When We Return To Sports: A Sharing Session by Dr. Azim
On 9th of September 2021 from 9pm – 10.30pm, grassroots sports communities had come together on Clubhouse to share their ideas & solutions. Here is the sharing session by our medical practitioner, Dr Azim.
Q: “Is it safe for sports to return?”
A: I would answer “Yes with tight SOPs in place.” Sports is beneficial not only to physical health, but also mental health- playing sports release the happy hormones, as we called it- dopamine, serotonin and endorphins. It helps with anxiety and panic attack. During this difficult time, we need maintain a good physical and mental health.
First, I just want to emphasize on what Izrin Nabil (Secretary General of FA Selangor) regarding endemic. The Ministry of Health announced that we are heading towards an endemic by end of the October. Endemic means a constant presence in a specific location, example of endemic is like Malaria to some parts in Africa or Denggue to Malaysia. This means we can’t aim zero covid cases like New Zealand or Singapore. We are way past containment and instead we are moving toward mitigation. We missed the boat already. But it doesn’t mean that we can’t resume normal activities like participating in sports. However, with the current trend of high new daily cases, hospitalisation and deaths, we can’t ignore the fact that we are still in an epidemic. So, high level of safety precaution needs to be taken. Endemic like dengue, no matter if we fogging or gotong royong every day, risk of getting dengue is still there. Same with Covid, no matter if we’re fully vaccinated or wear 3-4 layers of protection, the risk of getting covid will still be there. However, with the proper public health surveillance measures, we can avoid an outbreak or sports cluster as Nadzry (Venue Operator or Arena Legacy) said and protect from spreading and serious illness if you do get infected. This is what we have to keep in mind.
Q: “Do players become infected after participating with COVID-19 positive players?”
A: For the second part of the question, I really would like to just focus on 3 things:
Ventilation
Vaccination
Testing
For ventilation, I hope by now, everyone is aware the importance of ventilation against COVID-19. In April this year, the CDC issued new guidance on outdoor activities due to the raise of the highly transmissible Delta Variant. In the guideline, it stated that “transmission occurring in outside settings is less than 10%”, they got the 10% value from this paper ““Outdoor Transmission of SARS-CoV-2 and Other Respiratory Viruses: A Systematic Review.” However, the authors of the paper have clarified that the actual risk of outdoor transmission is far lower- likely less than 1%. So, what’s the science of ventilation and covid? If simply put, when we are outside or have good ventilation, there is more air to disperse the virus and reduce its concentration. But we must keep in mind that if we are face to face with someone, breathing in the breath that they are exhaling, you are at greater risk even outside. SO, this is Nadzry’s point regarding lepak mamak. That’s why playing sports or exercising outdoors is much less likely to result in the spread of infection compared to, say, a crowded outdoor concert. For indoor courts or gym, we can refer to the KKM ventilation guideline released in June this year (JKKP) and I would suggest to install HEPA filters. Recently our health minister, YB Khairy Jamaluddin mentioned about jointly developing some ventilation guidelines with MKN. This is really good news because good ventilation reduce COVID-19 transmission. The key is to make sure it’s ventilated, like berangin, to not let air be stagnant because covid is airborne and when the air is stagnant, the viral load can be concentrated. But once ventilated well, there is more air to disperse the virus and reduce its concentration, it become quite low risk.
Second point is vaccination. When sports facilities open, I think should only be open for fully vax only. Because Delta variant has been nicknamed pandemic of the unvaccinated. It’s quite aggressive to unvaccinated people. So to be safe, we open only for fully vax people. For safety of the people that is not vaccinated. Because if fully vax become positive, insyaallah, it’ll be mild and recovered. But for the non vax, it could be serious and hospitalisation. I don’t think its worth it.
Third point is testing. Although vaccination has shown it’s benefit but testing is still needed. Testing is key to avoid outbreak. Now, we have the saliva RTK testing right? I would suggest for the venue operator to implement testing in their SOPs. If the people that wants to play sports, although already vaccinated, to take a quick RTK saliva test. Recently, government reduced the price, and its easy to do. Can watch Youtube. I know it seems a bit of hassle, but better be safe than sorry. Testing should be part of a norm. Like even today, I did the RTKtest because my pregnant wife is coming from JB. So to be safe, just check. I think with this extra initiative, it will help. Also, should be common understanding, if you you have symptoms, you shouldn’t join. Especially during this time. So, that’s my suggestion to mitigate risk of transmission: ventilated, fully vax, RTK negative and asymptomatic.
Although ventilated, I’m sure what people are worried is regarding contact sports is the close distance between players. There was a study last year on 4 super league rugby matches, where 8 players were covid-19 positive. They tested the referees and 128 players involved in the 14 day period after a match. No referees were tested positive, although being in close contact. Out of the 128 players, only 5 were tested positive after the matches, but only 1 were heavily involved in the game- more tackles, spent more time on the pitch. And the research proposes it is more likely that the 5 players had contracted the virus from other social activities instead from the actual match itself. Other social activities like: sharing same car, social interactions in the club. Although the sample size is quite small but this shows that contact sports is quite low risk for transmission. If we watch the UEFA Euro 2020, there were cases where players tested positive but there were no outbreak as in the team of the players and staff infected, or the team that the player played against got infected also.
I would strongly discourage to bring kids to the sport facilities because of their vaccination. Although our vaccination rate is high, it’s still not enough to protect the unvaccinated, which includes the kids. Even though, Malaysia about to start vaccination on 12-17 years, below 12 is still not allowed. I wouldn’t take the risk, although open air.
Thank you to everyone that attend. With the opportunity sports able to play, we should take more responsibility.
By Dr. Azim who you can follow here Azim Nasaruddin, MD