Sports Are Linked to COVID Outbreaks in Kids—Here's How Parents Can Keep Them Safe

For many school-aged kids, there's no greater joy than running out onto a football field or picking up a tennis racket to whack balls over a net. The pandemic weighed heavily on young athletes, who were saddened when they learned they could no longer do what they loved. With schools taking a lengthy break from team sports, practices, and competitions over the past few years, it's no wonder that kids were thrilled when their beloved games came back again. But with health officials warning that athletic activities could cause COVID-19 outbreaks, you might be wondering: Is it safe?

It's a fair question. School sports do tend to create a cluster where the virus can spread. And it's not just contact sports that are a problem; it's the fact that kids are packed into gymnasiums, locker rooms, and other tight spaces throughout the day, and they're constantly breathing on each other. "We're finding out that it's the team sports where kids are getting together, obviously many without masks, that are driving [viral outbreaks]—rather than in-the-classroom spread," said Anthony Fauci, M.D., the director of the National Institute of Allergy and Infectious Diseases, to Good Morning America in April 2021.

Rochelle Walensky, M.D., the director of the Centers for Disease Control and Prevention (CDC), has also addressed the rise in coronavirus cases among those engaging in sporting activities. She spoke to the topic at a White House press briefing last year, acknowledging that new strains of the virus were amplifying the spread of COVID-19 among those who played sports. "We know that these increases are due in part to more highly transmissible variants, which we are very closely monitoring," she said.

Flash forward a year, and the story looks a little different. For one thing, kids age 5 and over are eligible to be vaccinated against the coronavirus, which offers student athletes a higher level of protection. At the same time, the shot isn't perfect and not everyone is getting it, so many of the basic precautions remain the same. In January 2022, the CDC issued what seemed like a throwback recommendation and urged schools in areas of high COVID-19 transmission to cancel sports, which implicated 99 percent of U.S. communities. Now much fewer communities are at high risk, so schools make their own rules.

Why Are Sports Such A Problem?

It's one thing to establish a rule and another to expect a group of sweaty, amped-up kids to follow it. Masking has clearly been shown to reduce the incidence of COVID-19 among student athletes, yet so often adolescents succumb to peer pressure and secretly ditch them (or coaches don't enforce the rules). Indoor sports like basketball, volleyball, and ice hockey often take place in poorly ventilated spaces, and involve full-body contact, so they can be extra-risky; in December 2020, a Florida wrestling tournament spread COVID to dozens of students, and similar incidents have followed.

Social distancing rules aren't always observed when teams are outdoors, either. But outdoor sports at least have the advantage of fresh air and space that allows the virus to disperse more easily. "Anything that's transmitted airborne is going to have a more difficult time outdoors than indoors," says COVID-19 and vaccine expert Jonathan Baktari, M.D., a specialist in internal, pulmonary and critical care medicine, who runs e7 Health in Chicago. Here again, the degree of contact matters. Kids who play baseball will be less at risk than those who play football and slam into each other on the field.

Should My Kid Even Be Playing Sports?

Deciding whether or not your kid should keep playing sports during the pandemic can be difficult, especially when you hear reports about COVID-19 cases surging across the country. But experts agree that sports are critical for kids, helping them build muscle, learn to socialize, and develop a sense of independence and teamwork. Kids form lifelong bonds on the field, and they get something special from group exercise that they don't get from academics. Sports also beat back anxiety and depression, which shot up when schools shut down their sports programs.

In one University of Wisconsin survey of 3,200 adolescent athletes, it was easy to see the effects of the pandemic sports hiatus in schools. Students who had previously loved being active cut their exercise in half once it happened, and 33 percent reported feeling symptoms of depression (up from 10 percent pre-COVID), while 25 percent exhibited anxiety. When that survey was extended to 13,000 athletes nationwide, those numbers rose: Now 38 percent of kids showcased depression, while 35 percent had symptoms of anxiety (findings that were particularly marked among young women).

Pediatrician Drew Watson, M.D., a sports medicine physician at UW, helped conduct the survey in his other role as chief medical advisor of Elite Clubs National League, a youth soccer organization. He believes that sports have a vital role in kids' development, and thinks it's essential to weigh the evidence before deciding what to do. "Considering the dramatic and wide-ranging physical and mental health benefits of sport participation for children, my hope is that we can successfully work to minimize risk off the field while still providing the opportunities to play that so many kids truly need," he says.

So What Can Parents Do?

According to the CDC, the best way for parents to mitigate their children's risk when playing sports is to get them vaccinated, encourage sick team members stay home, and emphasize that coaches post signs around practices that encourage social distancing and masking up. (With one caveat: In some sports, like wrestling and swimming, masks may be dangerous, so alternatives must be found.) Even with vaccinations, kids need to learn that COVID-19 transmission is possible on and off the field, whether they are pinning each other down at wrestling matches, sitting next to each other on the way to tournaments, or hanging out on the bench at games. No vaccine offers complete protection.

Of course, every family has a different level of medical vulnerability. Parents who know that their child will regularly interact with someone who's high-risk, whether that's a sibling or a grandparent, need to encourage them to mask up at indoor sporting events and when they're hanging out after games. Look closely at how large the kids' teams are, whether the other children are engaging in COVID-safe behavior off the field, and whether all of them are immunized, says pediatrician Michael B. Grosso, M.D., an assistant professor of pediatrics at Hofstra University in Hempstead, New York.

• RELATED: The COVID-19 Vaccine and Kids: Everything Parents Need to Know

Little things can make the difference. If you live in a high-transmission community, you may want to tell kids to skip the high-fiving, hugging, or huddling to celebrate when they score a goal. But you don't want to suck all of the fun out of sports, either. And just playing sports doesn't mean your kid is going to get the coronavirus, especially if the school has a plan in place. In fact, a follow-up study by the University of Wisconsin found that 90,000 student soccer players in 34 states nationwide had even lower levels of COVID-19 than the general population, and just one contracted it from soccer.

There is hope on the horizon as more and more children are getting vaccinated, offers Dr. Baktari. "The good news is the odds are tipping in our favor because really the major issue during the pandemic was that youth [who got] infected could spread it to vulnerable people," he says. Now that a majority of the country has had at least one dose of the vaccine, some of that potential downside is gone.

The Bottom Line

COVID-19 no longer decimates towns and cities the way it did in the early pre-vaccine days. Now a neighborhood's ability to thrive depends on how well it has addressed prevention and awareness. "Each community may need to make adjustments to meet its unique needs and circumstances," points out Dr. Steven Abelowitz, M.D., the president and medical director of Coastal Kids, a pediatric medical group with seven locations in California. The same goes for school athletic programs. Communicate with them and ask questions to ensure safety measures are being taken.