Medical Partners

COVID-19 Protocols For Sports & Entertainment

The Centers for Disease Control and Prevention (CDC) have implemented guidelines with regards to protecting the health and safety of America's workers and workplaces during COVID-19. These are recommendations as well as descriptions of mandatory safety and health standards and are intended to assist employers in providing a safe and healthy workplace.

No Wait Medical Partners focuses on the need to follow appropriate guidelines during work shifts and while at home.


Administrator Responsibilities



Assess the hazards to which your staff, athletes, or entertainers may be exposed; evaluate the risk of exposure; and select, implement, and ensure workers use controls to prevent exposure.


1. Implementing Basic Infection Prevention Measures



-Hand Hygiene


  • Promote frequent and thorough hand washing, including providing employees and customers with a place to wash their hands. If soap and running water are not immediately available, alcohol-based hand rubs containing at least 60% alcohol should be provided. Young children must be supervised when using hand sanitizer to prevent swallowing alcohol. Regular hand washing or using of alcohol-based hand rubs are necessary. Hands should be washed when they are visibly soiled and after removing any Personal Protective Equipment (PPE). Provide resources and environment that promotes personal hygiene, including tissues, no-touch trash cans, hand soap, disinfectants, and disposable towels to clean surfaces. Post hand washing signs in restrooms. Ensure clean toilet and hand washing facilities. Fill hand sanitizer dispensers regularly. Disinfect frequently touched items, including door pulls and toilet seats often.


-Respiratory Etiquette


  • The importance of covering coughs and sneezes with a tissue should be emphasized. Afterwards, throw the tissue away into the trash and perform hand hygiene.


-Source Control


  • Staff, athletes, and workers should be permitted to wear masks over their nose and mouth to prevent them from spreading the virus, though it is not PPE. Cloth face coverings should not be placed on babies and children younger than 2 years old, anyone who has trouble breathing or is unconscious, or anyone who is incapacitated or otherwise unable to remove the cloth face covering without help.


-Enhanced Sanitation


  • Maintain regular housekeeping practices, including routine cleaning and disinfecting of surfaces, equipment, and other elements of the environment. When equipment must be shared, instruct staff and older children to use alcohol-based wipes to clean before and after use. When cleaning tools and equipment, staff should consult manufacturer recommendations for proper cleaning techniques and restrictions (e.g., concentration, application method and contact time, PPE).


  • When choosing cleaning chemicals, administrators should consult information on Environmental Protection Agency (EPA)-approved disinfectant labels from List N, or that have claims against emerging viral pathogens, or that have label claims against the coronavirus for cleaning frequently touched surfaces like handles, fountains, physical education equipment, and games. Products with EPA-approved emerging viral pathogens claims are expected to be effective against COVID-19, based on data for harder to kill viruses. Keep cleaning agents securely away from children.


  • Develop a disinfection schedule or routine plan, especially for high contact areas like restrooms. Ensure sufficient stocks of cleaning and disinfecting supplies to accommodate ongoing cleaning and disinfection. High touch areas should be cleaned and disinfected (e.g. doorknobs, display cases, equipment handles, ATMs) at least once daily and preferably more frequently.

Donation

2. Training and Education



  • Provide staff, workers, and athletes with up-to-date education and training on COVID-19 risk factors and protective behaviors (e.g., cough etiquette, proper hygiene practices, and care of PPE). Employees should be encouraged to wear cloth face coverings in the workplace.


  • Train staff who need to use protecting clothing and equipment, and on how to put it on, use/wear it, and take it off correctly, within the context of their current and potential duties. Training should be conducted virtually or maintain social distancing.


  • Staff, workers, and athletes should be trained on the signs and symptoms of COVID-19 with an explanation of how the disease is potentially spread, including the fact that infected people can spread the virus even if they do not have symptoms. Daily self-health checks should be conducted by student- athletes, athletes, and staff before face-to-face activities. Employees should know when to stay home to prevent spread. Management should also stagger or rotate shifts to minimize congregation of employees.


  • Emphasis should be placed on the need for staff to report any safety and health concerns.


  • Communicate with the public, families, and staff over changed hours of operation or closures due to COVID-19.


