Dr. George Chiampas: Returning to play safely in a pandemic requires a collective effort

Dr. George Chiampas, U.S. Soccer’s Chief Medical Officer, serves on the FIFA Medical Committee and is Chairman of the Concacaf Medical Committee. In February, COVID-19 became the focus of his work in all three capacities, the products of which include U.S. Soccer’s detailed PLAY ON recommendations and best practices for return-to-play. PLAY ON includes precise guides for return-to-play phases, for when and if local authorities deem it safe.

SOCCER AMERICA: You’re also still doing emergency room shifts at Chicago's Northwestern Memorial Hospital?

GEORGE CHIAMPAS: I am. I worked a night shift on Monday night.

SA: How has COVID-19 affected your work in the ER?

GEORGE CHIAMPAS: Obviously, we're all wearing masks the entire shift. PPE is a part of every interaction that we have, whether it be with patients or staff. There's a heightened awareness for those present with symptoms that could be COVID.

SA: In late February and early March, your roles with U.S. Soccer, Concacaf and FIFA started to focus on coronavirus. Did you think back in March -- or in early May when we spoke about planning for soccer's return -- that COVID-19 would be plaguing the USA as badly it is in mid-July?

GEORGE CHIAMPAS: From the virus perspective -- as a scientist and clinician -- one understands that the virus is going to be a part of our lives for an undetermined amount of time. That I knew 100 percent.

But I would be lying to say that I would feel in July that the responsibility and the seriousness of this has yet to be comprehensively appreciated. And that compliance and guidance from all components of our community have yet to be implemented. That's led to my disappointment. It's led to my concern. I think that's probably how most of us are feeling right now.

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For guidelines and best practices for WHEN AND IF your local authorities have deemed it safe to return to the field, check out U.S. Soccer's PLAY ON home page HERE.

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SA: The presentation of U.S. Soccer’s guidelines emphasize that a return-to-play phase should be introduced only when “local authorities have deemed it safe to return to the practice field.” How do leagues, clubs and coaches confirm that information?

GEORGE CHIAMPAS: I think it's very easy to do that. If you're not in tune with what's going on locally -- as a club, as a parent -- then you're not following the news. You're not even watching TV. It's very evident when numbers of concern are increasing with regards to the percentage of positive tests. I think that information is accessible to everyone.

The CDC [Centers for Disease Control and Prevention] provides that information. Each state does. You can go to your county, your city [web sites] to understand what is taking place in your area, especially if you're a club and have the responsibility, that information is extremely accessible.

U.S. Soccer demonstrated our responsibility and has shown the sensitivity of what the virus was going to look like. And I think our language from early on recognized that there are going to be adaptations during this period.

That's what makes PLAY ON a very good platform and guidance, because it takes all of that into consideration. It talks about if you have to pause, if you have to go back. It talks about a pathway to be able to responsibly play the game. PLAY ON is a good example of guidance in our sport during this pandemic.

The CDC's links to State & Territorial Health Department Websites:

SA: What if I’m running a club or league in one of the states or counties where the leaders previously erred in their reaction COVID-19, such as prematurely allowing public gatherings, not requiring masks, or even discouraging mask use? How do I trust them the next time they say it’s going to be safe?

GEORGE CHIAMPAS: The best practices with regards to COVID are fairly obvious and simple to implement. Wearing a mask in all aspects of soccer, short of training and actual competition, washing your hands, practicing social distancing in all elements when you're not in competition. Those things are really basic and fundamental.

I think the noise that we're seeing is exactly that. If you are a club coach in an area, regardless of what's taking place, I think that you can look to the guidelines by the CDC, by the health experts, by the public health experts.

What’s unfortunately taking place is that narratives are written for other purposes. The basic fundamentals are evident that they work, are evident that they provide layers of protection.

There are so many stakeholders, including parents and players, that all of us have to collectively set a tone, define how we want to be able to move forward safely and responsibly. Whether it be in small group environment or in a larger community -- we all have to do it together.

SA: Is it possible for you to keep track of how much youth soccer in the USA is returning at various phases? And whether it's being done prudently?

GEORGE CHIAMPAS: What I can share with you is that we have held countless webinars with coaches, with our members, across the country to walk through the phases, to answer questions, to really be able to get our message out about PLAY ON in a very responsible way. And it's been extremely well received. It's been very heavily attended.

