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Recommendations For drawing up a recovery plan for high-performance sporting activities COVID-19 01. Preamble The purpose of this contribution from CAF is not to encourage member associations and their professional clubs to resume their competitions at any cost, while one of the most devastating pandemics of our time continues to rage, to varying degrees, around the world and across our continent. It is our responsibility to plan for every eventuality and to consider the risk assessments and factors that must be in place for professional football eventually to resume safely. This can happen only when the health, social and economic benefits outweigh the risks associated with COVID-19, while maximising the safety of athletes, staff, supporters and society in general. CAF also takes the view that football activities are secondary to the well-being of those who wish to participate. The health of footballers, both mental and physical, across our continent and the world is paramount and should underpin the ethics of every decision concerning the reintroduction of football activities. The aim of this process is to define the main planning considerations for organisers of football events in the context of the novel coronavirus (COVID-19) outbreak. It must be read alongside organisational medical standards and international and national guidelines on public health and mass gatherings. 02. The COVID-19 pandemic It is widely acknowledged that the COVID-19 pandemic, caused by the SARS-CoV-2 virus, has placed considerable strain on health systems in every country worldwide. In the absence of preventive treatment (a vaccine) or curative treatment (definitively established), lockdown provides an opportunity to buy time and allow health authorities to build the resources and systems ideally needed to ‘Test–Trace–Treat’, the well-known three-part approach launched by Margaret Chan, Director-General of the WHO. This viral pandemic is difficult to track because it varies according to: Location, ethnicity, pattern of progression, clinical and symptomatic presentation, and mode of transmission: from airborne and contact transmission to other routes such as organic waste. Given the differences between African countries in the progression of COVID-19, each member association is responsible for decisions to stop, suspend or continue its domestic competitions. In all circumstances, it must obtain authorisation from the relevant national authorities. The present document provided by CAF is a guide. Responsibility for the consequences of any use made of its content therefore rests solely with the user. 03. Impact of the pandemic Suspension of football activities Suspended championships: Most domestic championships CAF interclub competitions (Total CAF Champions League and Total CAF Confederation Cup / Total Women’s Africa Cup of Nations qualifiers) Postponed competitions: The Tokyo 2020 Olympic Games The intercontinental Olympic qualifying play-off The European Football Championship (Euro) The Copa América has been postponed by one year FIFA World Cup qualifiers 03. State of the pandemic Suspension of football activities Cancelled events: Total African Nations Championship CHAN 2020 Psychological impact Lockdown and the interruption of competitions are difficult for those involved because they are not accustomed to long periods of inactivity and are concerned about the future of their careers. Clubs’ financial circumstances also remain dire. Some players have become unemployed because their clubs terminated their contracts. Others have had their salaries reduced. 04. The national resumption plan will depend on the circumstances of each member association The living and working conditions of those involved in football It is clear that federations must first ensure that players’ pay circumstances are conducive to any resumption of training and competition. Psychological support must also be offered to teams and players. Match scheduling (frequency) It is advisable to plan the first two weeks at a rate of one match every seven days. Only thereafter may a rate of two matches every seven days be considered. 05. Health rules Measures taken to combat COVID-19: Social distancing measures: Isolation, lockdown, quarantine, testing Protective measures: Wash your hands with soap and water Cough or sneeze into your elbow or a tissue Maintain a social distance of 2m (6ft) Stay at home Use a disposable tissue Greet without shaking hands; avoid embracing Wear a mask Wear gloves when necessary 05. Health rules Team preparation: Instil a new discipline of behaviour: healthy living Targeted / partial lockdown Mutual protection: distancing, wearing masks and gloves Hand and body hygiene Think ‘Corona’ in every situation 06. Medical assessment and monitoring RECOVERY RESOURCES An enhanced comprehensive medical assessment before resumption, based on fitness and recovery assessments. PCMA + Schedule biological assessments (IGE, mineral, haematological and vitamin tests) to detect risks Adapt nutrition carefully to the level of sporting activity and biological assessments Schedule recovery sessions to prevent injuries and maintain an appropriate level of physical fitness according to the activity: preparation, competition and resumption 07. Considerations relating to players’ fitness The effect of a period of detraining combined with isolation has received little