  • Designate a COVID-19 point of contact for staff, athletes, and visitors to contact with concerns.


3. Support for Employees



  • Mental health support should be provided to all workers, including access to an employee assistance program (EAP) if available. Emergency communications plans should be developed, including a forum for answering workers' concerns and internet-based communications, if feasible.


  • No Wait Medical Partners is available to provide psychological supports, including mental health support, and psychoeducation.


  • Right one: No wait medical could help find a third-party mental health provider upon request.


4. Screening



  • Conduct daily health checks on staff, athletes, and entertainers (e.g. upon arrival). Verbally screen to determine whether they have had a fever, respiratory symptoms (e.g. coughing, shortness of breath) or other symptoms in the past 24 hours. Anyone with a fever of 100.4 F or greater should not enter the facility. Screeners should be are trained to use temperature monitors that are accurate under conditions of use and wear appropriate PPE.


  • Health checks should be conducted in a way that helps maintain social distancing guidelines, such as providing multiple screening entries into the building. Administration should inform and encourage employees to self-monitor for signs and symptoms of COVID-19 if they suspect possible exposure.


  • Confidentiality of the medical records should be maintained. To prevent stigma and discrimination in the workplace, health screenings should be made as private as possible, and determinations of risk, should not be made based on race or country of origin.


  • No Wait Medical Partners ensures ongoing follow-up of employees sent home who may be at risk.


5. Absenteeism



  • Flexible sick leave policies should allow staff to stay at home in the event of sickness, possible exposure, or caring for someone who is sick. Evaluate whether the work duties can be done through telework.


  • Ask higher risk people (e.g. older adults, people with underlying medical conditions) to assess their risk. Offer modified job responsibilities that do not involve face-to-face interaction and telework for higher risk staff.


  • Cross train staff and establish a roster of back-up staff.


  • Administration should inform and encourage staff to self-monitor for signs and symptoms of COVID-19 if they suspect possible exposure.


  • Staff who have symptoms should notify their supervisor and be encouraged to stay home, and a note from their healthcare provider does not need to be provided in order to validate illness, or their ability to return to work. Sick leave policies should be flexible and consistent with public health guidance and with No Wait Medical Partners, and employees should be made aware of these policies. Employees should not return to work until the criteria to discontinue home isolation are met, in consultation with No Wait Medical Partners. Prompt identification and isolation of potentially infectious individuals is a critical step in protecting employees and customers.


  • Staff who are well but who have a sick family member at home with COVID-19 should notify their supervisor and consult with No Wait Medical Partners regarding the mandatory precautions. Policies should permit employees to stay home to care for sick family members, including sick children or children who are in schools or day care centers that have been closed, or who have immunocompromised family members, and are afraid to come to work because of fear of possible exposure. Staff concerns about pay, leave, safety, health, and other issues that may arise during infectious disease outbreaks should be addressed, and employers are encouraged to work with insurance companies (e.g., those providing employee health benefits) and state and local health agencies to provide information to staff and families about medical care in the event of a COVID-19 outbreak.


  • No Wait Medical Partners will provide daily follow up on employees who are self-isolating at home, and on what their expected return to work dates will be.


6. Symptoms of Sickness



  • A confirmed case is a positive test for COVID-19. Suspected cases are people who have signs and symptoms consistent with COVID-19.


  • Isolate: In the event of a sick person, close off areas used by the person who was sick. Have an isolation area or room. Depending on the severity of their symptoms, transport them home or to a healthcare facility.


  • Notify: Call healthcare personnel and tell them that the person may have COVID-19 if calling an ambulance or bringing them to a facility.


  • Clean and Disinfect: Increase circulation by opening windows and doors. Clear the area and wait 24 hours, or long as possible for droplets to settle, before disinfecting areas the person used using EPA approved disinfectants. If 7 days have passed since the person used the facility, extra cleaning is not required.


  • Trace the person's contacts from 2 days before symptom onset to identify other exposed people. Inform them if there is a case of confirmed COVID-19 while keeping confidentiality according to the Americans with Disabilities Act (ADA). In a confirmed case, also notify relevant state health or environmental safety departments.