There have been really good questions. We feel that this document isn't something that just lives on our website. We've done a tremendous amount of work to make sure that we engage those leaders who need to implement PLAY ON, but also remind them that it's OK if in your state you have to pause. It's OK if you have to take a step back because the circumstances have changed. We've without question not only created the platform and the guide for our sport, but we've actively been front and center to walk through all of the phases with everyone who needs to implement it.

SA: What if you hear about a multi-day tournament being held somewhere?

GEORGE CHIAMPAS: Every scenario is different. It depends on what's taking place in the state where the tournament's at. It depends on what's taking place in the state the players and the clubs are coming from who travel to another state. To broadly answer that -- I think it depends on the circumstances.

Generally – and we said it eight weeks ago and we’re saying it now while we’re in this larger surge across the country -- that in areas where we can minimize risk and decrease exposure, we should do that.

We can be creative as a sport and as clubs to build opportunities, to develop our players, to create competitions, with same-day matches and minimizing the exposure of bus trips or hotel rooms. It requires all of us -- not just the club or the coach but the parents, the players and the community -- to do what we feel is the safest and the best thing for players at this time.

SA: Clubs and leagues can create a safe playing environment on the field – but it seems that if return-to-play includes bus or van trips, car pools, hotel stays and team meals, there’s an off-field danger ...

GEORGE CHIAMPAS: Absolutely. There are elements that we can control, and there are elements that we can't control. And the ones you just described are those elements we can control.

We recognize the importance of the off-field camaraderie from bringing people together -- bus rides, team meals, hotel stays. We also know that those are the highest risk.

If our goal is for youth players to be able to develop on the field and be able to build their skills, get the physical fitness and health benefits of being able to play the game, to continue to grow as a soccer player – it's our responsibility to limit those off-field high-risk situations as much as possible. During this pandemic, to provide the benefits of play means sacrificing those off-field areas of the experience.

Hopefully that statement makes it very clear that we can't turn on the lights in the stadium if we don't do everything that needs to be done leading up to that.

SA: If U.S. Soccer finds out that a club or league is blatantly doing something that goes against the state and local regulations, would U.S. Soccer punish that organization?

GEORGE CHIAMPAS: U.S. Soccer, we're not an organization that has that authority. Obviously, there are elements like your public health officials that provide guidance. There are also our member associations. There are entities in place to react to a circumstance occurring that is outside of the guidance of the local or state public officials.

What I can share from our soccer perspective is we've created a very comprehensive guideline to return to sport that really should be a single voice providing the guidance across our game. Especially in a pandemic, we need compliance. We need a single message that is responsible.

Additionally, we've done a tremendous amount of work across clubs, across regions, so that there's really no confusion.

We may be seeing some confusion and some different messaging in other parts of society, but that’s not the case with regards to U.S. Soccer. It's not the case with PLAY ON. It is very clear what the message is for our sport.

On June 1 when Phase 1 came out, some questioned as to why we didn’t already offer competition phases. Back then, some clubs and states were ready to start playing games and matches.

The reason why we came out [only] with Phase 1 and small group trainings at beginning was to really create a foundation of compliance with this pandemic so that there is a very clear process of being able to move forward.

I think what we're seeing is, when you don't respect the virus and when you're not compliant, when you're not taking this seriously -- you're going to be forced to pause. You're going to be forced to take a step back.

Obviously, that's not good for any of us. It’s not good for our kids, who we want to be able to participate in sports and have this very important social, physical and mental aspects of their lives back.

SA: Anything else you’d like to add?

GEORGE CHIAMPAS: COVID is a virus that's going to be with us for the unknown future.

I’ve said from the beginning: setting a tone and a culture is critically important. Everyone should understand that the surges and troughs of COVID we’re seeing is to be expected. And we can't lose sight of what PLAY ON is.

PLAY ON provides a pathway and a structure to be able to participate in soccer in this country. We look forward to continue to be engaged with all of our stakeholders.

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Phase I Grassroots Soccer Recommendation Guide

Fase I Guía de Recomendaciones de Fútbol Base

Phase II Grassroots Soccer Recommendation Guide

Fase II Guía de Recomendaciones de Fútbol Base

Phase III Grassroots Soccer Recommendation Guide

Fase III Guía de Recomendaciones de Fútbol Base

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