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WEST VALLEY PREPS
COVID-19 waiver now part of game for HS athletes
Dysart Unified, Paradise Honors forms differ slightly
Posted
IF AN ATHLETE TESTS POSITIVE FOR COVID-19
Included in the modified Arizona Interscholastic Association recommended guidelines for returning to athletic activity document modified by the AIA Sports Medicine Advisory Committee and approved by its executive board Sept. 2 is the following section is the following protocols for an athlete who test positive for COVID-19:
Returning to Participation Following COVID Exposure or Diagnosis
Should an athlete have a positive COVID-19 test they will need to follow the return to participation protocol outlined below. The AIA has developed the COVID-19 Return to Play Form that will need to be completed by a qualified medical provider. Individuals who have had COVID-19 are at risk of developing severe cardiac complications that can affect participation in sport. There is limited research in this area particularly in youth athletes to standardize clinical decision making. For these reasons, it is strongly recommended that this form be
completed by the patient’s primary care provider who is preferably an MD or DO. Evaluation and management by the primary care provider allows for the patient’s past medical and cardiac history to be known.
The school’s medical staff (athletic trainer and team physician) should develop a list of referrals for local pediatric and family practice providers that includes all health systems (to account for various insurances) for patients who may not currently have a medical home. This list should be provided to families who do not have an identified primary care physician along with information on the CDCs self-isolation criteria and the COVID-19 return to play form.
Families have a minimum of 14 days to establish and arrange an appointment with a primary care provider for clearance to begin the return to sport protocol.
The evaluation to determine whether an athlete is ready to begin the return to play progression must include:
• Symptoms are resolved or nearly resolved, any remaining symptoms are not interfering with daily activities
without medication
• No fever (above 100.4F) for minimum of 14 days without fever reducing medication
• COVID-19 respiratory and cardiac symptoms (moderate/severe cough, shortness of breath, fatigue) have resolved
• Athlete was not hospitalized due to COVID-19 infection.
• Cardiac screen negative for myocarditis/myocardial ischemia (All answers below must be no)
Chest pain/tightness with daily activities YES NO
Unexplained Syncope/near syncope YES NO
Unexplained/excessive dyspnea/fatigue w/ daily activities YES NO
New palpitations YES NO
Heart murmur on exam YES NO
• If any cardiac screening question is positive or if athlete was hospitalized, had prolonged fevers (greater than 3 days) or was diagnosed with multisystem inflammatory syndrome in children (MIS-C), further workup is recommended based on the Return to Play After COVID-19 Infection in Pediatric Patients Clinical Pathway.
If the athlete has met the above criteria, they may begin a return to play progression under the supervision of the school’s athletic trainer or other school personnel. Each stage must be completed without development of chest pain, chest tightness, palpitations, lightheadedness, pre-syncope or syncope. If these symptoms develop at any stage, the patient shall be referred back to the evaluating provider who signed the form. This protocol will take a minimum of 7 days to complete.
Liability waivers for athletic participation are part and parcel for high school sports.
This school year, districts statewide, and likely nationwide, are adding another waiver specifically focused on COVID-19 transmission.
This includes the Dysart Unified School District. Dysart, along with many other Valley districts including Chandler Unified and Paradise Valley Unified, is covered by the Arizona School Risk Retention Trust, Inc., a nonprofit corporation that provides Arizona public school districts and community colleges with property and liability coverages and related services.
Jim Dean, DUSD assistant superintendent for support services (including athletics), said the trust is requiring the district to distribute the waiver that deals specifically with COVID and require athletes to sign it before participating.
Thus far, Mr. Dean has not noticed a great deal of concern among the district’s high school parents.
“I’m aware of one parent at one of our schools that was not comfortable about signing the waiver. What I’m seeing the most is an excitement to be back,” Mr. Dean said.
That worldview appears to be present at one of the district’s larger football programs.
Elvis Getejanc said he and his son Logan, a sophomore offensive lineman for Shadow Ridge’s varsity, received and read only one COVID-related waiver before the Stallions started summer conditioning camp. They did not have many qualms about signing it.
“I had conversations with Logan and other parents and collectively felt that going back to football outweighed the risk of the boys returning,” Mr. Getejanc said.
Mr. Getejanc said he will keep an eye out on any developments. But nothing happening recently in terms of dropping case rates Arizona, wildly different case levels across college sports or during game play in football and other sports made the family more leery of playing this football season.
A few miles east at Paradise Honors High School, the mood among the charter school’s athletic community is similar.
“We have had nothing but positive responses. Parents were happy to sign it to get athletes back at it,” stated PHHS athletic director Ben Clark in a Twitter interview.
