It is exciting to see trail races returning to our area after so many cancellations due to the COVID pandemic. Over the past few months, race directors and medical directors are working with public health officials to figure out ways to bring racing back without creating superspreader events. While numbers are looking good in Nevada and California, COVID is spiraling out of control in my home state of Michigan. Over the next 12-18 months, you will likely see various strategies to bring racing back. At this point, we don’t know what is going to work best, but as everything COVID-related, look for a lot of research and data about this over the next few months.
Over the past year, we have learned incredible amounts about how COVID is spread. In general, we do know that outdoor spread is incredibly rare. As an example, a study out of the UK looked at people playing rugby. While eight of the players were COVID positive, the study couldn’t demonstrate any in-match transmission. There was, however, transmission from car sharing, social interactions, and other community exposures. So with most outdoor sports, the current thinking is that while the events are low risk, the most significant considerations about contributing to spread are travel to the event and start line/finish line activities.
The basic tools to prevent COVID spread in sport haven’t changed. They include physical distancing, masks, symptom screening, testing, contact tracing, vaccination, and the “bubble” concept. While the bubbles used in professional and college sports have worked well, they aren’t practical for trail running events. The most significant changes in the past few months have been more availability of testing and vaccines.
Testing, oddly, is one of the more complex issues and is also one where there is a lot of debate within the medical community. While the availability of quick rapid tests is much better, the accuracy of these tests has been primarily studied in people with COVID symptoms. When they are used to screen asymptomatic people, some experts worry about their accuracy. Newer technologies, however, may have accuracy closer to that of the gold standard PCR testing.
The biggest thing that is going to get COVID under control is vaccinations. There are now three FDA EUA (emergency use authorization) approved vaccines on the market, and the FDA might approve two more vaccines in the next 1-2 months. Because the vaccines aren’t still under emergency authorization, most organizations have not made them mandatory. That could change in April or May, when Pfizer and Modera may apply for full approval. While it is unlikely that the state or federal governments will mandate vaccines, it is highly likely that employers or other groups may require vaccines. We know that vaccines are already working to decrease hospitalizations, deaths, and the severity of COVID cases. From a mass participation standpoint, one big question is how well the vaccines reduce the spread of cases. While we are starting to see some evidence showing that the vaccines reduce transmission, we’re still not 100% sure. I’m hoping that we see more data on this as this will affect CDC recommendations on what you can do once you are vaccinated. We already know that once you are vaccinated, you can now get together with other people who are vaccinated in small groups without social distancing and masks. Hopefully we see the size of those groups getting bigger and bigger over the next couple of months.
So how does this all relate to trail races? Again, the goal is how do we get back to bigger and bigger events without contributing to COVID rates doing up? Testing and vaccination are going to be key, but races should also conduct follow up evaluations with their runners and volunteers to see if what they’ve done has worked.