The collective effort and sacrifice of San Francisco residents staying at home limited the spread of COVID-19. But community transmission of COVID-19 within San Francisco continues, including transmission by individuals who are infected and contagious but have no symptoms. Infected persons are contagious 48 hours before developing symptoms (“pre-symptomatic”), and many are contagious without ever developing symptoms (“asymptomatic”). Pre-symptomatic and asymptomatic people are likely unaware that they have COVID-19. Sports, dance, and cardio/aerobic exercise are at higher risk for COVID-19 transmission and have been linked to numerous outbreaks. In other parts of the U.S., youth sports have been a significant source of COVID-19 spread among youth. The risks are generally much higher indoors than outdoors for these activities. But these activities are at higher risk for COVID-19 in any environment because people breathe much more air when exercising, and have close contact in many sports. During exercise, a person with COVID-19 breathes many more infectious droplets into the air. The infectious droplets in their breath travel further because they are breathing harder. People are also more likely to be infected during exercise because they are breathing more air. The availability of organized youth sports activities hosted by a school program, childcare program, or out-of-school time program, is an important step in the resumption of activities. But the decision by the Health Officer to allow organized youth sports activities that follow required safety rules does not mean that attending and participating in organized youth sports activities is free of risk. Enrolling a child in organized youth sports could increase the risk of the child becoming infected with COVID-19. Moderate contact and high-contact sports, which can require frequent, close contact between participants, increase the risk of COVID-19 transmission. While the majority of children that become infected do well, there is still much more to learn about coronavirus in children, including about the risks of Multisystem Inflammatory Syndrome in Children (MIS-C) and COVID19 associated myocarditis, which can result in sudden death during exercise. Each parent or guardian must determine for themselves if they are willing to take the risk of enrolling their child in organized youth sports, including whether they need to take additional precautions to protect the health of their child and others in the household. They should carefully review the SFDPH COVID-19 youth safety guidance at
http://www.sfcdcp.org/CovidSchoolsChildcare. They should particularly consider the risks to household members who have a higher risk of severe COVID-19 illness, including older adults and other people with chronic conditions or compromised immune systems. Parents and guardians may want to City and County Department of Public Health San Francisco Health Officer Directive 7 discuss these risks and their concerns with their pediatrician or other health care provider. More information about COVID-19 and MIS-C is available on the Centers for Disease Control and Prevention website at
https://www.cdc.gov/coronavirus/2019- ncov/. See
sfcdcp.org/covid19hcp for a list of groups at higher risk for severe COVID-19.I understand the risks associated with enrolling my child in organized youth sports with SFBA Sports Performance and agree to assume the risks to my child and my household. I also agree to follow all safety requirements that SFBA Sports Performance imposes as a condition of enrolling my child.