National Federation Issues Guidelines for Re-Starting High School Sports

There is movement towards having high school sports across the country this fall, albeit with some strict guidelines for state associations and local athletic programs. The National Federation of State High School Associations released guidance for its 51 member state high school associations Monday to consider in re-opening high school athletics and other activity programs. According to a release, the guidance document was developed by the NFHS Sports Medicine Advisory Committee, which is a 15-member advisory committee composed of medical doctors, certified athletic trainers, high school coaches and officials, research specialists and state high school association executives.

Officials state thast similar to the manner in which different parts of the country have re-opened ahead of others due to containment levels of the virus, the document was developed with the strong possibility that there likely will be variation in what sports and activities are allowed to be played and held from one part of the country to another.

The NFHS guidance document describes a staged approach to re-opening high school sports and other activities and suggests that state high school associations consult with their state and local health departments for determining the appropriate dates for implementing a phased-in approach.

The guidance developed for state associations suggests a possible sport breakdown for higher risk, moderate risk and lower risk, with the basis for the breakdown tied to the potential exposure to respiratory droplets. The recommendations also include a possible progression for returning to activities, hygiene practices, transportation to and from events, social-distancing suggestions during contests and a tiered approach to who should be allowed to attend events.

Key points from the document are below:

 

Preliminary Questions for State Associations:
Some state associations may wish to consider the following four questions before further deliberation
on this document:

1. Will your state association conduct an athletics/activities regular season or championship if public
schools statewide are closed to in-person learning (apart from regularly scheduled school breaks)?

2. Will your state association conduct an athletics/activities regular season or championship if schools
are closed only in COVID-19 “hotspots” in your state? (excluding participants from schools that are
closed)?

3. Will your state association conduct an athletics/activities regular season in sports deemed “lowerrisk” for COVID-19 transmission while cancelling athletics/activities considered “higher-risk?”
4. Are there recommendations unique to your state – or regions of your state – that you need to take
into consideration when developing return-to-activity guidelines?

Points of Emphasis:

1. Decreasing potential exposure to respiratory droplets is the guiding principle behind social distancing and the use of face coverings. It is also the basis of the stratification of risk by sport presented later on in this document. The use of cloth face coverings is meant to decrease the spread of respiratory droplets. As state and local COVID-19 prevalence decreases, the need for strict social distancing and the use of face coverings will lessen. Look to guidance from your state
and local health departments.
a. The Centers for Disease Control and Prevention (CDC) is additionally “advising the use of simple cloth face coverings to slow the spread of the virus and help people who may have  the virus and do not know it from transmitting it to others.” (“Recommendation Regarding  the Use of Cloth Face Coverings, Especially in Areas of Significant Community-Based  Transmission”)
b. Recognizing the benefits and potential drawbacks of the use of cloth face coverings during conditioning and physical activity, the NFHS SMAC recommends the following: i. State, local or school district guidelines for cloth face coverings should be strictly followed. ii. Cloth face coverings should be considered acceptable. There is no need to require or recommend “medical grade” masks for athletic activity. iii. Any student who prefers to wear a cloth face covering during a contest should be allowed to do so. iv. In the absence of guidelines to the contrary, we recommend that cloth face
coverings be worn by students during Phases 1 and 2 as outlined below. Exceptions are swimming, distance running or other high intensity aerobic activity. Cloth face coverings may continue to be used during Phase 3 when not engaging in vigorous activity, such as sitting on the bench during contests, in the locker room and in the athletic training room. v. Plastic shields covering the entire face (or attached to a helmet) shall not be allowed during contests. Their use during practices increases the risk of unintended injury to the person wearing the shield or teammates. vi. Coaches, officials and other contest personnel may wear cloth face coverings at all times during Phases 1 through 3. (Artificial noisemakers such as an air horn or a timer system with an alarm can be used to signal in place of a traditional whistle.)

2. Testing regimens, specific guidelines regarding mass gatherings, and response to a student or team member testing positive for COVID-19 (including contact tracing) are all currently under review, and guidance will come from CDC and state and local health departments. Limited testing availability, lack of resources for contact tracing, and expanding knowledge of the characteristics of COVID-19 transmission could all result in significant changes to the recommendations below. The NFHS SMAC and state association SMACs expect to disseminate this information as it becomes available.