study in the past. Account must be taken of the fitness of footballers returning to normal training and the measures to be taken to prevent the anticipated increase in injury risk. Attention should be paid to the following factors: Whether or not the player has contracted COVID-19 and, if infected, whether there are any lasting effects. The length of the period of detraining and confinement. The level of physical activity the player maintained during the training period. Consequently, in accordance with the points above, it is extremely important that: When sporting activity resumes, a battery of tests is carried out to allow an objective assessment of the player’s physical condition. There is an appropriate pre-competition period with a training programme comprising both aerobic training and muscle-conditioning activities. 08. Resumption of training After 12 days of complete inactivity, it is necessary to: Start from scratch; regain your physical capabilities. PHASE 1 The first few days will be devoted to medical tests (‘3 to 4 days’) and athletic testing. PHASE 2 Players could then resume individual training for seven days before training in small groups for a week. PHASE 3 The return to full-team training would follow. 09. Organisation of training and matches The arrangements for resuming training and matches will not be easy to manage from a health-safety perspective. African federations, their professional leagues and their clubs face a major challenge, made all the greater because health safety is non-negotiable. Basic standards and procedures, which are absolutely necessary and unavoidable, must be put in place. Africa’s elite clubs must have genuinely organised medical departments. The COVID-19 pandemic will demonstrate this need. Adequate, simple but precise procedures must be established and strictly observed. Standards may emerge, even basic ones within the reach of African clubs, which could become regulations that must be drafted and legally adopted. Those involved in the game must be protected and insured, and thus reassured. The responsibilities of associations, leagues and clubs must be acknowledged and assumed in advance. 10. How training should proceed WEEK 1 Sessions in pairs, with a physiotherapist, a doctor and two coaches present. ‘It was mainly running, 30 x 30 interval work and endurance.’ At the outset, this can be done while keeping players 1m apart (marked out with cones). WEEK 2 Groups of six or seven, on the pitch every other day. On the alternate day, indoor work involving core stability, cycling and resistance training. On the pitch, contact is prohibited; there are no games and no opposition. Exercises are based on passing circuits or running with the ball. WEEK 3 Gradual resumption of group training, in groups of ‘a maximum of 14 players’. WEEK 4 Groups of 18 to 22 players. 10. How training should proceed Players will initially receive their exercises: by video or by email They must then arrive at the training centre: in kit wearing gloves and a mask to avoid having to use the changing rooms. They will be able to keep their protective equipment on during training. x6 No more than six players may be on the pitch at the same time. After this initial phase of resumption, teams should gradually lift the protective measures to return to normal full-team training conditions. 11. Training content Careful thought is needed to provide suitable exercises despite the safety distances. This will allow players to get a feel for the ball again, shoot at goal and recover their sensations. Then, from groups of six players onwards: introduce tactical elements and work on more situations in detail. These are things that cannot be done with a large group. Defensive positioning, finishing, crosses and positioning in the penalty area, in particular, should be introduced last and gradually. 12. Methodological advice 9 VS. 9 Minimum: 45m x 60m Maximum: 50m x 67m 7 VS. 7 Minimum: 30m x 45m Maximum: 35m x 50m 5 VS. 5 Minimum: 20m x 30m Maximum: 25m x 35m 4 VS. 4 Minimum: 12m x 20m Maximum: 15m x 25m 13. Preparing the programme Appoint/recruit, within each federation and each professional club, a person (Mr or Ms Corona) responsible for coordinating all pandemic-related actions. Ideally, this should be someone who loves football, has sound medical and technical knowledge and can use modern communication tools. Review national and international health regulations relating to COVID-19 and keep constantly informed of the local situation and development of the pandemic. Monitor government measures on the subject. Upgrade the medical structures of the federation and professional clubs if necessary: human and structural resources. Financial resources: as COVID-19 represents a new category of expenditure, this new activity must be budgeted for and the necessary funds requested and secured. 13. Preparing the programme Organise a training programme on COVID-19, particularly for medical structures and those involved in the game: players, technical staff, referees, and managers of academies, training sites and competition venues (remote conferences). If sporting events return, compliance with WHO guidelines and close liaison with local/national authorities and public health authorities are necessary. It will be useful to: Minimise the risk of transmission. Endeavour to ensure testing is available without diverting it from the health systems that need it most. Be able to contact the players being monitored accurately. 