of routes were designed, marked, and signposted, and canopies with explanatory posters about the possibilities of healthy physical activity and recommendations were added. Free-use facilities were installed, and opening events were carried out in such a way as to stimulate sports practice among the population. This article presents the results obtained from the analysis, as well as the possibilities of replication in other municipalities with similar needs.


Subject(s)
Exercise , Sports , Cities , Health Promotion , Humans , Rural Population , Surveys and Questionnaires
18.
JAMA Netw Open ; 5(2): e2147810, 2022 02 01.
Article in English | MEDLINE | ID: covidwho-1680205
19.
JAMA Netw Open ; 5(2): e2147805, 2022 02 01.
Article in English | MEDLINE | ID: covidwho-1680204

ABSTRACT

Importance: The COVID-19 pandemic initially led to the abrupt shutdown of collegiate athletics until guidelines were established for a safe return to play for student athletes. Currently, no literature exists that examines the difference in SARS-CoV-2 test positivity between student athletes and nonathletes at universities across the country. Objective: To identify the difference in risk of COVID-19 infection between student athlete and nonathlete student populations and evaluate the hypothesis that student athletes may display increased SARS-CoV-2 test positivity associated with increased travel, competition, and testing compared with nonathletes at their respective universities. Design, Setting, and Participants: In this cross-sectional analysis, a search of publicly available official university COVID-19 dashboards and press releases was performed for all 65 Power 5 National Collegiate Athletic Association (NCAA) Division I institutions during the 2020 to 2021 academic year. Data were analyzed at the conclusion of the academic year. Schools that released at least 4 months of testing data, including the fall 2020 football season, for student athletes and nonathlete students were included in the analysis. Power 5 NCAA Division I student athletes and their nonathlete student counterparts were included in the analysis. Exposure: Designation as a varsity student athlete. Main Outcomes and Measures: The main outcome was SARS-CoV-2 test positivity for student athletes and nonathlete students at the included institutions for the 2020 to 2021 academic year, measured as a relative risk for student athletes. Results: Among 12 schools with sufficient data available included in the final analysis, 555 372 student athlete tests and 3 482 845 nonathlete student tests were performed. There were 9 schools with decreased test positivity in student athletes compared with nonathlete students (University of Arkansas: 0.01% vs 3.52%; University of Minnesota: 0.63% vs 5.96%; Penn State University: 0.74% vs 6.58%; Clemson University: 0.40% vs 1.88%; University of Louisville: 0.75% vs 3.05%; Purdue University: 0.79% vs 2.97%; University of Michigan: 0.40% vs 1.12%; University of Illinois: 0.17% vs 0.40%; University of Virginia: 0.64% vs 1.04%) (P < .001 for each). The median (range) test positivity in these 9 schools was 0.46% (0.01%-0.79%) for student athletes and 1.04% (0.40%-6.58%) for nonathlete students. In 1 school, test positivity was increased in the student athlete group (Stanford University: 0.20% vs 0.05%; P < .001). Overall, there were 2425 positive tests (0.44%) among student athletes and 30 567 positive tests (0.88%) among nonathlete students, for a relative risk of 0.50 (95% CI, 0.48-0.52; P < .001). There was no statistically significant difference in student athlete test positivity between included schools; however, test positivity among nonathlete students varied considerably between institutions, ranging from 133 of 271 862 tests (0.05%) at Stanford University to 2129 of 32 336 tests (6.58%) at Penn State University. Conclusions and Relevance: This study found that in the setting of SARS-CoV-2 transmission mitigation protocols implemented by the NCAA, participation in intercollegiate athletics was not associated with increased SARS-CoV-2 test positivity. This finding suggests that collegiate athletics may be held without an associated increased risk of infection among student athletes.


Subject(s)
Athletes/statistics & numerical data , COVID-19/epidemiology , SARS-CoV-2/pathogenicity , Sports/statistics & numerical data , Students/statistics & numerical data , Adult , Cross-Sectional Studies , Female , Humans , Male , United States/epidemiology , Universities/statistics & numerical data , Young Adult
20.
Pediatrics ; 149(12 Suppl 2)2022 02 01.
Article in English | MEDLINE | ID: covidwho-1674085

ABSTRACT

OBJECTIVES: We evaluated the impact of distancing practices on secondary transmission of severe acute respiratory syndrome coronavirus 2 and the degree of sports-associated secondary transmission across a large diverse cohort of schools during spring 2021. METHODS: Participating districts in North Carolina and Wisconsin and North Carolina charter schools offering in-person instruction between March 15, 2021 and June 25, 2021 reported on distancing policies, community- and school-acquired infections, quarantines, and infections associated with school-sponsored sports. We calculated the ratio of school-acquired to community-acquired infection, secondary attack rates, and the proportion of secondary transmission events associated with sports. To estimate the effect of distancing and bus practices on student secondary transmission, we used a quasi-Poisson regression model with the number of primary student cases as the denominator. RESULTS: During the study period, 1 102 039 students and staff attended in-person instruction in 100 North Carolina school districts, 13 Wisconsin school districts, and 14 North Carolina charter schools. Students and staff had 7865 primary infections, 386 secondary infections, and 48 313 quarantines. For every 20 community-acquired infections, there was 1 within-school transmission event. Secondary transmissions associated with school sports composed 46% of secondary transmission events in middle and high schools. Relaxed distancing practices (<3 ft, 3 ft) and increased children per bus seat were not associated with increased relative risk of secondary transmission. CONCLUSIONS: With universal masking, in-person education was associated with low rates of secondary transmission, even with less stringent distancing and bus practices. Given the rates of sports-associated secondary transmission, additional mitigation may be warranted.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Schools , Adolescent , Child , Child, Preschool , Communicable Disease Control , Humans , North Carolina/epidemiology , Physical Distancing , Quarantine/statistics & numerical data , Sports , Wisconsin/epidemiology
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