Not breathing easy over virus fears

LONDON • Research from Germany and Italy suggests that footballers and other athletes face a particular risk of the coronavirus infecting their lungs, raising major questions over attempts to restart professional football.

The research, produced by Italian immunologists and lung specialists based at institutes in Berlin, Rome and Verona, claimed that elite athletes are more likely to inhale virus particles and direct them to the lower areas of their lungs due to strenuous exercise.

Covid-19 can cause lung damage and complications such as pneumonia and, in severe cases, acute respiratory distress syndrome (Ards).

The pre-print paper, which has yet to be peer-reviewed, also suggests that athletes who are asymptomatic could make their condition worse by infecting their lungs during physical exertion.

Football has ground to a halt in all major leagues across Europe and none have yet to resume.

While Uefa has set a May 25 deadline for leagues to outline their plans to restart, clubs have said they will adhere to medical advice and return only when play is safe.

In their paper, The First, Comprehensive Immunological Model of Covid-19, Roberto Nisini, Paolo Matricardi and Roberto dal Negro have raised questions over the safety of playing while the virus remains.

"Professional athletes (are) particularly exposed due to their frequent practice of long-lasting and extreme exercise."

They also state the "ideal lungs" of athletes, while helpful in normal conditions, significantly favour the deep inhalation of infectious agents like the coronavirus.

"Covid-19 can then spread more easily to the deepest areas of the lungs during strenuous exercise, and there start its aggressive action.

"Not by chance, a great proportion of professional football players claimed the occurrence of fever, dry cough and malaise (and dyspnea in some cases) immediately after, or a few hours following their last official match."

There is also the danger of athletes exacerbating their condition, with the virus spreading from their upper to lower airways, according to the paper.

Asymptomatic but infected athletes might exhale or eliminate aerosolised particles that could contain Covid-19, which is then re-inhaled, causing further damage.

With social distancing impossible for team sports like football and marathon running, there is also an increased risk of Covid-19 being transmitted during play.

"In sports where many athletes are in close contact, the same particles have high chances to be inhaled by others, facilitating viral transmission," the paper added.

"To emphasise that, strenuous exercise induces a much more frequent spitting of secretions and this can further contribute to Covid-19 spreading, particularly if the distancing recommendations are not strictly followed."

A separate study from Aarhus University in Denmark looking at how much exposure players would have to a single infected player on the field, showed that, on average, a player is positioned within an "exposure zone" for 1min 28sec during a match.

The clear risks involved in returning to competitive action while Covid-19 continues to run rampant has led Dr Michel D'Hooghe, the head of Fifa's medical panel, to express his doubts over the possibility of football resuming by this summer as there are "consequences of life and death".

"My proposal is, if it is possible, avoid playing competitive football in the coming weeks," he told the BBC on Tuesday. "Try to be prepared for the start of good competition next season.

"I speak as a medical doctor, I don't have to speak as an organiser of matches, but for the moment, from my medical standpoint, I would be very sceptical."

FifPro, the global players' union for football, has also called for procedural safeguards before play can even be contemplated.

"We need guidance and protocols on how to return in a healthy and safe manner. Football is a contact sport and we feel very high protection standards are required," said its secretary-general Jonas Baer-Hoffmann.

The World Players Association, which represents some 85,000 athletes from different sports in over 60 countries, agreed, adding that competitors should not be rushed back to action.

Given the dangers involved, former Liverpool and Tottenham director of football Damien Comolli also believes players' insurance will be another stumbling block to any recommencement of play.

Policies could be declared null and void should clients contract a potentially career-threatening illness after playing again, despite being aware of the risks.

Highlighting how this would especially affect players whose deals expire this summer like Spurs' Jan Vertonghen, he told Sky Sports: "Assume the Premier League restarts and (a player) catches the virus and then dies or gets severe lung damage and can't play football any more, what's going to happen?"

AGENCE FRANCE-PRESSE, REUTERS