14. Beforehand Designate and organise the teams’, referees’ and officials’ (permanent) accommodation. Designate and organise training and competition sites: Define arrangements for closed-door events Establish restricted-access zones Establish a safe circulation plan Organise transport systems for everyone involved in the game Disinfect all enclosed sites Disinfect all technical equipment, including kit and balls, including after training sessions and matches Maintain and strengthen the usual medical arrangements during training and matches 15. Organisational principles Temperature checks for everyone entering the stadium: Ideally, depending on resources, install an infrared temperature-screening entrance at the stadium or training site (as at hospital entrances), preventing anyone suspected of infection from entering. Install sanitiser dispensers or handwashing facilities (better than wearing gloves) Wear masks in all circulation areas of the site 16. Organisation of testing Closely monitor participants for any flu-like symptoms and refer them immediately to medical staff if respiratory illness is noted. Implement the recommended protective measures, including daily health checks (ranging from monitoring signs/symptoms/temperature checks to specific COVID-19 tests). Specific respiratory, cardiac and musculoskeletal tests as advised by healthcare professionals, depending on: Availability, exposure to COVID-19 Access to finance The level of competition 16. Organisation of testing Testing of football participants will depend on the availability and reliability/validity of test kits. A proposed COVID-19 screening procedure: all players, referees and managers returning to football must be tested for COVID-19 to safeguard and strengthen psychological confidence within the team and its environment. The first test is to be carried out 72 hours before football activities resume to prevent false negatives (asymptomatic carriers of the virus). The second test is to be carried out before the first session begins. Football participants must be tested at their club’s designated sites by team doctors in accordance with hygiene guidelines. Participants who test positive must follow the recommendations of the health authorities of the country concerned. Football participants who test negative will be authorised to participate in football activities. 17. Travel precautions and facilities (INCLUDING HOTEL STAYS) IT WILL BE NECESSARY TO: Disinfect means of transport for matches/training. Disinfect accommodation and food-preparation facilities. Implement and maintain ‘social distancing’ measures. Consider wearing masks and gloves during travel. Recommendations A health protocol must be introduced for the resumption of football-related activities, both training and matches. This health protocol must take account of the following measures: Ensure the availability of hand sanitiser and hygiene equipment at all sites Ensure medical staff check competitors’ temperatures Ensure capacity to isolate suspected cases Ensure healthy living at all sites Test everyone involved for COVID-19 48 to 72 hours before a match and immediately after the match Recommend disposable towels Provide essential equipment and personnel at all sites Quarantine travelling teams Medical masks must be made available to medical staff and participants Recommendations Give prevention kits to athletes Matches behind closed doors No children to accompany players Team staff, volunteers, etc. must ensure they have received information on COVID-19 Observe physical distancing in changing rooms No handshakes or embraces to celebrate goals All participants must be informed and cooperate with medical staff in taking their own competitors’ temperatures The two teams must enter the pitch separately Disinfect balls several times Recommendations Bring all teams together in one city (in the same place) until the end of the championship Each team must comprise 23 players and 10 technical and medical staff All match officials working in stadiums during the match must be tested (ball attendants) No exchanging shirts Use five substitutes Drinks breaks at 30 and 75 minutes Discourage spitting on the pitch Provide federations with the resources needed to guarantee testing Substitutes and coaches must wear masks on the bench… No press conferences, except flash interviews with players Interviews must observe a distance of 2m Recommendations Bring all teams together in one city (in the same place) until the end of the championship Each team must comprise 23 players and 10 technical and medical staff All match officials working in stadiums during the match must be tested (ball attendants) No exchanging shirts Use five substitutes Drinks breaks at 30 and 75 minutes Discourage spitting on the pitch Provide federations with the resources needed to guarantee testing Substitutes and coaches must wear masks on the bench… No press conferences, except flash interviews with players Interviews must observe a distance of 2m Contributors CAF Development Division CAF Medical Committee CAF Technical and Development Committee CAF Elite Instructors CAF GUIDELINES for the resumption of football in Africa Confederation of African Football 3 Abdel Khalek Tharwat Street, El Hay El Motamayez, P.O. Box 23, 6th October City, Egypt Tel.: +202 38247272 / Fax: +202 38247274 info@cafonline.com, CAFdevelopment@cafonline.com