SARS-CoV2 Infection of Athletes in Brazilian Soccer Competitions: Lessons from Recent Events Worldwide and the Return of Fans to Stadiums

Abstract

Dear Editor, Soccer activities in Brazil are in the eminency of returning with the public. The fans' return was the choice of 18 of the 20 clubs in the first division, even though high transmission rates are described between the athletes. Additionally, preventive measures are still not being taken considerably, both in relation to the athletes and the fans at stadium entrances. Although vaccination rates have been advancing, most lowincome countries are still not with desirable vaccination rates for herd immunity. The absence of preventive measures and the returning of soccer activities are a concerning issue for returning. The paper by Ruiz-Lozano et al, highlights this finding, that both deaths and cases of deaths by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have considerably increased during the European Soccer Championship. 1 However, preventive measures alone may be quite interesting to avoid SARS-CoV-2 transmission, which justifies the public's non-return. Considering only athletes, the paper by Krug et al, 2 described that some preventive measures taken were able to reduce the spread of SARS-CoV-2 (ice hockey athletes), and resulted in zero cases of SARS-CoV-2 infection in the athletes, considering a total time bigger than 500 practices and games and at least 15. 858 athlete-hours. Krug et al, highlight that the transmission appears to be more likely in congested indoor areas involving adults than in the game space. 2 Therefore, we highlight the importance of a protocol that considers fewer opportunities for crowded indoor areas (e.g., not using changing rooms in stadiums, but using bathrooms in hotel rooms that delegations have concentrated; transport in vehicles for small groups or even just with a driver; food in an individual environment, such as in the hotel room) should be a rule to be accomplished by athletes and organizers of these events. We highlight that if the transmission control with a few dozen athletes is difficult to control, we should increase transmission rates considering thousands of fans in the ten stadiums that host games in the Brazilian championship. Additionally, Krug et al reported that during the 18 weeks of follow-up of the ice hockey tournament, high stringency preventive measures protocols reduced to zero cases of SARS-CoV2 transmission. This finding supports how the need of preventive measures to avoid transmission. 2 Especially in Brazil, this critical finding brought us to reflect regarding the need for strict preventive measures for sanitary safety of soccer championships that have gradually returned. In fact, a recent study revealed that the new infection rate of SARS-CoV2 in the state of São Paulo was 11.7% and 7.2% for athletes and staff, respectively, during soccer events, after the resuming of the championships. 3 Brazil has recently held one of the main Latin American soccer championships, the Conmebol American Coup 2021, competing in around 10 nations. Some of them had a high incidence of SARS-CoV2 infection. Previously, Argentina and Colombia h...