Australian Institute of Sport Chief Medical Officer Dr David Hughes answers your questions

Everyone involved in the resumption of sport needs to be accountable for their actions if they fail to comply with health directives, says the Australian Institute of Sport’s Dr David Hughes.

Australian Institute of Sport Chief Medical Officer, Dr David Hughes, answers your questions

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A RETURN to sport features prominently in the Federal Government’s plan to ease COVID-19 restrictions.

Prime Minister Scott Morrison and the National Cabinet have agreed on a three-step plan to navigate Australia out of the coronavirus lockdown and “to achieve a COVID safe economy and society”.

In a press conference on Friday, Mr Morrison said he hoped to move Australia through the three steps by July, depending on health advice. Each of the states and territories would ultimately control their own progress, he said.

The Australian Institute of Sport (AIS) has played a key role in developing a framework to guide a return to competitive and community sports as safely as possible.

Dr David Hughes, chief medical officer of the AIS, said sport organisations and participants were faced with complex decisions regarding resumption of training and competition in the current circumstances.

“The AIS Framework covers all levels of sport from community participation to high performance competition, guiding sporting organisations and individuals on how to resume sporting activity in a cautious and methodical manner,” he said.

“A key principle guiding the creation of the Framework has been to ensure the resumption of sport does not endanger the health of the community.”

The AIS Framework recommends a staged approach in any return to sport, with each stage – Level A, B and C – requiring a range of risk management considerations, including an analysis of safe environments and education of participants.

It also provides detailed consideration of the differences across all sports including contact and non-contact sport, indoor and outdoor activity, along with a sport-by-sport guide to return to play.

Dr Hughes was online today to answer your questions in an hour-long Q&A.

Here’s what he had to say:

Q. From your discussions with government, what is the realistic timeframe for a widespread return to sport - and do you think we will see spectators back in 2020?

A. I wish I had a crystal ball, but unfortunately I do not. I doubt that any State/Territory government could confidently answer this for you at the moment. The reason for the staged approach to the reintroduction of sporting activity is that we need to see what happens at each step. The incubation cycle for the virus causing COVID-19 is somewhere between 2 and 14 days. For this reason, any increase in transmission rates, related to easing of restrictions (including sport), will not be seen for at least a fortnight after the changes are made. Most States/Territories have adopted a stepwise approach to the resumption of sport, with each step being approximately 2 incubation cycles (4 weeks). If everything goes very well and we don’t see any significant increase in community transmission rates as a result of the easing of restrictions, then permitting mass gatherings (spectators) at sporting events could potentially come back later this year. If on the other hand, we do observe significantly increased community transmission rates in response to easing of restrictions, then I would expect the reintroduction of mass gatherings to be significantly delayed.

Q. I don’t think any professional sport should return until the governing body has committed to tough, non-negotiable sanctions on anyone who breaks the rules. Given the fiasco of the NRL return, that doesn’t seem to be happening. Is enough pressure being put on administrators to take a tough stance?

A. There is no doubt that to successfully reboot sport in a COVID-19 environment, we are going to have to rely heavily on each individual taking responsibility for their own behaviours. COVID-19 does not differentiate between highly paid professional athletes and amateur community level athletes. They are equally susceptible. It is at adherence to the simple things (hand hygiene, respiratory hygiene, maintaining social distance wherever possible, avoiding unnecessary social interaction) which will determine whether we can resume sport activity without causing an increase in community transmission of COVID-19. The National Principles for the Resumption of Sport and Recreation Activities clearly states that ‘for high performance and professional sporting organisations, the regime underpinned in the AIS Framework is considered a minimum baseline standard required to be met before the resumption of training and match play.’ Any organisation wishing an exemption from the community-wide restrictions has to convince the relevant State/Territory governments that they have a plan which will ensure that they are able to conduct the sporting activities without endangering the community. I am unsure whether such plans require the inclusion of non-negotiable sanctions. I do however agree with your premise that everyone wishing to participate in resumption of sport should be held accountable for their actions, should they not comply with health directives.

Q. Have you differentiated between junior sport and adults in your recommendations? Children have markedly lower rates of infection, transmission and symptoms. Assuming parents of juniors are managed (eg drop off like at school).