  • No Wait Medical Partners enables safe and timely triage, antibody testing, monitoring, contact tracking and containment of suspected or confirmed COVID 19 positive employees. No Wait Medical Partners contributes to limiting exposure and risk management and enables contact tracing for suspected COVID-19 positive employees.


Sports



7. Venue



  • Sporting events usually seat many individuals, with a high level of contact intensity and frequency of contacts. If seating is to be reopened for live sports, plans must be drawn that support social distancing for seating and queuing. Otherwise, some sporting organizations may consider events where only athletes, production personnel, and essential venue staff would be present.


8. Transition



  • Create a 7 to 10-day transition period to reacclimatize athletes, considering performance factors (e.g. cardiovascular conditioning, heat, altitude). Evidence based resources for sports medicine can be found at the NCAA Coronavirus Resource Page.


  • Prior Infection


    • Cardiac screening is recommended for athletes with a prior COVID-19 infection due to the potential for endothelial damage, especially in the heart and lungs, found in some preliminary evidence. Additional guidelines based on limited evidence can be found on the AMSSM website.


    • Consider the history and severity of the prior COVID-19 infection for additional testing.


9. Testing



-Broad Spectrum Testing


  • Test before all athletic activities, preseason, regular season, and post season.


-Symptom based strategy


  • Test symptomatic individuals.


-Discontinuing precautions after a positive test

  • Asymptomatic individuals who have a positive PCR test for SARS-CoV-2 can discontinue isolation and other additional precautions 10 days after their first positive test date.


  • Most symptomatic individuals can discontinue isolation and other additional precautions 10 days after their symptom onset, resolution of fever for at least 24 hours without using fever-reducing medications, and improvement of other symptoms.


  • Individuals with a severe case of COVID-19 may extend the duration of additional precautions and isolation to 20 days.


  • Individuals with conditions that weaken their immune systems may consider a longer duration of isolation to prevent prolonged shedding of the virus.


  • The recommended duration of isolation for people infected with the virus is different form the duration of quarantine for people exposed to the virus due to the time it takes to develop the illness.


10. Mitigating Risk



A high risk of COVID-19 transmission, as defined by the CDC, is any situation where there has been greater than 15 minutes of close contact (i.e. being less than 6-feet apart) with an infectious individual, who can be symptomatic, pre-symptomatic or asymptomatic.


  • Cohorting: Consider assigning student-athletes to functional units of 5 to 10 people who are on the same team to train, wok out, and participate in the same activities together. For training scenarios, always have one functional unit train against another specific functional unit so contact tracing may be manageable.


  • Electronic Whistles: Consider using electronic whistles to prevent deep inhales and forceful bursts of using traditional whistles.


  • Frequent Testing: Close contact sports may make social distancing difficult to maintain. For high contact-risk sports, obtain test results within 72 hours of competition.


  • Outdoor Training: Maximize outdoor training to mitigate risk of transmission.


  • Indoor Training: If training inside, ensure measures (e.g. proper ventilation maintenance, maximize outdoor circulation, transparent barriers, tape for social distancing, additional filtration systems) to have adequate ventilation, maximize airflow, and maintain social distancing


  • Education: Student-athletes should always implement basic infection prevention measures, including outside of athletic activities to mitigate risk to themselves and their colleagues.


11. Universal Source Control



  • Cloth face coverings or face masks should be worn for all phases of non-water-based activities that involve proximity to other individuals. Wearing cloth face coverings or face masks can be challenging for rigorous sports. If no masks are worn, physical distancing of 6-feet should be required.


  • Face shields should be considered due to them being less restrictive for breathing and prevent the wearers from touching tier faces. Face shields can also be constructed for specific equipment (e.g. affixed to football helmets), though they must be certified by the National Operating Committee on Standards for Athletic Equipment. Consult manufacturers before making this decision.


12. Travel



  • Groups must follow applicable guidelines and regulations by the CDC and local/state health departments. Groups should also consult government health agencies to assess destination safety and risk.


  • International travel decisions should be made on a case-by-case basis by balancing benefits (e.g. goals of training, risk of location), risks (e.g. number of people, accommodations, destination medical capacity), and risk mitigation strategies (e.g. team doctor, risk assessment for individuals, reduced travel group size, travel insurance, action plan for sickness).


