Health commissioner: COVID linked to youth sports likely higher than the raw numbers

Jan Malcolm and Gov. Tim Walz explained the reasoning behind the decision to shut down youth sports.
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News that youth sports will be put on a four-week "pause" due to rising COVID-19 rates has been met with disappointment – and in some cases opposition – since it was announced by Gov. Tim Walz Wednesday.

Organized sports for both youths and adults are among the things affected by the four-week shutdown, with the latest Minnesota Department of Health figures showing that there have been 192 outbreaks of COVID-19 linked to youth sports, comprising 11.1% of the known outbreaks statewide. 

But the inclusion of youth sports in the executive order sparked questions from the media and those involved in it, given that state data shows those outbreaks have led to 780 cases of COVID-19 out of almost 250,000 cases statewide.

When that was put to Walz and Health Commissioner Jan Malcolm, they explained that those 780 cases refer to "primary" infections, where an infection can be attributed to a specific setting.

What it doesn't take into account are the "second and third-effect infections" that occur when someone – for example in youth sports – gives the virus to somebody else, which can happen unknowingly if the student is asymptomatic.

By the time it reaches the fourth-generation of transmission, Walz noted, the multiplication of cases has the potential to be as high as 70 from that single case given the exponential spread of the virus in Minnesota right now, meaning there's the potential for cases liked to youth sports to be responsible for thousands, or even tens of thousands of COVID-19 cases moving forward.

The problem for state health officials is that it's becoming increasingly difficult to track where everyone is getting the virus due to the uncontrolled spread of "community transmission" – where a person's diagnosis can't be attributed to a single source of infection.

As a result, Malcolm said that the numbers MDH has put out regarding youth sports as well as from other settings including bars and restaurants, and weddings, are likely a "very significant undercount."

"That is the problem with just focusing on the numbers," Malcolm said. "The primary cases we can attribute with some certainty to a specific setting. When we count something associated with an outbreak there's a certain threshold, we don't even start counting until there's a certain number of cases form different households associated with these different settings.

"These numbers to begin with are a very significant undercount. It's not just the primary case, it's who it's spread to, and who they spread it to."

Noting that somewhat lost over the course of the past few months is how pandemics work, saying: "One person spreads it to three, they spread it to three, and you then get to 70 by the fourth level of transmission."

Walz added that with the restrictions he announced Wednesday, which go into effect Friday, the main aim was the "predictability of the activity that is leading to some of those cases," as well as the "the amount of exposure, the nearness, the unmasked and the time you're unmasked."

Outbreaks linked to youth sports have been steadily rising over the past five months, MDH figures show, and make up all-but-one of the known COVID-19 outbreaks reported so far in November.

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Earlier this week, MDH's Kris Ehresmann, director of infectious disease, said there have been 46 COVID-19 outbreaks linked to hockey, 41 with volleyball, 35 with football, 20 with basketball and 15 with soccer, though these numbers may have risen since.

"We know that overall, at least 10% of all the cases in school are associated with sports," said Ehresmann, adding that two unidentified schools were forced to move to distance learning "just because of sports exposures."

One of the other questions asked of Walz was why should high school sports shut down but the Gophers and Vikings can continue to play, with the governor acknowledging that there's a "great inequity here, and like so many things it comes with money."

"They're testing every single person, we're not testing every single high school athlete, we're not keeping them in a pod close together, we're not keeping the coaches all working together and testing 2-3 times a day, The ability to control this and the mitigation efforts they put in place is vastly different," he said.

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