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Sports medicine leaders working with government and public health to plan a ‘return-to-sport’ during the COVID-19 pandemic: the UK’s collaborative five-stage model for elite sport
  1. Simon Kemp1,2,
  2. Charlotte M Cowie3,
  3. Mark Gillett4,
  4. Richard Higgins5,
  5. Jerry Hill6,
  6. Zafar Iqbal7,
  7. Paul Jackson8,
  8. Rod Jaques8,
  9. Jo Larkin9,
  10. Gemma Phillips10,
  11. Nicholas Peirce11,12,
  12. James Calder13,14
  1. 1 Rugby Football Union, London, UK
  2. 2 Faculty of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, London, UK
  3. 3 Football Association, Burton upon Trent, UK
  4. 4 Premier League, London, UK
  5. 5 English Football League, London, UK
  6. 6 British Horseracing Authority Ltd, London, UK
  7. 7 Crystal Palace FC, London, UK
  8. 8 English Institute of Sport, London, UK
  9. 9 LTA, London, UK
  10. 10 Rugby Football League Ltd, Leeds, UK
  11. 11 Centre For Sports Medicine, Nottingham University Hospitals Trust, Nottingham, UK
  12. 12 England and Wales Cricket Board, Loughborough, UK
  13. 13 Fortius Clinic, London, UK
  14. 14 Imperial College of Science Technology and Medicine, London, UK
  1. Correspondence to Dr Simon Kemp, Rugby Football Union, London TW2 7BA, UK; simonkemp{at}

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The WHO declared COVID-19 a global pandemic on 11 March 2020.1 On 20 and 23 March 2020, faced with a rising number of both COVID-19 cases and deaths, the UK government imposed a range of measures in an attempt to control the pandemic in the UK. Although individuals were allowed to run and cycle outdoors, these instructions effectively put sport on hold, resulting in widespread training disruption to the elite athlete population.

Collaborating to form ‘one voice’

The chief medical officers of many of the major Olympic, Paralympic and Professional Sports in the UK formed a group to share thinking around how elite sport might best plan for a return at the appropriate time. While it was acknowledged that there were fundamental differences between the sports, including but not limited to current and future competition schedules, financial and personnel resources, potential risks of COVID-19 transmission between participants and their ability to align with any relaxation of population social distancing (SD), a collaborative approach to planning ‘how’ elite sport might restart was agreed to be the most effective manner to inform a single dialogue with government and Public Health England.

Central to this approach was the development of a five-stage model (figure 1) that set out the discrete stages that sport would need to progress through, to ultimately return to unrestricted competition, starting with stages with a lower risk of COVID-19 transmission. It was hoped that this model would help create a consistent taxonomy when …

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