  • Facilitate travel safety by making transportation arrangements for the traveling party while visiting other cities.


  • Have members wear masks while traveling and ensure adequate hand hygiene supplies are present. Have a stock of cleaning products to distribute to members for cleaning personal items upon arrival.


13. Basketball



  • During game time, have measures separating players from each other and opposite teams such as separate team spaces and larger distances between substation seats. Refrain from greetings that require contact like handshakes and high-fives.


  • Change and shower before coming to onsite facilities.


  • Plan media interactions that facilitate social distancing.


14. Baseball



  • Follow school and municipality regulations over suspension of events and activities and travel guidance.


  • Consider that Major League Baseball has canceled Pitch, Hit, Run competitions for 2020.


  • Review upcoming budgets, incomes, and expenses. Financial support can be found at various places (e.g. small business loan, non-profit loan, GARES Act loan or grant).


Other Entertainment



Many other forms of entertainment involve many people gathering in one place, which increase the risk of COVID-19 transmission. Guidance is intended to supplement and not replace local, state, territorial, federal, and tribal laws, rules, and regulations.


1. Basic Measures



-Restrooms


  • Stock adequate hand washing supplies or hand sanitizer with at least 60% alcohol.


  • Portable handwashing stations should be provided in the case of portable toilets. Hand sanitizer stations that are touch-free are preferred.


-Physical Distancing Measures

  • Modify layouts so individuals who do not live together can remain 6-feet apart.


  • Install physical barriers and place guides (e.g. partitions, lane lines, tape on surfaces, signage) to help maintain social distancing.


  • Limit the number of people in shared spaces (e.g. staff break rooms, offices, indoor areas).


-Food

  • For large events, uses prepackaged food instead of self-service buffet or family style.


  • Self-service containers and items requiring frequent hand contact should be removed from use, or appropriately washed, cleaned and sanitized, and changed after each customer/party is served (e.g. seating covers, table cloths, linen napkins, throw rugs, condiments such as ketchup bottles and salt/pepper shakers, and reusable menus).


  • If there is not enough single-service and single-use articles available, all reusable food service items should be are handled with gloves and washed with dish soap and hot water or in a dishwasher.


  • High-touch areas and equipment cleaned should be and disinfected (e.g. doorknobs, display cases, equipment handles) more frequently.


-Faculty

  • Ensure proper function of ventilation systems. Increase the circulation of outdoor air (e.g. opening windows, doors) when feasible and safe for staff and attendees. Prevent direct air from being directly blow from one person to the next when using fans or misters.


  • Water systems (e.g. faucets, fountains) should be evaluated to prevent legionnaires disease. Fountains should be sanitized on a regular basis.


-Payment

  • Cashless transactions are preferred. Cash should not be accepted for places food handling but may be accepted for ticket sales and registers with ticket sales and concessions.


2. Parks and Recreation



-Restrooms

  • Ensure toilets are functional and disinfect at least once daily with List N supplies.


  • Supply no touch trash cans, handwashing supplies or 60% alcohol-based hand rubs.


  • For portable restrooms which do not have handwashing supplies, have signage encouraging guests to bring their own alcohol-based hand rub.


-Playgrounds

  • Continue to do routine cleaning and hygiene practices for outdoor areas. Additional disinfection can be done on frequently touched surfaces (e.g. handrails, benches); ensure disinfectant is dry before children are allowed.


-Social Distancing

  • Areas may require temporary closures (e.g. sports fields, playgrounds, basketball courts, picnic areas) to support social distancing practices. Post signs explaining the area closure.


  • Consider adding physical guides (e.g. markings on ground tape, signage) to facilitate social distancing.


3. Aquatic Venues and Beaches



Evidence suggests COVID-19 does not spread by using recreational waters. When reopening venues, operate according to local, state, territorial, federal, and tribal laws, rules, and regulations. Communicate with those authorities over gathering requirements and whether certain swim events may be held. Encourage visitors to social distance and perform hand hygiene.

  • Clean and disinfect frequently touched surfaces at least once daily with the best List N disinfectant for the venue. Pools should be cleaned and disinfected as per guidelines.


  • Assign monitoring duties for handwashing, mask use, and social distancing compliance to staff who are not actively lifeguarding.


