Health Risk Communication from Orange County Department of Health – High-Risk Sports

I hope that this finds you and your family healthy and safe. At the Health Department, the protection of the public’s health is our fundamental goal. Governor Cuomo has announced that schools may allow high-risk sports and recreation activities as of February 1, 2021 if permitted by local health departments. This information is provided to you at this time in order for you to make an informed choice for your child regarding the participation in these activities as you know your child and their circumstances best.

The local impact of the COVID-19 global pandemic as of January 27, 2021 has resulted in 31,137 confirmed cases as well as 674 deaths in Orange County to date. Of those cases, 46% have been in individuals 18-44 years of age, with the second largest number of confirmed cases in the 45-64 age group (32%). The prevalence of COVID-19 in our region is higher than the statewide average. Our County 7- day percent positivity rolling average is 7.9 and we are experiencing 273.3 cases per day on average as of January 27, 2021. The CDC “Indicators and thresholds for risk of introduction and transmission of COVID-19 in schools” is outlined in the document found at
childcare/indicators-thresholds-table.pdf. In addition, we are finding that there are variant strains present in our state. Globally, we are seeing reports of a disproportionate impact of the SARS CoV-2 UK (B.1.1.7) variant in women and children. While Orange County is using every dose of vaccine given to us by the State, we are nowhere near achieving “herd immunity” with the current rate of vaccine allocation.

While children account for 2,165 cases or (6.9%) of the total cases, this virus is completely new and although some symptoms are common among those suffering from the illness, the complete list of symptoms, as well as long term complications remain unknown. In fact, some children seem to be at risk for developing more severe complications from COVID-19, such as multi-
system inflammatory syndrome in children (MIS-C), which is of great concern, especially for children who are medically fragile. For more information about MIS-C, please visit the following website: -life-coping/children/mis-
c.html. At present, it cannot be predicted who will become severely ill, although older people and those with underlying health conditions are at higher risk. The long-term effects of SARS-CoV-2 are not known; even people with mild cases may experience long-term complications. Of additional concern is that the American Academy of Pediatrics noted that in the two- week period from 12/31/20-1/14/21, there was an 18% increase in child COVID-19 cases.

Please understand that the State’s decision to permit higher-risk sports and recreation activities does not mean that health risk has been eliminated. In fact, as the recent study by the Journal of the American Medical Association found, while in-school transmission of COVID-19 was not found to be high, the resumption of in-person athletics increased risk, especially wrestling. This
study concluded that, “Even though high school athletics are highly valued by many students and parents, indoor practice or competition and school-related social gatherings with limited adherence to physical distancing and other mitigation strategies could jeopardize the safe operation of in-person education. While there are likely many factors, the pressure to continue
high school athletics during the pandemic might be driven at least in part by scholarship concerns; colleges and universities recruiting athletes for the 2021/2022 academic year should consider approaches that do not penalize students for interruptions to high school sports related to the pandemic to avoid incentivizing activities posing high risk for SARS-CoV-2 infection.”
Please see the study for more information: Additionally, this article cites a recent CDC report regarding an outbreak of COVID-19 that resulted from a wrestling tournament. For more information regarding the CDC investigation, please see

As you are aware, any time people are gathered, there is a risk of exposure to COVID-19, which can lead to serious medical conditions and even death. Symptomatic and asymptomatic individuals can spread the virus and indoor, close contact practices and tournaments increase this risk. In the Spring of 2020, we witnessed the resumption of college sports activities which
resulted in campus closings, conversion to remote learning, and increased community transmission. Masking, distancing, and other mitigation measures reduce, but do not eliminate risk. The American Academy of Pediatrics COVID-19 Interim Guidance: Return to Sports warns that masks cannot be worn for all activities and described medical clearance needed for student athletes who have contracted COVID-19 in the past. Please see:…ns/clinical-guidance/covid-19-interim-guidance-return-to-sports/ for more information regarding the recommendations. Additionally, there is a significant risk of transmission to those in the home of an infected student-athlete. The JAMA study also noted that, “Outbreaks among athletes participating in high contact sports can impact in-person learning for all students and increase risk for secondary in-school and community transmission with potentially severe outcomes, including death.” The CDC conducted a study entitled, “Implementation and Evolution of Mitigation Measures, Testing, and Contact Tracing in the National Football League, August 9–November 21, 2020”
which concluded that, “To date, the ability to define a close contact has been limited. [This study] confirmed that cumulative brief interactions exceeding 15 minutes in total could lead to transmission.” For more information, see

Parents should understand that other social interactions outside of an actual practice or competition including but not limited to interactions in locker rooms and buses are also potential places of transmission among student-athletes. Many counties have had experience with positive athletes presenting to sports tournaments which have resulted in athletes isolated and quarantined
as well as exposure to others.

Decisions made by parents and guardians today can help contribute to the safest possible in-person operation of schools. These are often not easy decisions and require a balancing of the public health best practices to limit the transmission of SARS-CoV-2 in the community and other societal factors. As we collectively learn more about this ongoing pandemic, new health information will be shared with you. With two vaccines now being distributed and more vaccine options anticipated for the near future, there is every reason to hope for a much safer environment for schools and school- related activities as time progresses. However, there are no SARS CoV-2 vaccines that have been authorized for use in individuals under 16 years of age, at this time.

Should you have any questions, please feel free to contact the Orange County Health Department at (845) 291-2330.

The Orange County Health Department takes the health and safety of our children very seriously, even more so during the worst public health crisis in a century. While infection rates are increasing daily, we need to proceed with caution and take every step possible in resuming in-person activities safely and responsibly.

Best regards,

Dr. Irina Gelman, Commissioner
Orange County Department of Health