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A rapid review of recommendations for mitigating COVID-19 transmission in community sport and recreation facilities




public health, sport, recreation, facility management, occupational health, COVID-19


This rapid review was conducted to develop recommendations that can mitigate COVID-19 transmission in community sport and recreation facilities so that the industry that supports physical activity and mental health can return to a degree of normalcy. Three databases (SPORTDiscus, Web of Science, Scopus) and the WHO COVID-19 database were systematically searched for peer-reviewed literature that provided practical implications for the return to community sport and recreation facilities. The search and screening processes yielded 63 articles for full text review. The analysis resulted in 25 recommendations that were categorized in accordance with the National Institute for Occupational Safety and Health’s hierarchy of controls framework for addressing occupational hazards: elimination/substitution, engineering controls, administrative controls and personal protective equipment. The results provide recommendations for public health (i.e. mandatory vaccination), architects/engineers (i.e. ventilation) and facility managers (i.e. cleaning) that can be enacted progressively in the event of future public health crises.


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Almasari, D., Noor, A. & Diri, R. (2020). Behavioral changes in gym attending due to COVID-19 pandemic: A descriptive survey. Journal of Microscopy and Ultrastructure, 8(4), 165-167.

Altavilla, G., Macri, I. & Esposito, G. (2021). Data collection on indoor and outdoor physical activities during the SARS-COVID-2 pandemic. Journal of Physical Education and Sport, 21(1), 686-691.

Amagasa, S., Machida, M., Ding, D. & Inoue, S. (2020). Preventing infectious diseases outbreaks at exercise facilities. Managing Sport and Leisure,

Amimi, H., Habibi, S., Islamoglu, A. H., Isanejad, E. & Daniyari, H. (2021). COVID-19 pandemic-induced physical inactivity: The necessity of updating the Global Action Plan on physical activity 2018-2030. Environmental Health and Preventative Medicine, 26, 32.

Asif, I. M., Chang, C. J., Diamond, A. B., Raukar, N., Zaremski, J. L. (2020). Returning athletes back to high school sports in the COVID-19 era: Preparing for fall. Sports Health, 12(6), 518-520.

Bae, S., Kim, H., Jung, T., Lim, J., Jo, D., Kang, G.,… Kwon, H. (2020). Epidemiological characteristics of COVID-19 outbreak at fitness centers in Cheonan, Korea. Journal of Korean Medical Science, 35(31), e288.

Bates, L. C., Zieff, G., Stanford, K., Moore, J. B., Kerr, Z. Y., Hanson, E. D., Barone Gibbs, B., Kline, C. E., & Stoner, L. (2020). COVID-19 Impact on Behaviors across the 24-Hour Day in Children and Adolescents: Physical Activity, Sedentary Behavior, and Sleep. Children-Basel, 7(9), 138.

Blocken, B., van Druenen, T., Ricci, A., Kang, L., van Hoof, T., Qin, P.,… Brombacher, A. C. (2021). Ventilation and air cleaning to limit aerosol particle concentrations in a gym during the COVID-19 pandemic. Building and Environment, 193(15), 107659.

Blocken, B., van Druenen, T., van Hoof, T., Verstappen, P. A., Marchal, T. & Marr, L. C. (2020). Can indoor sports centers be allowed to re-open during the COVID-19 pandemic based on a certificate of equivalence? Building and Environment, 180, 107022.

Carmody, S., Murray, A., Borodina, M., Gouttenbarge, V. & Massey, A. (2020). When can professional sport recommence safely during the COVID-19 pandemic? Risk assessment and factors to consider. British Journal of Sports Medicine, 54(16), 946-948.

Casasco, M., Pigozzi, F., Porcelli, S., Beltrami, G., Agnello, L., Parisi, A.,… Pecorelli, S. (2020). FMSI guidelines for return to physical activity after coronavirus pandemics lockdown. Medicina dello Sport, 73, 1-9.

Castagna, C., Bizzini, M., Leguizamon, A. P., Pizzi, A., Torquati, R. & Povoas, S. (2020). Considerations and best practices for elite football officials return to play after COVID-19 confinement, Managing Sport and Leisure,

Chu, D., Gu, H., Chang, L., Cheuk, S., Gurung, S., Krishnan, P., Ng, D., Liu, G., Wan, C., Tsang, D., Peiris, M., & Poon, L. (2021). SARS-CoV-2 Superspread in Fitness Center, Hong Kong, China, March 2021. Emerging Infectious Diseases, 27(8), 2230–2232.