A. It is a good question. No, we have not differentiated between junior sport and adults in the AIS Framework. The issue of transmission risk involving children and adults remains controversial and contested. As I am sure you will have observed, there are quite strongly opposed views (many of those opposed views coming from equally reputable sources) regarding the transmission risk posed by groups of children. Clearly there is no such thing as a purely junior-sport environment. Children require supervision from adults and there will almost always be adults supervising or observing children participating in sport. COVID-19 is a new disease and we are still learning about the nuances of transmission rates in different age groups. The evidence at this stage is not strong enough for AIS to confidently make recommendations which differentiate between junior sport and adult sport.

Q. With states all doing their own thing, how do we ensure we’re following the right rules at the right time? Will there be enough support for club volunteers to understand and manage the various restrictions?

A. I completely sympathise with the confusion that inevitably surrounds COVID-19. The world has never encountered a virus like this. It is impacting on every facet of our social, sporting and work lives. The AIS Framework provides recommendations but it is the individual State/Territory governments and Public Health Authorities that make the final decision about what is permitted and what is not permitted in each State/Territory. The National Sporting Organisations and the State Sporting Organisations are doing their best to stay abreast of the decisions made by each of the State and Territory governments in relation to the resumption of sport. That information should then be fed down through the NSOs and the SSOs, to the grassroots clubs. I would recommend that any club or individual that has doubts about what is permitted in their particular State or Territory, goes to the website for their particular State/Territory, which clearly indicates what is and is not permitted.

Q. Why have the NRL been given exemptions so that they can return on the 28th May? The can only tackle at Level C, yet we aren’t there yet, so how is this possible?

A. The AIS worked closely with Federal/State/Territory governments in forming the National Principles for the Resumption of Sport and Recreation Activities. Principle 11 states: “If sporting organisations are seeking specific exemptions in order to recommence activity, particularly with regard to competitions, they are required to engage with, and where necessary seek approvals from, the respective State/Territory and/or Local Public Health Authorities regarding additional measures to reduce the risk of COVID-19 spread.” My understanding therefore is that for any sporting group (including the NRL) to receive an exemption, they must have submitted a detailed proposal which received approval from the respective State/Territory and/or Local Public Health Authorities.

Q. Do you see events such as Great Ocean Road marathon (August) and Melbourne marathon (October) being a possibility?

A. Marathon running events really fall under the classification of ‘mass gatherings’. These were one of the first events to be cancelled as restrictions related to COVID-19 were introduced in February and March. I expect that these and other mass gatherings will be one of the last events to be reintroduced in the process of easing restrictions. Individual States/Territories will move at their own pace in terms of the type of activities which they reintroduce. When it comes to COVID-19, no one can predict the future. I certainly can’t. State/Territory governments would have to have a very high level of comfort that they have controlled COVID-19 transmission, before they would introduce mass events such as marathon races. I doubt whether such events will be held as early as August/October, but I would love to be proven wrong, for the sake of marathon runners.

Q. My son is desperate to get back to playing soccer. How does the staged approach work for community clubs and what safety measures should I be looking for as a parent?

A. I completely sympathise with your son’s plight. There is overwhelming benefit for the physical, psychological and emotional benefits that children derive from participation in sport, particularly team sport. It is important to understand that it is the State/Territory governments which have the ultimate jurisdiction over what is permitted or not permitted at each stage of the easing of restrictions. Each person who joins a sporting group, brings with them their own individual transmission risk. None of us can know what the transmission risk is, of any other individual. For this reason, almost all States and Territories agree with the AIS Framework that initially, we should bring only small groups together. The AIS Framework recommends that initially, sporting groups should not be larger than 10 people, including coaching staff. This means that each individual has potential contact with a maximum of nine other people. Some States/Territories are recommending that in the first instance, these groups of 10 can only train outdoors. This is because there is some evidence that there is increased transmission risk for gatherings held indoors. I recommend you search the Internet for the COVID-19 restrictions in your own State/Territory to be sure of what is permitted and what isn’t. Your soccer club should be aware of the specific restrictions in your jurisdiction.

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