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Covid-19 and community mitigation strategies in a pandemic

BMJ 2020; 368 doi: (Published 17 March 2020) Cite this as: BMJ 2020;368:m1066

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Rapid Response:

Re: Covid-19 and community mitigation strategies in a pandemic

Dear Editor,

This is a welcomed contribution and I commend the authors, Ebrahim and colleagues [1] for producing this timely piece of work. The editorial highlights some important factors related to community mitigation strategies during the covid-19 pandemic. These include the cancellation and suspension of events with superspreader potential [2], social distancing measures to reduce contact between people and travel restrictions [3], amongst others.

One aspect discussed in the Editorial which is worthy of further consideration is mass gatherings in sport [4]. Indeed, the 2020 Olympic Games, overseen by the International Olympic Committee (I.O.C) are highlighted as one mega-sport event, yet to make a decision to cancel or postpone. Throughout March, 2020, there has been a steady stream of cancellations and postponements of international and national sporting mass gatherings. These include the Formula 1 Grand Prix in China, Major League Baseball in the USA and The Grand National horseracing event in England.

It is worth noting footballs approach to covid-19. On the 12th March 2020, the English Premier League, The Football Association (FA), English Football League, Barclays FA Women’s Super League and FA Women’s Championship collectively agreed to postpone the professional game in England until Friday 3 April at the earliest. On the 17th March 2020, UEFA postponed EURO 2020 by 12-months, its flagship national men’s team competition. At the times of these decisions, in England, the Government had yet to make too many decisions on the restrictions of events. Therefore, schools, universities and childcare facilities all remained open. Indeed, many events, included mass gatherings took place. For example, a major horseracing event, The Cheltenham Festival, took place between the 16th and 19th March, attracting in the region of 60,000 visitors per day. Therefore, football could be considered as showing leadership during the pandemic.

This comes to no-surprise, as there are many within football who have an understanding of the potential football has to offer to promoting health [5]. Certainly, football's global governing body, FIFA, have also contributed $10 million USD to the World Health Organizations (WHO) COVID-19 Solidarity Response Fund, alongside a football relief fund and showing further leadership through direct cooperation with WHO.

Taking stock, this editorial and analysis provides a welcome nudge to those working in and around sport and raises further questions for community and grassroots sport. However, given the superspreader potential of mass-gatherings, all eyes are firmly focused on I.O.C and their decisions surrounding the 2020 Olympic Games in Tokyo, a short-term decision that could have long-term consequences?

References –
1. Ebrahim S.H, Ahmed Q.A, Gozzer E, Schlagenhauf P, Memish, Z.A. Covid-19 and community mitigation strategies in a pandemic, BMJ 2020; 368: m1066.
2. Rashid H, Haworth E, Shafi S, Memish Z.A, Booy R. Pandemic influenza: mass gatherings and mass infection, Lancet Infectious Diseases, 2008; 8:526-7. doi:10.1016/S1473-3099(08)70186-5
3. Tian H, Li Y, Liu Y, Wu C-H, Chen B, Kraemer M.U.G, Li B, Cai J, Xu B, Yang Q, Wang B, Yang P, Cui Y, Song Y, Zheng P, Wang Q, Bjornstad O.N, Yang R, Grenfell B, Pybus O, Dye C. Early evaluation of Wuhan city travel restrictions in response to the 2019 novel corona virus outbreak. Medrxiv, 2020. doi:10.1101/2020.01.30.20019844
4. McCloskey B, Zumla A, Ippolito G, Blumberg L, Arbon P, Cicero A, Endericks T, Lim P.L, Borodina M. Mass gathering events and reducing further global spread of COVID-19: a political and public health dilemma, Lancet, 2020. doi:
5. Krustrup P, Parnell, D. Football as Medicine: Prescribing Football for Global Health Promotion, 1st Edition, Critical Research in Football Series, Routledge.

Competing interests: No competing interests

23 March 2020
Daniel Parnell
Senior Lecturer
University of Liverpool Management School, University of Liverpool