3. Due to the near certainty of recurrent outbreaks this coming fall and winter in some locales, state associations must be prepared for periodic school closures and the possibility of some teams having to isolate for two to three weeks while in-season. Development of policies is recommended regarding practice and/or competition during temporary school closures, the cancellation of contests during the regular season, and parameters for the cancellation or premature ending to post-season events/competitions.

4. With the uncertainty of which phase will be attained at the beginning of a sports season or maintained during a season, scheduling contests that require less travel when possible should be considered. Such scheduling will reduce time spent in buses or vans. It will also potentially decrease the need for rescheduling contests as “opening up” may occur regionally. If opponents at the time of a contest are subject to different restrictions, re-scheduling that contest for a later date may be
problematic.

5. The principles presented in this guidance document can be applied to practices, rehearsals, and events for the performing arts with the exception of singing and the playing of wind instruments. The extent of the spread of respiratory droplets during these activities is currently under investigation and further guidance will issued as it becomes available.

6. “Vulnerable individuals” are defined by CDC as people age 65 years and older and others with serious underlying health conditions, including high blood pressure, chronic lung disease, diabetes, obesity, asthma, and those whose immune systems are compromised such as by chemotherapy for cancer and other conditions requiring such therapy.

7. Until a cure, vaccine or very effective treatment is readily available, or so-called “herd immunity” is
confidently reached, social distancing and other preventive measures such as face covering will be a
“new normal” if workouts, practices and contests are to continue.

Phase 1
Pre- workout Screening:
• All coaches and students should be screened for signs/symptoms of COVID-19 prior to a workout.
Screening includes a temperature check.

• Responses to screening questions for each person should be recorded and stored so that there is a
record of everyone present in case a student develops COVID-19 (see Appendix II for sample
Monitoring Form).

• Any person with positive symptoms reported should not be allowed to take part in workouts and
should contact his or her primary care provider or other appropriate health-care professional.

• Vulnerable individuals should not oversee or participate in any workouts during Phase 1.

Limitations on Gatherings:
• No gathering of more than 10 people at a time (inside or outside).

• Locker rooms should not be utilized during Phase 1. Students should report to workouts in proper gear
and immediately return home to shower at end of the workout.

• Workouts should be conducted in “pods” of students with the same 5-10 students always working out
together. Smaller pods can be utilized for weight training. This ensures more limited exposure if
someone develops an infection.

• There must be a minimum distance of 6 feet between each individual at all times. If this is not possible
indoors, then the maximum number of individuals in the room must be decreased until proper social
distancing can occur.

Facilities Cleaning:
• Adequate cleaning schedules should be created and implemented for all athletic facilities to mitigate
any communicable diseases.

• Prior to an individual or groups of individuals entering a facility, hard surfaces within that facility should
be wiped down and sanitized (chairs, furniture in meeting rooms, locker rooms, weight room
equipment, bathrooms, athletic training room tables, etc.).

• Individuals should wash their hands for a minimum of 20 seconds with warm water and soap before
touching any surfaces or participating in workouts.

• Hand sanitizer should be plentiful and available to individuals as they transfer from place to place.

• Weight equipment should be wiped down thoroughly before and after an individual’s use of
equipment.

• Appropriate clothing/shoes should be worn at all times in the weight room to minimize sweat from
transmitting onto equipment/surfaces.

• Any equipment such as weight benches, athletic pads, etc. having holes with exposed foam should be
covered.

• Students must be encouraged to shower and wash their workout clothing immediately upon returning
to home.

Physical Activity and Athletic Equipment:
• There should be no shared athletic equipment (towels, clothing, shoes, or sports specific equipment)
between students.

• Students should wear their own appropriate workout clothing (do not share clothing) individual
clothing/towels should be washed and cleaned after every workout.

• All athletic equipment, including balls, should be cleaned after each use and prior to the next workout.

• Individual drills requiring the use of athletic equipment are permissible, but the equipment should be
cleaned prior to use by the next individual.

• Resistance training should be emphasized as body weight, sub-maximal lifts and use of resistance
bands.

• Free weight exercises that require a spotter cannot be conducted while honoring social distancing
norms. Safety measures in all forms must be strictly enforced in the weight room.

