Adolescents in St. Louis County continue to contract and spread COVID-19, and the data demonstrate that sports activity is a factor in a number of cases.
The St. Louis County Department of Public Health has documented five clusters of COVID transmission among student-athletes linked directly to sports practices or games. Each incident involves a group of high school students. In addition to those cases, we have identified more than 20 student-athletes who have contracted COVID-19 in recent weeks. In those instances, it’s not clear whether transmission occurred at an athletic or social activity. This comes amid a high number of cases among our adolescents – typically defined by medical authorities as those between 15 and 19 years old.
St. Louis County isn’t alone in seeing a link between youth sports and youth cases. In Jefferson County, several high school students who participated in a football game last week have tested positive for COVID-19, leaving one high school to order all varsity and JV team members to stay away from school for 14 days. In college athletics, the University of Missouri football team will have at least 12 players who won’t be able to play in the team’s first game later this month due to COVID-19.
Even professional sports teams like the St. Louis Cardinals are not immune from transmission. The Cardinals have reported that 18 players and staffers have tested positive for COVID-19, and one has lost his life to the disease.
The reality is that games in high-contact sports present a risk of transmission. Players are within inches of other players, breathing, spitting and yelling without masks. Physical exertion entails heavy breathing, which is known to be a vector of disease spread. And related activities such as team huddles, shared meals, team bus rides, frequent carpooling and crowds of spectators further compound transmission risk. Decreasing opportunities for young people to congregate and spread the virus is a priority for St. Louis County, particularly because transmission among young people puts in-person education at risk.
Based on this data and in conjunction with study of best practices across the country, we have divided youth sports into three categories based on the amount of person-to-person contact that is involved. For low-contact sports and for medium-contact sports played by younger children, we are allowing games, with social distancing restrictions. For high-contact sports like football and some medium-contact sports played by older teens, we are not yet allowing games. See our youth sports guidelines here.
The long-term effect of COVID-19 among children and adolescents is unknown. Alarmingly, studies have begun to show that young athletes who test positive for COVID-19 can suffer myocarditis as a result. Myocarditis is an inflammation of the heart muscle that can weaken the heart and affect its electrical system, reducing its ability to pump and causing rapid or abnormal heart rhythms (or arrhythmias). Myocarditis is the third leading cause of sudden death in children and young adults.
It's critical to understand that every single person who contracts COVID-19 has the potential to infect multiple networks of people around them. Young people with COVID-19 may spread it to older relatives, friends and those in the community who are more apt to develop serious symptoms – or die – from the disease. Research indicates that adolescents spread the virus just as efficiently as adults. At this time, more than 600 students and staff at schools in St. Louis County have been quarantined because of potential exposures, all while no games are being played in high-contact sports.
Until community transmission in St. Louis County is reduced and until we can recommend that high schools return to in-person education, we cannot recommend resumption of games in high-contact high school sports. All of these decisions have been – and will continue to be - driven by public health department data and lived experience.
The Department of Public Health recognizes the importance of the physical activity and social support provided by athletics. DPH allows – and encourages – individual and team workouts, skill development work and other activities. Participants in many sports are permitted to play competitive games. However, we are recommending – but not requiring – that high-contact fall sports shift to a spring schedule, as allowed by the Missouri High School Sports Activities Association.
Our guidance will continue to change as we closely monitor transmission in the community. We will continue to seek feedback from stakeholders and watch the data with the knowledge that our decisions regarding how and when we resume many activities, include youth sports, could significantly affect the well-being of many residents, not just young athletes. We take our responsibility to protect St. Louis County very seriously.
The St. Louis County Department of Public Health will continue to make decisions to keep our children safe, fight community transmission and encourage healthy activities.