key: cord-252799-p2ulrnsi authors: Ying-Ying Wong, Ashley; Ka-Kin Ling, Samuel; Louie, Lobo; Ying-Kan Law, George; Chi-Hung So, Raymond; Chi-Wo Lee, Daniel; Chung-Fai Yau, Forrest; Shu-Hang Yung, Patrick title: Impact of the COVID-19 pandemic on sports and exercise date: 2020-07-28 journal: Asia Pac J Sports Med Arthrosc Rehabil Technol DOI: 10.1016/j.asmart.2020.07.006 sha: doc_id: 252799 cord_uid: p2ulrnsi COVID-19 is a droplet-transmitted potentially fatal coronavirus pandemic affecting the world in 2020. The WHO recommended social distancing and human-to-human contact was discouraged to control the transmission. It has put many countries in a state of lockdown and sporting events (including the 2020 Olympics) have been affected. Participation in sports and exercise, typically regarded as healthy activities, were also debated. The local professional football leagues, governed by the Hong Kong Football Association, ultimately postponed all matches after much deliberation on the transmission risk for the spectators and on-field players. Large spectating crowds are well-known to be infectious hazards, but the infection risk for on-field players is less recognized. To address this question, we performed a small-scale investigation that showed, in a 90 min match, the average duration of close contact between players was 19 min and each player performed an average of 52 episodes of infection-risky behaviours. This suggests that the infection risk was high for the players, even without spectators. Aside from watching professionals exercise, many people opted to hike in the countryside during the weekends to avoid city crowds. This led to a widespread discussion on the issue of masked versus unmasked hiking. We performed a laboratory study to investigate the physiological effect of wearing a facemask during simulated hiking and found that it significantly elevated heart rate and perceived exertion. The clinical implication is that hikers need to realize masks increase the physiological burden, especially in those with multiple underlying comorbidities. Elite athletes, especially those training for the upcoming Olympics, needed to balance and reschedule their training regime since the risk of deconditioning versus the risk of infection was a genuine dilemma for themselves and their team. We described the multiple infection-control measures imposed by the national team training centre to help strike this balance. Amidst a global pandemic affecting millions; staying active is good, but staying safe is paramount. The coronavirus disease was first identified in December 2019 in China and caused 38 clusters of respiratory illnesses. 1 The highly transmittable viral infection is caused by the virus 39 known as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), which genomic 40 analysis revealed that it is genetically related to the SARS outbreak 2 that infected 8098 individuals From the currently available data available to this date, the main mode of human-to-human 59 transmission occurs through close contact with an infected individual and exposed to droplets or 60 aerosols. When the infected individual is coughing or sneezing, these aerosols are believed to enter 61 the lungs via inhalation through the mouth or nose. 3 The virus was detectable in stool samples 62 despite the course of illness, even after the virus was no longer detected in respiratory samples. 8 The contaminated environment may cause transmission through contact with mucosal membranes, such as the eyes, mouth, and nose. 9 Studies have also shown that the virus is viable up to hours as 65 aerosols and days on surfaces. 10 The average median incubation period was estimated to be around 5 days, majority of those who 68 will develop symptoms will do so within 11.5 days, and approximately 1% will develop symptoms 69 after 14 days. 11 The estimated R 0 was approximately 2.2, which means that on average an infected 70 person will transmit the virus to approximately 2 other individuals. 12 The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) 73 and cough (67.8%). 13 Infected people were often asymptomatic and did not present with a fever, 74 which will impose a challenging situation in terms of developing a surveillance method for sporting In order to maintain physical activity during the COVID-19 control period, many families avoided the 169 crowded city centres and opted to travel to the countryside for a leisurely walk or hike during the 170 weekends. This issue of wearing facemasks during outdoor activities became a topic of interest. The objective of this experiment was to investigate the effects of a facemask during exercise. This was a controlled laboratory, within-subject, repeated measures study of 23 healthy volunteers at 4 kilometres per hour for six minutes with the intention of simulating outdoor recreational hiking 176 on an uphill slope at a comfortable pace. 35 Heart rate (HR) was continuously monitored using a 177 chest strap (Polar H10) and rate of perceived exertion was charted minute by minute. The rate of 178 perceived exertion (RPE) rating is based on a 6 to 20 rating scale which was measured at rest and 179 also the end of each minute interval with a total of six minutes. All participants repeated the test with 180 and without wearing a surgical mask (in a randomized order); sufficient rest was given between 181 trials. Informed consent was obtained from all participants prior to the testing. Twenty-three participants (10 males, 13 females) with a mean age of 33.8 (range 21-60) were 184 recruited (Table 3) . Paired t-test showed significant (P < 0.01) differences among the heart rate and 185 RPE between wearing a mask and without a mask, as shown in With the increased cardio-respiratory burden following masked exercise, it is important to stay within 200 safe limits. This is especially true for more mature hikers and those with multiple comorbidities; in 201 general, it will be wise to rest when the heart rate exceeds 150 beats per minute 39 and/or 70% of age-predicted maximum heart rate. Masked exercises increase physiological demands, therefore 203 activities should be adjusted according to the individual's ability. The final impact of the COVID-19 pandemic on sports and exercise cannot be determined at this 257 stage, however, the information that we gathered may provide valuable guidance to athletes and governing committees to move forward safely. COVID-19 is highly transmittable in sporting 259 environments due to its viability, long incubation period, and milder symptoms; especially in contact 260 sports. The essential preventive measures include minimizing human-to-human contact and 261 practising proper personal hygiene. Athletes' on-field own risky behaviours should be avoided to 262 minimize unnecessary infection as close contact with others is unavoidable during contact sports. The decision to resume sporting events should correlate to the local number of cases and strict 264 infection measures will need to be implemented at the early phases of resumption. Exercise with a 265 facemask definitely has a toll on the human body and it is advised to adjust the exercise intensity Clinical features of patients infected with 2019 novel coronavirus 294 in Wuhan, China. The Lancet Genomic characterisation and epidemiology of 2019 novel coronavirus: 296 implications for virus origins and receptor binding. 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