• Examples (including by limited to):
o A basketball player can shoot with a ball(s), but a team should not practice/pass a single ball among
the team where multiple players touch the same ball.
o A football player should not participate in team drills with a single ball that will be handed off or
passed to other teammates. Contact with other players is not allowed, and there should be no
sharing of tackling dummies/donuts/sleds.
o A volleyball player should not use a single ball that others touch or hit in any manner.
o Softball and baseball players should not share gloves, bats, or throw a single ball that will be tossed
among the team. A single player may hit in cages, throw batting practice (with netting as backstop,
no catcher). Prior to another athlete using the same balls, they should be collected and cleaned
individually.
o Wrestlers may skill and drill without touching a teammate.
o Cheerleaders may not practice/perform partner stunts or building. (Chants, jumps, dances without
contact are permissible.)
o Tennis players may do individual drills, wall volleys and serves.
o Runners should maintain the recommended 6 feet of distancing between individuals

Hydration:
• All students shall bring their own water bottle. Water bottles must not be shared.

• Hydration stations (water cows, water trough, water fountains, etc.) should not be utilized.

Phase 2
Pre-Workout/Contest Screening:
• All coaches and students should be screened for signs/symptoms of COVID-19 prior to a workout.
Screening includes a temperature check.

• Responses to screening questions for each person should be recorded and stored so that there is a
record of everyone present in case a student develops COVID-19 (see Appendix II for sample
Monitoring Form).

• Any person with positive symptoms reported should not be allowed to take part in workouts and
should contact his or her primary care provider or other appropriate health-care professional.

• Vulnerable individuals should not oversee or participate in any workouts during Phase 2.
Limitations on Gatherings:

• No gathering of more than 10 people at a time inside. Up to 50 individuals may gather outdoors for
workouts.

• If locker rooms or meeting rooms are used, there must be a minimum distance of 6 feet between each
individual at all times.

• Workouts should be conducted in “pods” of students with the same 5-10 students always working out
together. Smaller pods can be utilized for weight training. This ensures more limited exposure if
someone develops an infection.

• There must be a minimum distance of 6 feet between each individual at all times. If this is not possible
indoors, then the maximum number of individuals in the room must be decreased until proper social
distancing can occur. Appropriate social distancing will need to be maintained on sidelines and
benches during practices. Consider using tape or paint as a guide for students and coaches.

Facilities Cleaning:
• Adequate cleaning schedules should be created and implemented for all athletic facilities to mitigate
any communicable diseases.

• Prior to an individual or groups of individuals entering a facility, hard surfaces within that facility should
be wiped down and sanitized (chairs, furniture in meeting rooms, locker rooms, weight room
equipment, bathrooms, athletic training room tables, etc.).

• Individuals should wash their hands for a minimum of 20 seconds with warm water and soap before
touching any surfaces or participating in workouts.

• Hand sanitizer should be plentiful and available to individuals as they transfer from place to place.

• Weight equipment should be wiped down thoroughly before and after an individual’s use of
equipment.

• Appropriate clothing/shoes should be worn at all times in the weight room to minimize sweat from
transmitting onto equipment/surfaces.

• Any equipment such as weight benches, athletic pads, etc. having holes with exposed foam should be
covered.

• Students must be encouraged to shower and wash their workout clothing immediately upon returning
to home.

Physical Activity and Athletic Equipment:
• Lower risk sports practices and competitions may resume (see Potential Infection Risk by Sport below).

• Modified practices may begin for Moderate risk sports.

• There should be no shared athletic towels, clothing or shoes between students.

• Students should wear their own appropriate workout clothing (do not share clothing), and individual
clothing/towels should be washed and cleaned after every workout.

• All athletic equipment, including balls, should be cleaned intermittently during practices and contests.

• Hand sanitizer should be plentiful at all contests and practices.

• Athletic equipment such as bats, batting helmets and catchers gear should be cleaned between each
use.

• Maximum lifts should be limited and power cages should be used for squats and bench presses.
Spotters should stand at each end of the bar.

Hydration:
• All students shall bring their own water bottle. Water bottles must not be shared.

• Hydration stations (water cows, water trough, water fountains, etc.) should not be utilized.

Phase 3
Pre- Workout/Contest Screening:
• Any person who has had a fever or cold symptoms in the previous 24 hours should not be allowed to
take part in workouts and should contact his or her primary care provider or other appropriate healthcare professional.

• A record should be kept of all individuals present.

• Vulnerable individuals can resume public interactions, but should practice physical distancing,
minimizing exposure to social settings where distancing may not be practical, unless precautionary
measures are observed.

Limitations on Gatherings:
• Gathering sizes of up to 50 individuals, indoors or outdoors.

• When not directly participating in practices or contests, care should be taken to maintain a minimum
distance of 3 to 6 feet between each individual. Consider using tape or paint as a guide for students
and coaches.

