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Return to sport for North American professional sport leagues in the context of COVID-19
  1. John P DiFiori1,
  2. Gary Green2,
  3. Willem Meeuwisse3,
  4. Margot Putukian4,
  5. Gary S Solomon5,
  6. Allen Sills5
  1. 1 National Basketball Association, New York City, NY, USA
  2. 2 Major League Baseball, New York City, NY, USA
  3. 3 National Hockey League, New York City, NY, USA
  4. 4 Major League Soccer, New York City, NY, USA
  5. 5 National Football League, New York City, NY, USA
  1. Correspondence to Dr Gary S Solomon, National Football League, New York, NY 10154, USA; Gary.Solomon{at}


COVID-19 is a respiratory illness that can spread from person to person. A range of clinical scenarios exist, from an asymptomatic disease course to SARS and death. This document describes important considerations for 5 North American professional sports leagues (Major League Baseball, Major League Soccer, National Basketball Association, National Football League and National Hockey league) assessing when and how to resume phased operations, including practices and games. Sports should prioritise and promote the health and safety of athletes, team and operational staff, and other participants, and should not unduly increase those individuals’ relative health risk while contributing to economic recovery, providing entertainment for the public and leading a responsible restoration of civic life. Because elite professional sport ordinarily is conducted in a controlled environment, professional sports leagues may be able to achieve these goals. This document is focused on professional sports leagues in North America, and although many of the statements are generalisable to professional sporting settings throughout the world, other considerations may apply to sports in other countries.

  • health
  • sporting organisation

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  • Correction notice This article has been corrected since it published Online First. The competing interests statement has been corrected.

  • Contributors All authors contributed to the writing of this article.

  • 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 JPD, GG, WM, MP and GSS are paid consultants for their respective organisations. AS and WM are employees of the NFL and NHL, respectively.

  • Patient consent for publication Not required.

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

  • Author note This document on professional sports activities related to COVID-19 was prepared by chief medical officers of five North American professional sport leagues in response to an invitation from the White House on a conference call on 28 April 2020 to share draft documents for review and comment.