Cilhoroz, B.T., & DeRuisseau, L.R. (2021). Safety protocols in an exercise facility result in no detectable SARS-CoV-2 spread: A case study. Physiological Reports, 9, e14967.

Cortez, A. C. L., Pitanga, F. J. G., Ameida-Santos, M. A., Nunes, R. A. M., Botero-Rosas, D. A., Dantas, E. H. M. (2020). Centers of physical activities and health promotion during the COVID-19 pandemic. Revista da Associacao Medica Brasileira. 66(10).

Cunningham, G. B. (in press). Physical activity and its relationship with COVID-19 cases and deaths: Analysis of US counties. Journal of Sport and Health Science.

D'Agostino, E. M., Armstrong, S. C., Humphreys, L., Coffman, S., Sinclair, G., Permar, S. R., & Akinboyo, I. C. (2021). Symptomatic SARS-CoV-2 transmission in youth and staff attending day camps. Pediatrics, 147(4), 1-6.

Daly, M., Suttin, A. R. & Robinson, E. (2020). Longitudinal changes in mental health and the COVID-19 pandemic: Evidence from the UK household longitudinal study. Psychological Medicine, 1-10.

Dehghani, F., Omidi, F., Yousefinejad, S. & Taheri, E. (2020). The hierarchy of preventive measures to protect workers against the COVID-19 pandemic: A review. Work, 67, 771-777.

Denay, K., Breslow, R. G., Turner, M. N., Nieman, D. C., Roberts, W. O., Thomas, B. (2020). ACSM Call to action statement: COVID-19 considerations for sports and physical activity. Current Sports Medicine Reports, 19(8), 326-328.

Dennerlein, J. T., Burke, L., Sabbath, E. L., Williams, J. A. R., Peters, S. E., Wallace, L.,… Sorensen, G. (2020). An integrative total health framework for keeping workers safe and healthy during the COVID-19 pandemic. Human Factors, 62(5), 689-696.

DiFiori, J. P., Green, G., Meeuwisse, W., Putukian, M., Solomon, G. S., & Sills, A. (2021). Return to sport for North American professional sport leagues in the context of COVID-19. British Journal of Sports Medicine, 55(8), 417-421.

Ding, D., Kolbe-Alexander, T. L., Nguyen, B., Katzmarzk, P. T., Pratt, M. & Lawson, K. D. (2017). The economic burden of physical inactivity: a systematic review and critical appraisal. British Journal of Sports Medicine, 51, 1392-1409.

Doherty, C., Mann, L., Angus, S. A., Chan, J., Molgat-Seon, Y., & Dominelli, P. B. (2021). Impact of wearing a surgical and cloth mask during cycle exercise. Applied Physiology, Nutrition, and Metabolism, 46, 753-762.

Dominski, F. H. & Brandt, R. (2020). Do the benefits of exercise in indoor and outdoor environments during the COVID-19 pandemic outweigh the risks of infection? Sport Sciences for Health, 16, 583-588.

Donadu, M. G., Pizzi, A. R. & Zeppilli, P. (2020) COVID-19, indications for professional football teams and referees training resumption. The Journal of Infection in Developing Countries. 14(10), 1084-1089.

Drury, J., Rogers, M. B., Marteau, T. M., Yardley, L., Reicher, S., & Stott, C. (2021). Re-opening live events and large venues after Covid-19 ‘lockdown’: Behavioural risks and their mitigations. Safety Science, 139, 105243.

Egger, F., Bulmenauer, D., Fischer, P., Venhorst, A., Kulenthiran, S., Bewarder, Y., Zimmer, A., Bohm, M., Meyer, T., & Mahfoud, F. (2021). Effects of face masks on performance and cardiorespiratory response in well-trained athletes. Clinical Research in Cardiology.

Epstien, D., Korytny, A., Isenberg, Y., Marcusohn, E., Zukermann, R., Boaz, B.,… Miller, A. (2021). Return to training in the COVID-19 era: The physiological effects of face masks during exercise. Scandinavian Journal of Medicine & Science in Sports, 31, 70-75.

Feiler, S., & Breuer, C. (2021). Perceived threats through COVID-19 and the role of organizational capacity: Findings from non-profit sports clubs. Sustainability, 13(12), 6937.

Fitzgerald, H.T., Rubin, S.T., Fitzgerald, D.A., & Rubin, B.K. (in press). Covid-19 and the impact on young athletes. Paediatric Respiratory Reviews.

