SARS-CoV-2 transmission during team-sport: Do players develop COVID-19 after participating in rugby league matches with SARS-CoV-2 positive players?

Objectives Evaluate the interactions between SARS-CoV-2 positive players and other players during rugby league matches, to determine the risk of in-game SARS-CoV-2 transmission. Design Observational. Setting Super League rugby league during four matches in which SARS-CoV-2 positive players were retrospectively found to have participated (2nd August and 4th October 2020). Participants 136 male elite rugby league players: eight SARS-CoV-2 positive participants, 28 identified close contacts and 100 other players who participated in any of the four matches. Main Outcome measures Close contacts were defined by analysis of video footage for player interactions and microtechnology (GPS) data for proximity analysis. Close contacts and other players involved in the matches becoming positive for SARS-CoV-2 by RT-PCR within 14 days of the match were reported. Results The eight SARS-CoV-2 positive players were involved in up to 14 tackles with other individual players. SARS-CoV-2 positive players were within a 2 m proximity of other players for up to 316 secs, from 60 interactions. One identified contact returned a positive SARS-CoV-2 result within 14 days of the match (subsequently linked to an outbreak within their club environment, rather than in-match transmission), whereas the other 27 identified contacts returned negative SARS-CoV-2 follow up tests and no one developed COVID-19 symptoms. Ninety-five players returned negative and five players returned positive SARS-CoV-2 RT-PCR routine tests within 14 days of the match. Sources of transmission in the five cases were linked to internal club COVID-19 outbreaks and wider-community transmission. Conclusion Despite a high number of tackle involvements and close proximity interactions between SARS-CoV-2 positive players and players on the same and opposition teams during a rugby league match, these data suggest that in-game SARS-CoV-2 transmission is limited during these types of team sport activities played outdoors.