January 27, 2021
Health Risk Communication
I hope that this finds you and your family healthy and safe. At the Sullivan County Public 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 3,994 confirmed positive cases as well as 62 deaths to date, of which eight new deaths have occurred since Jan. 1, 2021. Of those cases, 6.9 percent of positive cases (281) have been in individuals under 15 years of age, with 11.3 percent of cases (464) in the 16-24 yr old age group.
The prevalence of COVID-19 in our region is higher than the statewide average. The County 7-day percent positivity rolling average for the Mid-Hudson Region is 6.3 percent, and for Sullivan County is 5.5 percent. We are experiencing an average of 20-30 cases per day over the past few weeks.
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 Sullivan 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 a very small percentage 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.
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 percent 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 that 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.”
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.
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.”
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 to continue the safe in-person operation of schools which provide critical services to the children of our County. 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.
Should you have any questions, please feel free to contact Sullivan County Public Health Services at (845) 292-5910, ext. 2179.
The Department of Public Health 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 services safely and responsibly.
Nancy McGraw, MPH, MBA, LCSW
Public Health Director Sullivan County