Francis, J. & Francis, L. (2020). Immunization and participation in amateur youth sports. Journal of the Philosophy of Sport, 47(2), 151-167.

Gentil, P., de Lira, C. A. B., Souza, D., Jimenez, A., Mayo, X., Gryschek, A. L. d. F. P. L.,… Carnevali Junior, L. C. (2020). Resistance training safety during and after the SARS-Cov-2 outbreak: Practical recommendations. BioMed Research International, 2020, 3292916.

Haddad, M., Abbes, Z., Mujika, I., Chamari, K. (2021). Impact of COVID-19 on swimming training: Practical recommendations during home confinement/isolation. International Journal of Environmental Research and Public Health, 18, 4767.

Hall, G., Laddu, D. R., Phillips, S. A., Lavie, C. J. & Arena, R. (2021). A tale of two pandemics: How will COVID-19 and global trends in physical inactivity and sedentary behaviour affect one another? Progress in Cardiovascular Diseases, 64, 108-110.

Hamer, M., Kivimaki, M., Gale, C. & Batty, G. D. (2020). Lifestyle risk factors, inflammatory mechanisms, and COVID-19 hospitalizations: A community-based cohort study of 387,109 adults in UK. Brain, Behavior, and Immunity, 87, 184-187.

Haraf, R. H., Faghy, M. A., Carlin, B. Josephson, R. A. (2021). The physiological impact of masking is insignificant and should not preclude routine use during daily activities, exercise, and rehabilitation. Journal of Cardiopulmonary Rehabilitation and Prevention, 41(1), 1-5.

Harder, T., Koch, J., Vygen-Bonnet, S., Kulper-Schiek, W., Pilic, A., Reda, S.,... Wichmann, O. (2021). Efficacy and effectiveness of COVID-19 vaccines against SARS-CoV-2 infection: Interim results of a living systematic review, 1 January to May 2021. Euro Surveillance, 26(28), 2100563.

Hodgson, L., Phillips, G., Gordon, J., Hanson, J., Maclean, J., Matherma, P., Smith, A., Woolcok, M., Cowie, C.M., Kemp, S., Patterson, M., Larkin, J., Hill, J., Rossiter, M., Elliot., Bennett, P., Power, J., Pillay, A., Singh, H., … Patricios, J. (2020). Interassociation consensus recommendations for pitch-side emergency care and personal protective equipment for elite sports during the COVID-19 pandemic. British Journal of Sports Medicine, 55, 531-538.

Hodgson L., Phillips, G., Saggers, R.T., Sharma, S., Papadakism M., Redhead, C., Cowie, C.M., Massey, A., Weiler, R., Mathema, P., Larkin, J., Gordon, J., Maclean, J., Rossiter, M., Elliot, N., Hanson, J., Spencer, S., Jaques, R., Patricios, J. (2021). Medical care and first aid: An interassociation consensus framework for organised non-elite sport during the COVID-19 pandemic. British Journal of Sports Medicine, 0, 1-12.

Hopkins, S. R., Dominelli, P. B., Davis, C. K., Guenette, J. A., Luks, A. M., Molgat-Seon, Y.,… Strickland, M. K. (2020). Face masks and the cardiorespiratory response to physical activity in health and disease. Annals of the American Thoracic Society, 18(3), 399-408.

Hou, H. C., Remoy, H., Jylha, T. & Putte, H. V. (2021). A study on office workplace modification during the COVID-19 pandemic in The Netherlands. Journal of Corporate Real Estate, 1463-001X.

Hughes, D., Saw, R., Perera, N. K. P., Mooney, M., Wallett, A., Cooke, J.,… Broderick, C. (2020). The Australian Institute of Sport framework for rebooting sport in a COVID-19 environment. Journal of Science and Medicine in Sport, 23(7), 639-662.

Jones, B., Phillips, G., Beggs, C., Calder, J., Cross, M., Pearce, N., Readhead, C., Smith, J., Stokes, K.A., & Kemp, S. (2021). British Journal of Sports Medicine, 0(0), 1-2.

Karmeniemi, M., Lankila, T., Ikaheimo, T., Koivumaa-Honkanen, H. & Korpelainen, R. (2018). The built environment as a determinant of physical activity: A systematic review of longitudinal studies and natural experiments. Annals of Behavioral Medicine, 52(3), 239-251.