Facilities Cleaning:
• Adequate cleaning schedules should be created and implemented for all athletic facilities to mitigate
any communicable diseases.

• Prior to an individual or groups of individuals entering a facility, hard surfaces within that facility should
be wiped down and sanitized (chairs, furniture in meeting rooms, locker rooms, weight room
equipment, bathrooms, athletic training room tables, etc.).

• Individuals should wash their hands for a minimum of 20 seconds with warm water and soap before
touching any surfaces or participating in workouts.

• Hand sanitizer should be plentiful and available to individuals as they transfer from place to place.

• Weight equipment should be wiped down thoroughly before and after an individual’s use of
equipment.

• Appropriate clothing/shoes should be worn at all times in the weight room to minimize sweat from
transmitting onto equipment/surfaces.

• Any equipment such as weight benches, athletic pads, etc. having holes with exposed foam should be
covered.

• Students must be encouraged to shower and wash their workout clothing immediately upon returning
to home.

Physical Activity and Athletic Equipment:
• Moderate risk sports practices and competitions may begin.

• There should be no shared athletic towels, clothing or shoes between students.

• Students should wear their own appropriate workout clothing (do not share clothing), and individual
clothing/towels should be washed and cleaned after every workout.

• Hand sanitizer should be plentiful at all contests and practices.

• Athletic equipment such as bats, batting helmets and catchers gear should be cleaned between each
use. Other equipment, such as hockey helmets/pads, wrestling ear guards, football helmets/other
pads, lacrosse helmets/pads/gloves/eyewear should be worn by only one individual and not shared.

• Maximum lifts should be limited and power cages should be used for squats and bench presses.

Spotters should stand at each end of the bar.

• Modified* practices may begin for Higher risk sports:
o *Continue pre-practice screening as in Phases 1 and 2. Shower immediately after
practices/contests.
o Re-assess epidemiology data and experiences in other states and other levels of competition to
determine when Higher risk sports competition may resume.

Hydration:
• All students shall bring their own water bottle. Water bottles must not be shared.

• Hydration stations (water cows, water trough, water fountains, etc.) may be utilized but must be
cleaned after every practice/contest.

E. Contests
1. Potential Infection Risk by Sport (modified from United States Olympic and Paralympic
Committee – Sports Medicine recommendations)

Higher Risk: Sports that involve close, sustained contact between participants, lack of significant
protective barriers, and high probability that respiratory particles will be transmitted between
participants.
Examples: Wrestling, football, boys lacrosse, competitive cheer, dance

Moderate Risk: Sports that involve close, sustained contact, but with protective equipment in place
that may reduce the likelihood of respiratory particle transmission between participants OR
intermittent close contact OR group sports OR sports that use equipment that can’t be cleaned
between participants.
Examples: Basketball, volleyball*, baseball*, softball*, soccer, water polo, gymnastics* (if equipment
can’t be sufficiently cleaned between competitors), ice hockey, field hockey, tennis*, swimming relays,
pole vault*, high jump*, long jump*, girls lacrosse, crew with two or more rowers in shell, 7 on 7
football
*Could potentially be considered “Lower Risk” with appropriate cleaning of equipment and use of
masks by participants

Lower Risk: Sports that can be done with social distancing or individually with no sharing of equipment
or the ability to clean the equipment between use by competitors.
Examples: Individual running events, throwing events (javelin, shot put, discus), individual swimming,
golf, weightlifting, alpine skiing, sideline cheer, single sculling, cross country running (with staggered
starts)

2. Transportation to events
Schools must consider social distancing requirements when scheduling contests and events
for the fall. Social distancing (as required by state or local health department) will need to be
maintained on buses/vans. Thus, multiple buses/vans and/or parental/guardian transportation
will likely be needed.

3. Social distancing during Contests/Events/Activities
a. Sidelines/benches
Appropriate social distancing will need to be maintained on sidelines/bench during contests
and events. Consider using tape or paint as a guide for students and coaches.
b. Who should be allowed at events?

Group people into tiers from essential to non-essential and decide which tiers will be
allowed at an event:
1. Tier 1 (Essential): Athletes, coaches, officials, event staff, medical staff, security
2. Tier 2 (Preferred): Media
3. Tier 3 (Non-essential): Spectators, vendors

Only Tier 1 and 2 personnel will be allowed to attend events until state/local health
departments lift restrictions on mass gatherings.