Infectious diseases and football – lessons not only from COVID-19

Abstract

The past few weeks have seen us make numerous and increasing adjustments to our regular schedules as the Corona virus (COVID-19) outbreak turned from an epidemic to a pandemic. Virtually every aspect of daily life has been influenced by preventive measures, the most notable of which is social distancing, and sporting events have not been an exception. In the case of football, this ended in the postponement of the EURO 2020, one of the largest tournaments world-wide. However, this is not the first time that an outbreak occurs at an ‘inconvenient’ time for football. In 2007 and 2008 a measles outbreak was noticed in Switzerland shortly before the 2008 European Football Championship (Richard et al. 2008). A similar measles outbreak took place in 2009 in South Africa, before the start of the 2010 FIFA World Cup (Blumberg et al. 2010; Sartorius et al. 2013). In 2011, there was an endemic EHEC (enterohemorrhagic E. coli) outbreak in Germany before the start of the Women’s World Cup. The 2014 FIFA World Cup in Brazil posed the risk of vector-transmitted diseases. During the tournament, Dengue risk was close to its peak when matches were played in at least three cities: Fortaleza, Natal, and Salvador (Hay 2013). In this particular tournament, there were other mosquito-transmitted diseases, such as Zika and Yellow Fever, for which attendants and players had to take special precautions. None of these events was cancelled or postponed because preventive measures were able to either confine the outbreak or sufficiently reduce the risk of transmission. Moreover, every year sports events take place during the flu season. Although it may seem like previous experience with respiratory diseases should teach us how to cope with the current situation, there are very important differences in the case of COVID19: There is no vaccine available, the virus is very contagious and its letality is considerable. In both measles outbreaks, attendants, participants, and staff were strongly encouraged to vaccinate against measles beforehand, and such vaccination provides high safety against the disease. The same is true in the case of influenza although vaccination is a bit less effective. This, however, is clearly not a possibility at the moment and evidently necessitates different management. Given that social distancing has been identified as a key factor in the prevention of COVID-19 spread spread, matches were initially carried out without fans. However, the increasing number of COVID-19 cases forced sporting associations to postpone and even cancel competitions. The 2020 UEFA European Football Championship, UEFA Champions League, and major national leagues, to name only a few, have now been deferred and it is unclear when the pending matches will take place. Rescheduling events without clear dates foreshadows a period of financial uncertainty for football. The loss of income could soon even force clubs to shut down. However, the immediate priority for our society is to control the COVID19 pandemic. Therefore, clubs will have to abide regulations from health authorities and attempt to recover afterwards, which will probably involve tight schedules.