  • Masking or the use of cloth face coverings outside the water is encouraged. Masks are not recommended in the water as they can be difficult to breathe through when wet.


  • Before modifying aquatic features (e.g. slides, play structures) consult the company who designed the venue.


  • Items


    • Have a disinfection rotation for shared objects.


    • Label containers for items that have not been cleaned and disinfected.


    • Label containers for items that have been cleaned and disinfected.


    • Launder towels and clothing in the warmest possible water and dry appropriately.


    • Difficult to clean, disinfect, or sanitize items, or items that touch the face (googles, nose clips, snorkels) should not be shared. Visitors should not share items with people they do not live with.


    • Minimize shared equipment by having adequate supplies, or limit use to one group at a time, cleaning, and disinfecting between users.


  • Create a communication system for self-reporting symptoms of COVID-19 or exposures to COVID-19 and notifying local health authorities of COVID-19 cases, patrons and staff of potential exposures while maintaining confidentiality according to the ADA, and venue closures.


  • 4. Amusement Parks and Carnivals



    Gathering sizes should be determined based on state, local, territorial, or tribal safety laws and regulations. Consider the higher the level of community transmission, the higher the risk of COVID-19 spreading during park activities. The risk of transmission can also be determined by measures enacted.


    • Encourage masking or the use of cloth face coverings when feasible.


    • Surfaces (e.g. game surfaces, safety bars, harnesses) should be disinfected between users. Surfaces should be dried thoroughly to prevent irritation and allergic reactions. Porous items should be cleaned daily using approved disinfectants for the material. Clean equipment according to manufacturer guidelines.


    • Increase the number of restrooms to minimize crowding and ensure adequate cleaning and handwashing supplies. Have markers to help guests maintain a distance of 6-feet apart from one another.


    • Discourage sharing objects that are difficult to clean or disinfect. Minimize shared equipment by having adequate supplies, or limit use to one group at a time, cleaning, and disinfecting between users.


    • Reduce the number of touch points by using touchless alternatives (e.g. radio frequency identification bands, automatic entry gates, no-touch trash cans).


    5. Theater and Performance Arts



    Phase III of reopening allows for the opening of outdoor Theater and Performance Venues and indoor movie theaters. Phase IV will allow for the opening of additional large capacity events such as stadiums, arenas, ballparks, exhibitions, and convention halls. Consult local, state, territorial, federal, and tribal laws, rules, and regulations. The following safety standards have been taken from the Massachusetts government.

    -Occupancy


    • Occupancy counts should consider workers, customers, and any other persons present.


    • Individual indoor theaters or screening rooms may have up to 40% of their maximum permitted occupancy and never more than 25 people in an enclosed space. For venues without recorded permitted occupancy limitations, 8 persons are allowed per 1000 square feet of accessible space, and never more than 25 people in an enclosed space.


    • Outdoor venues must monitor customer entries and exists and can have up to 50 persons or 25% of the venues permit occupancy, depending on whichever one is lowest.


-Group sizes


  • No more than 10 individuals should attend together in a singular group.


-Social Distancing


  • Have measures (e.g. tape on floors/sidewalks, create 1-way routes in halls, partitions, 6-foot distance between tables, and signage on walls) to allow a 6-foot distance between staff and visitors and minimize face-to-face contact.


  • Signage explaining social distancing should be posted highly visible locations (e.g. entrances, restrooms, dining areas, classrooms, auditorium).


  • Develop a seating plan where customers can reserve seats and allow small groups to sit together while maintaining 6 feet of distance from other people.


  • Have workers guide visitors in organized entrances and exits to prevent congregation.


  • Avoid intermissions to limit performance time and congregation.


-Cleaning and Disinfection


  • Stagger events so thorough cleaning may be done between different customer groups. Always clean seating areas between uses.


  • Log cleaning, including date, time, and scope of tasks.


  • If there is a positive case, shut down the facility for deep cleaning.


-Live Performers


  • Wear cloth face coverings during performances if possible.


  • Limit activities requiring performers to be close than 6-feet and discourage scenes that require prolonged direct contact.


  • Always prohibit direct interaction between performers and audience (e.g. backstage, meet and greets).