Mr. Clark stated that Paradise Honors has a similar COVID-19 waiver form, though their insurance is not provided by The Trust.
Early Dysart district athletic participation numbers are down thus far in smaller winter sports like cross country and golf, particularly at high schools like Dysart that rely on recruiting kids once they get to campus. Mr. Dean said football participation has dropped — though not drastically so — and some of that decline can be pinned in particular on the lack of freshmen on campus.
One issue with COVID-19 is it is such a “new” virus that information is still coming in about its possible long-term effects.
Banner Health experts are encouraging cardiac screenings for student-athletes as new research revealed potential heart damage as an aftereffect of the virus. A study published on bioRxiv shared new findings where novel coronavirus can cause harm in the way the heart functions through inflammation it creates in the body, sparking concerns about the potential for heart failure among COVID-19 survivors.
“Recent cases are showing that athletes who have overcome a viral infection such as COVID-19 can result in an inflammatory response that can potentially cause structural damage to the heart,” stated Dr. Steven Erickson, medical director for Banner Sports Medicine and Concussion Specialists, in a press release.
This inflammation is better known as myocarditis, which is usually caused by a viral infection and is becoming more common among student-athletes who have recovered from COVID-19.
Myocarditis can affect the heart muscle and its electrical system, reducing the heart’s ability to pump, causing rapid or abnormal heart rhythms, also known as arrhythmias. This can be dangerous for athletes, especially for those who play competitive sports.
Dr. Michael Perez, a pediatric cardiologist for Banner Children’s, stated COVID-19 isn’t just impacting the pulmonary system of those patients who are hospitalized, but it is also creating health issues for people who have fully recovered from the virus.
If a patient is a competitive athlete who will be training or participating in an upcoming sports season and had COVID-19, Dr. Perez recommends they seek an evaluation with their primary care physician or sports medicine specialist to see if they need additional evaluation by a cardiologist.
“We are recommending athletes of all ages who have been sick for more than three days with COVID-19 to get an EKG [an electrocardiogram] to screen for myocarditis before clearing them to play,” stated Dr. Erickson. “All athletes should be symptom-free for at least 14 days before resuming sports and should gradually resume activities while monitoring them for cardiac symptoms.”
As reported by cbssports.com on Aug. 11, myocarditis emerged as a significant health concern that played a role in the Big Ten Conference decision to cancel its fall football season.
In addition to testing and contact tracing procedures for athletes who test positive for the virus, clearance by a doctor is included in the returning to athletic competition guidelines adopted by the Arizona Interscholastic Association.
“When we have student-athletes who are injured, or in this case test positive for COVID-19, before returning to play they have to receiver a release from a medical provider,” Mr. Dean said.
While the liability waiver is designed to protect the district from legal challenges related to the coronavirus, staging sports as safely as possible during a pandemic already has led to a greater financial outlay.
While the overwhelming majority of school districts can not even consider spending for one round of COVID-19 test — much lest the multiple weekly tests common with NCAA and professional teams — Dysart is requiring temperature checks before practices and games.
The district is sanitizing commonly touched items, such as weights, weight benches, balls and pads.
“Where the financial strain comes in is related to the extra cleaning we’re doing, of footballs and volleyballs, and facilities. Those leather items are not built to be sanitized on a regular basis so they wear out more quickly. We also clean the athletic facilities far more than in the past,” Mr. Dean said.
Plus, every school district with football is looking at an almost unavoidable revenue shortfall.
The AIA tweeted on Sept. 9 that it will not impose statewide restrictions on fan attendance, leaving those decisions in the hands of local schools, districts and health departments. But current conditions will not allow for anything close to a full house and for football the lost ticket and concessions revenue will be acute.
“Schools rely on that gate revenue to pay for things like officials. Football typically carries the rest of the sports in terms of revenue,” Mr. Dean said.
Richard Smith Associate Editor | Surprise & West Valley Preps @rsmithYWV
Richard Smith has been with Independent Newsmedia since 2016, and worked at a Sun City-based news outfit covering the Northwest Valley for 22 consecutive years.
An NAU alum and lifelong Arizona resident, Richard began as a copy editor and page designer at Surprise Today and the Daily News-Sun, then rekindled his love of sports writing by taking the reins on West Valley Preps in 2008.
For most of the mid-2010s he was the Surprise editor and West Valley Preps reporter. Now he’s the West Valley Preps Editor and Surprise Associate Editor.
As COVID restrictions slowly lift, Richard is cautiously optimistic he will visit book stores, football fields and gyms again this fall.