Leander ISD COVID-19 Return to Play Protocol

1. Any athlete exhibiting signs & symptoms of COVID-19 will be removed from activity and isolated from other student/staff.

Signs & Symptoms of COVID-19

• Feeling feverish or a measured temperature greater than or equal to 100.0 degrees Fahrenheit Loss of taste or smell

• Cough

• Difficulty breathing

• Shortness of breath

• Fatigue

• Headache

• Chills

• Sore throat

• Congestion or runny nose

• Shaking or exaggerated shivering

• Significant muscle pain or ache

• Diarrhea

• Nausea or vomiting

• Known close contact with a person who is lab confirmed to have COVID-19

2. The appropriate school staff will be notified:

   • Staff Athletic Trainer (High School Campus)

   • School Nurse

   • Campus Athletic Coordinator

   • Campus Principal

Campus Principal/Athletic Coordinator will contact the following:

2. • Executive Director of Campus Support

   • Director of Risk Management

   • District Nurse

3. Parents will be encouraged to seek out examination and possible testing for COVID-19 infection by the physician of their choice.

   • The athlete will take the Leander ISD COVID-19 Release Form to the Dr. appointment

   • Leander ISD COVID-19 Release Form

4. If Parents elect to have a physician exam and testing is warranted then a copy of the COVID -19 testing results must be turned into the appropriate campus staff member

   • High School - School Nurse/Athletic Trainer

   • Middle School - School Nurse

1. In the case of an individual who was diagnosed with COVID-19, the individual may return to athletics school protocols have been met and when all three of the following criteria are met for athletics:

   • A copy of the lab confirmed COVID-19 positive result

   • Written documentation with clearance by a physician of the families choice

1. • Leander ISD COVID-19 Release Form

• • • At least ten days have passed since symptoms first appeared. (CDC Guidelines - CDC Isolation & Precautions Article

      • the individual has improvement in symptoms (e.g., cough, shortness of breath)

    • At least 24 hours have passed since recovery (resolution of fever without the use of fever-reducing medications);

2. In the case of an individual who has symptoms that could be COVID-19 and who is not initially evaluated by a medical professional or tested for COVID-19, such individual is assumed to have COVID-19, and the individual may not return to the campus until the individual has completed the same three-step set of criteria listed above.

3. In the case of an individual who has COVID-19 like symptoms but is not lab confirmed positive they must have written documentation with the date of return (required) and optional alternate diagnosis from the physician of the parents choice on the Leander ISD COVID-19 release form.

   • Leander ISD COVID-19 Release Form

4. Additionally, an athlete must report to the school if they have had close contact with an individual who is lab-confirmed with COVID-19, as defined at the end of this document, and, if so, must remain off campus and away from areas where UIL activities are being conducted until the 14-day incubation period has passed. The 14-day icubation period begins when the last day of exposure when fever was present. If no fever was present with the lab confirmed COVID-19 infection then the 14-day incubation period starts on the day of the positive lab test.

Persons are deemed contagious 2 two days before symptoms present or lab confirmation.

Athletes returning to activity may have varied Return to Play depending on the severity of COVID-19 symptoms and recommendations of the treating physician of the families choice.

Based on recommendations by the American College of Cardiology (ACC) return to play after COVID-19 infection in pediatric patients varies depending on severity (See Step 2 for classification). ACC Article. The physician of the families choice may use these guidelines as model for return to play.

1. Mild Infection

   • Following 10 Day isolation with last 24 hours asymptomatic can return to play per physician clearance (See Step 3 - Steps for Return to Activity)

2. Moderate Infection

   • Recommended an ECG per treating physician guidance for athletes over the age of 12 in high intensity competitive sports participation or physical activity.

     1. If Normal ECG then cleared for participation following the criteria above (Step 3)

     2. If Abnormal ECG then recommend referral to cardiologist/pediatric cardiologist for further evaluation per treating physician recommendation

3. Severe Infection

   • Follow myocarditis return to play guidelines per treating physician recommendation

     1. Testing - ECG, echocardiogram, 24 hour Holter monitor, exercise stress test +/- cardiac MRI

     2. Exercise restriction for 3-6 months

The treating phyisian may also recommend for mild or moderate a Graduated Return to Play exercise program. An example below of a graduated exercise program.

Graduated Return to Play for Performance