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Researcher sees bubble as the only alternative to football in São Paulo

Publicado em 01 abril 2021

O football in São Paulo he has been paralyzed for two weeks because of the increase in cases and hospitalizations due to the new coronavirus (covid-19). The ban on sporting events was determined by the government of São Paulo after recommendation by the State Public Ministry. Researcher Bruno Gualano, a professor at the Faculty of Medicine of the University of São Paulo (FMUSP), however, understands that the resumption could only occur in the form of a sanitary bubble, where those involved (players, coaching staff, etc.) are totally isolated.

“In a scenario like ours, where community transmission [ da covid-19 ] remains increasingly uncontrolled, the only way you can segment any type of sector, not just sport, is to isolate it from the community. Either isolate, or stop, ”he said in an interview with Agency Brazil.

Gualano is part of the coalition Sport Covid-19, which brings together researchers from institutions such as the hospitals of the Clinics of FMUSP, Albert Einstein and do Coração, the Federal University of São Paulo (Unifesp), the Complexo Hospitalar de Niterói (RJ), the Instituto Dante Pazzanese de Cardiologia and the Center for High Sports Performance of São Paulo (NAR-SP), with support from the FPF itself. The teacher coordinated a study, released by the São Paulo State Research Support Foundation (FAPESP), based on tests carried out on 4,269 athletes who competed in the São Paulo competitions in 2020 (male and female, professional and grassroots) and 2,231 members of teams from support.

The analysis noted that the incidence of infection with the new coronavirus was 11.7% (501) among athletes and 7% (161) among staff members. The last group, which brings together managers and members of the technical committee, where age is higher and health conditions vary widely, is the one that registered the most serious cases. Among them, a death.

According to Gualano, the percentage is equivalent to the incidence in frontline health professionals in the pandemic. In note, the FPF Medical Committee maintained that the comparison “is scientifically incorrect, as surely frequent testing in all athletes has enabled a greater number of diagnoses, mainly because they are asymptomatic” and that football “performs more tests” than most segments of society.

“The comparison we made is based on science,” says Gualano. “The frontline health professionals were tested by serology, so there is no need to talk about any cases not detected by the PCR exam that takes place in football. PCR is not the most sensitive instrument to detect exposures to the disease, since it is sensitive to a short period of time, three to ten days. Serological surveys are more informative in this regard ”, he adds.

The researcher understands that the performance of more than 30,000 tests (precisely 31,632, according to the FPF, between July 1 and December 31, 2020) shows that the application of the protocol in the sports environment has been fulfilled. The problem, according to him, is outside the football environment.

“The positivity [ considerando o total de testes realizados ] was low, which means that it was properly tested, this is important. The overriding factor for the high number of infections is the lack of control of community transmission. The players followed the protocol in the sporting environment. Outside of it, there was no control whatsoever. We did not know where these players would meet at night, where they would go out to dinner, how many people lived together, if they cleaned themselves, if the distance was fulfilled. The protocol didn’t go that far, ”argues Gualano.

The survey also compared the incidence of covid-19 in São Paulo soccer athletes with other countries, and found that the percentage surpassed leagues such as Qatar (4%) and the Bundesliga, first division of the German Championship (0.6%). The note from the FPF Medical Committee understands that, “from a scientific point of view”, such a correlation would be unfeasible, “after all, there are huge differences between countries / leagues”, such as the characteristics of protocols, the period of analysis, the social characteristics and the stage of the pandemic.

“When we do a study like ours, on the incidence of infection in a restricted population, the objective is to compare it with other scenarios, to know at what stage we are in epidemic control. What we compared, basically, was the opening of football with other countries, which had scientifically published data. Of course, there are peculiarities in the epidemic scenario of the various countries, more referring to community transmission and less regarding protocols. Precisely by comparison with other scenarios, we are able to reach the conclusion that the opening of sport in an unmitigated environment, with high community transmission, requires stricter transmission control measures ”, concludes the FMUSP professor.

Football games are banned in São Paulo until at least April 12, the day after the end of the Emergency Phase, the most restrictive of the São Paulo Plan, to fight covid-19. The FPF met, at the beginning of the week, with the Public Prosecutor’s Office to present a new protocol, more demanding, to try to make the resumption of competition possible before the 11th. Among the measures, are the adoption of bubbles for concentration of athletes and technical commissions, with testing in the 24 hours before entering the isolation, PCR exams before and after each game and removal of the athlete and tracking contacts in case of positive results. The organization has stated that the state A1 (first division) Series will be completed on the scheduled date, on May 23.

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