American Academy of Pediatrics Encourages Children and Teens to Wear Cloth Face Coverings During Sports Practices and Games

In updated recommendations on youth sports during the COVID-19 pandemic, the American Academy of Pediatrics (AAP) encourages players of most sports to wear cloth face coverings at all times for group training, competition, and on the sidelines.

Cloth face coverings have been shown to decrease transmission rates of COVID-19, and the coverings have been found to be tolerated well by the majority of people who wear them for exercise. The broader cloth face covering encouragement is one of the changes in the update to the Academy’s interim guidance on sports, which was published Friday, Dec. 4. Previously, AAP recommended that face coverings be worn by athletes on the sidelines and during less vigorous activity.

“Research shows that we can significantly lower the risk of COVID-19 transmission with cloth masks that completely cover the nose and mouth and that are fitted on the sides with no gaps,” said Susannah Briskin, MD, FAAP, author of the guidance and a pediatric sports medicine specialist. “Proper and consistent use of a cloth face mask is especially important right now as so many athletes move indoors for sports during the colder months.  While regular exercise is important for our kids’ mental and physical well-being, we must do everything we can to minimize the risk of COVID-19 spread.”

Roughly 35 to 45 million children and teens ages 6 to 18 participate in some form of athletics. The COVID-19 pandemic has altered many aspects of the lives of children and families, including youth sports, with many programs canceled or altered as virus infection rates have increased nationwide this fall.

Indoor sports bear a greater risk of transmission of COVID-19, and certain sports, including ice hockey, carry higher relative risk, the AAP notes, and cloth face coverings are strongly encouraged for indoor sports. The risks and benefits of indoor sports, as well as community prevalence of COVID-19 should be carefully considered when making decisions about continuing or resuming indoor sports.

Because prolonged, close contact with  a person infected with SARS-CoV-2 is the main driver of transmission, the sport (number of players, spacing, and frequency and duration of contact) and setting (indoor versus outdoor, size and ventilation of facility) will likely influence risk of infection. It is possible for SARS-CoV-2 to be transmitted on surfaces, so sports with shared equipment, facilities, or common surfaces may pose additional risk.

In the guidance, AAP notes that face coverings should not be worn during competition in certain sports.  Cloth face coverings should not be worn for competitive cheerleading and gymnastics (while on the apparatus), because the covering may get caught on objects and become a choking hazard or impair vision.

Likewise, during wrestling contact, a cloth face covering could become a choking hazard and is discouraged. Swimmers and divers also should not wear face coverings while competing. Individual sports performed outside, such as golf and singles tennis, are at a lower risk for transmission of COVID-19, and so a cloth face covering may not be necessary for those sports, according to the AAP.

The AAP also recommends:

• Practice groups should be kept at small sizes that do not mix youth athletes to help limit team-wide outbreaks. Small pods allow for easier contact tracing and fewer numbers of athletes needing to be quarantined if someone tests positive.
• Young athletes with any signs or symptoms of COVID-19 should not attend practices or competition. They should consult their physician for testing guidance and notify their coach, athletic trainer, school administrator of their signs / symptoms.
• Individuals should always wear a cloth face covering between practice drills, on the sidelines, arriving at and departing from the playing facility, in a locker room, and during shared transportation to and from an event.
• It is important that the cloth face covering fits the athlete well and is worn over the nose and below the chin at all times when in use. When the cloth face covering is removed for a water break, the athlete should remain at least 6 feet away from other people. Masks that become soaked with sweat should be changed immediately.
• Cloth face coverings should be worn by coaches, officials, spectators, and volunteers at all times. Coaches and other club / school officials should monitor proper use and encourage all athletes to have a properly worn cloth face mask in place.

For parents, an article on HealthyChildren.org is available: Youth Sports Participation During COVID-19: A Safety Checklist

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds