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Infectious Diseases Outbreak Management Tool for endurance mass participation sporting events: an international effort to counteract the COVID-19 spread in the endurance sport setting
  1. Paolo Emilio Adami1,2,
  2. John Cianca3,4,
  3. Brian McCloskey5,6,
  4. Wayne Derman7,8,9,
  5. Juergen Michael Steinacker10,11,
  6. Francis O'Connor3,12,
  7. Sergio Migliorini13,
  8. Richard Budgett14,
  9. Fumihiro Yamasawa1,3,15,
  10. Inggard Lereim16,17,
  11. Xavier Bigard18,19,
  12. Chris Troyanos3,
  13. Frederic Garrandes1,
  14. Stephane Bermon1,20
  1. 1 Health and Science, World Athletics, Monaco
  2. 2 Sport, Human and Health sciences, HUniversità degli Studi di Roma 'Foro Italico', Roma, Lazio, Italy
  3. 3 International Institute for Race Medicine, Plymouth, Massachusetts, USA
  4. 4 Human Performance Center, Houston, Texas, USA
  5. 5 Centre on Global Health Security, Chatham House, London, UK
  6. 6 Co-chair WHO Expert Group on COVID-19 and Mass Gatherings, World Health Organization, Geneva, Switzerland
  7. 7 Institute of Sports and Exercise Medicine, Stellenbosch University Faculty of Medicine and Health Sciences, Tygerberg, South Africa
  8. 8 International Olympic Committee Research Centre, Cape Town, South Africa
  9. 9 International Paralympic Committee, Bonn, Germany
  10. 10 Sport- und Rehabilitationsmedizin, Universitat Ulm, Ulm, Germany
  11. 11 Sports Medicine Commission, World Rowing Federation, Lausanne, Switzerland
  12. 12 Consortium for Health and Military Performance (CHAMP), Military and Emergency Medicine, Uniformed Services University, Bethesda, Maryland, USA
  13. 13 Medical Committee, International Triathlon Union, ITU, Lausanne, Switzerland
  14. 14 International Olympic Committee, Lausanne, Switzerland
  15. 15 Marubeni Health Promotion Center, Tokyo, Japan
  16. 16 Neuroscience Department, Norwegian University of Science and Technology, Trondheim, Norway
  17. 17 Medical Committee, International Ski Federation, Oberhofen/Thunersee, Switzerland
  18. 18 Val-de-Grace Medical School, Paris, France
  19. 19 Medical Department, International Cycling Union, Aigle, Switzerland
  20. 20 LAMHESS, Université Côte d'Azur, Nice, France
  1. Correspondence to Dr Paolo Emilio Adami, Health and Science, World Athletics, Monaco, Monaco, Monaco; paoloemilio.adami{at}

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The COVID-19 pandemic has caused considerable economic damage throughout the world in addition to a severe health crisis. Social distancing is the main preventative measure for person to person transmission of SARS CoV-2.1 This has essentially put a halt to all mass participation endurance sporting events, with road races, triathlons, cycling, Nordic skiing and rowing events being indefinitely postponed or cancelled. The benefits of endurance exercise have been widely demonstrated,2 therefore, the current halt has had significant health and social consequences worldwide. From a financial perspective, the economic impact on the endurance sport mass participation industry has also been catastrophic. Endurance events are estimated to generate over US$3 billion/year in the USA alone.3 Taking the example of road running, 17.6 million people registered for road running events in the USA in 2019.4 Endurance sports, thanks to the competition format, allow elite and amateur athletes to compete together, attracting large crowds of participants (e.g. Henley Royal Regatta, Vasaloppet, Gran Fondos, International Triathlon Union World Championship Grand Final). Therefore, the cessation of endurance events represents a huge societal loss.

At some point, the pandemic will give way to isolated clusters of cases with no widespread community transmission and people will be able to return to mass participation sporting …

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  • Twitter @paolo_emilio, @wderman

  • Contributors Authorship: PEA, JC, FG, CT and SB contributed to the conception or design of the work. JC and PEA drafted the manuscript. PEA, JC, BM, WD, JMS, FO, SM, RB, FY, IL, XB, FG, CT and SB critically revised the manuscript. All gave final approval and agree to be accountable for all aspects of work ensuring integrity and accuracy.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests WD reports grants from IOC Research Centers Grant, other from IPC Travel Support, grants from World Rugby, grants from AXA, grants from Ossur, outside the submitted work.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.