-Outdoor live performances


  • Discourage playing of brass and wind instruments due to high airflow. If singing, brass, or wind instrument performances are taking place, there should be 10-feet between performers and at least 25-feet between performers and the first audience row.


-Logistics


  • Operating hours should allow for off-hour sanitation and cleaning.


  • Maintain a visitor and worker log for contact tracing.


Staff Guidelines



  • The Centers for Disease Control and Prevention (CDC) have implemented guidelines on how employees can protect themselves and their co-workers from COVID-19. Employees are encouraged to forward any questions or concerns that they may have to No Wait Medical Partners.


Protecting Yourself and Others



-Hand Hygiene


  • Practice good hygiene. Wash your hands frequently with soap and water for at least 20 seconds, or if soap and water are not immediately available, then use an alcohol-based hand sanitizer that contains at least 60% alcohol and rubbing hands until they are dry. Avoid touching your face.
    COVID-19 Guidlines

    Click here to watch the video


-Respiratory Etiquette


  • Follow the proper guidelines for covering coughs and sneezing (i.e., sneezing or coughing into a tissue or into the upper sleeve). Always wear a face mask while in the workplace, and the mask should cover your nose and mouth. Learn how to properly put on, use/wear, and take off protective clothing and equipment.


  • If possible, wear cloth face coverings protect others in case the wearer is unknowingly infected. Cloth face coverings should not be placed on babies and children younger than 2 years old, anyone who has trouble breathing or is unconscious, or anyone who is incapacitated or otherwise unable to remove the cloth face covering without help.


-Social Distancing


  • Maintain 6-feet of social distancing as work duties permit, and avoid physical contact with others, including other staff, students, or campers.


  • Use alternatives ways to shake hands upon entry, and it is important to not touch your face (i.e., mouth, nose, eyes).


  • Drive to facilities or parking areas individually; when possible, an avoid having passengers or foods.


-Daily-health checks


  • Determine if you have fever, respiratory symptoms (e.g. coughing, shortness of breath) or other symptoms in the past 24 hours. If so, stay at home and notify the COVID-19 point of contact.


What should I do if I become ill?




Resources:

AMC reopening protocols (AMC guidelines)


Aquatic Checklist for Staff (CDC guidelines)


Considerations for Events and Gatherings (CDC guidelines)


COVID -19 Considerations for Traveling Amusement Parks and Carnivals (CDC guidelines)


DC Committee. Faith, Arts, Culture, Entertainment, Sports, and Hotels Committee submission to the Steering Committee for its recommendations to the Mayor (DC guidelines)


Disinfectants for Use Against COVID-19 (EPA guidelines)


EPA United States Environmental Protection Agency. List N: Disinfectants for Use Against SARS-CoV-2 (EPA guidelines)


FIBA Return To Basketball COVID-19 Restart Guidelines. (FIBA guidelines)


Government of Massachusetts MA COVID-19 Checklist. (Mass guidelines)


Government of Massachusetts MA Safety Standards (Mass guidelines)


Hand washing guidelines (CDC guidelines)


Information on the use of cloth face coverings (CDC guidelines)


Little League Coronavirus FAQs. (Little League guidelines)


NCAA Resocialization of Collegiate Sport: Developing Standards for Practice and Competition (NCAA guidelines)


NFL-NFLPA COVID-19 Protocols For 2020 Training Camp And Preseason (CDC guidelines)


Protection of yourself and others against COVID-19 (CDC guidelines)

What You Need To Know About Handwashing (Video)


OSHA Guidance on Preparing Workplaces for COVID-19 (OSHA guidelines)


Parks, Sports, and Recreation (CDC guidelines)


Reopening Guidance for Cleaning and Disinfecting Public Spaces, Workplaces, Businesses, Schools, and Homes (CDC guidelines)


Respirator Safety (United States Department of Labor.)


Self-assessment tool for employees (CDC guidelines)


Symptoms of COVID-19 (CDC guidelines)


UK Government Find out how to make your workplace COVID-secure (UK Gov guidelines)

UK Government Performing Arts (UK Gov guidelines)


When to screen (CDC guidelines)


Youth Sports Letter to Parents (CDC guidelines)