What is the transmission risk of SARS-CoV-2 during rugby league matches?

SARS-CoV-2 transmission is low during rugby league matches

The return of sports brings with it a delight and hope to athletes and sports fans worldwide. However, the presence of COVID-19 may dampen spirits and create anxiety around the risk of transmission during contact sports. In the August issue of Sports Injury Bulletin, David Power shed's light on the transmission risk in Rugby League.

Paper title: SARS-CoV-2 transmission during rugby league matches: do players become infected after participating with SARS-CoV-2 positive players?

Publication: British Journal of Sports Medicine 2021;55:807-813

Publication date: February 11, 2021

INTRODUCTION

Human-to-human transmission of SARS-CoV-2 is possible through various methods (respiratory droplets, fomites, and aerosols). Close contacts of positive cases are required to isolate for 10 to 14 days, which may negatively impact an individual’s mental and physical health, not to mention the broader societal impact. As a result, contact tracing should be precise to prevent people from being wrongly identified as close contacts. The COVID-19 pandemic impacts the organization of sporting events, with many postponed or canceled. The repetitive, close contact nature of rugby league results in many opportunities for transmission of SARS-CoV-2. This study aimed to investigate the interactions between SARS-CoV-2 positive players and other players during rugby league matches and determine within-match transmission risk.

METHODOLOGY

Investigators observed 36 Super League rugby matches between July and October 2020. The league administrators implemented a seven-day reverse transcriptase PCR (RT-PCR) screening cycle, and all participants returned a negative test seven days before a match. Players subsequently testing positive for SARS-CoV-2 were deemed at risk of shedding infectious virus when symptom onset or the test occurred within 48 hours of the match. Performance analysts then analyzed match video footage to identify in-match close contacts. Investigators defined close contacts as any player within one meter, face-to-face for >3 seconds.

RESULTS

Eight players from four teams tested positive across the 36 matches. Analysts identified 28 players to be increased-risk contacts. One contact returned a positive RT-PCR test during the 14-day isolation. However, the likely transmission source is social interaction. One hundred other players were involved in the four matches with infectious players, four returned positive, and 95 returned negative RT-PCR tests. Investigators deemed these subsequent positives to have sources of transmission outside the competitive matches.

In conclusion, despite the high number of close contacts during rugby, the risk of transmission is low. Therefore, high-risk sports, such as rugby may require risk re-evaluation. In addition, social interaction is a high-risk transmission source, and clinicians should emphasize to athletes the importance of adherence to public health advice outside of sporting environments to prevent SARS-CoV-2 transmission.

David Power, BSc. Physiotherapy