Kemp, S., Cowie, C.M., Gillett, M., Higgins, R., Hill, J., Iqbal, Z., Jackson, P., Jaques, R., Larkin, J., Phillips, G., Peirce, N., & Calder, J. (2021). Sports medicine leaders working with government and public health to plan a ‘return-to-sport’ during the COVID-19 pandemic: The UK’s collaborative five-stage model for elite sport. British Journal of Sports Medicine, 55(1), 4-5.

Khangura, S., Konnyu, K., Cushman, R., Grimshaw, J., & Moher, D. (2012). Evidence summaries: the evolution of a rapid review approach. Systematic reviews, 1(1), 1-9.

Kim, Y. & Kang, S. (2021). Perceived crowding and risk perception according to leisure activity type during COVID-19 using spatial proximity. International Journal of Environmental Research and Public Health, 18(2), 457.

Kim, Y., Cho, J. & Kang, S. (2020). Study on the relationship between leisure activity participation and wearing a mask among Koreans during COVID-19 crisis: Using TPB model. International Journal of Environmental Research and Public Health, 17, 7674.

Kohl, H. W., Craig, C. L., Lambert, E. V., Inoue, S., Alkandari, J. R., Leetongin, G. & Kahlmeier, S. (2012). The pandemic of physical inactivity: Global action for public health. Lancet, 380, 294-305. S0140-6736(12)60898-8

Kumar, A., Priya, B., & Srivastava, S. K. (2021). Response to the COVID-19: Understanding implications of government lockdown policies. Journal of Policy Modeling, 43(1), 76–94.

Lakicevic, N., D’Antona, G., Paoli, A., Bianco, A., Maksimovic, N., Ostojic, S., & Drid, P. (in press). Behind the mask: Rethinking the use of face masks while exercising. Science & Sports, 1–3.

Madhi, S. A. (2021). COVID-19 herd immunity v. learning to live with the virus. South African Medical Journal,

Martin, A. M., Champ, F., & Franklin, Z. (2021). COVID-19: Assessing the impact of lockdown on recreational athletes. Psychology of Sport and Exercise, 56, 1–11.

Matos, R., Antunes, N. A. & Rosa, M. (2021). Portuguese adults’ concern on return to indoor sports practice after confinement due to COVID-19 pandemic – mitigation strategies proposals COVID-19. Cuadernos de Psicología del Deporte, 21(2), 227-241.

McElheny, K. D., Little, D., Taylor, D., & Manzi, J. E. (2021). Communicable illness mitigation strategies for traveling elite sporting organizations. Sports Health: A Multidisciplinary Approach, 1–6.

McLarnon, M., & Heron, N. (2021). The COVID-19 athlete passport: A tool for managing athlete COVID-19 status surrounding the Tokyo 2020 Olympic games. The Physician and Sportsmedicine, 1–4.

Mercurio, A. M., Gianakos, A. L., Mulcahey, M. K. & Sutton, K. M. (2020). Five myths of COVID-19 for the team physician. HSS Journal, 16(Suppl 1), S173-S178.

Megahed & Ghoneim (2021). Indoor air quality: Rethinking rules of building design strategies in post-pandemic architecture. Environmental Research, 193, 110471.

Moore, S. A., Faulkner, G., Rhodes, R. E., Brussoni, M., Chulak-Bozzer, T., Ferguson, L. J., Mitra, R., O’Reilly, N., Spence, J. C., Vanderloo, L. M., & Tremblay, M. S. (2020). Impact of the COVID-19 virus outbreak on movement and play behaviours of Canadian children and youth: A national survey. International Journal of Behavioral Nutrition and Physical Activity, 17(1), 85.

Morawska, L., Tang, J. W., Bahnfleth, W., Bluyssen, P. M., Boerstra, A., Buonanno, G.,… Yao, M. (2020). How can airborne transmission of COVID-19 indoors be minimised? Environmental International, 142, 105832.

Morris, G.A. & Cannady, R. (2019). Proper use of the hierarchy of controls. Professional Safety, 64(8), 37-40.

Mulcahey, M. K., Gianakos, A. L., Mercurio, A., Rodeo, S. & Sutton, K. M. (2021). Sports medicine considerations during the COVID-19 pandemic. The American Journal of Sports Medicine, 49(2), 512-521.

Murakami, M., Miura, F., Kitajima M., Fujii, K., Yasutaka, T., Iwasaki, Y., Ono, K., Shimazu, S., Sorano, S., Okuda, T., Ozaki, A., Katayama, K., Nishikawa, Y., Kobashi, Y., Sawano, T., Abe, T., Saito, M.M., Tsubokura, M., Naito, W., & Imoto, S. (in press). COVID-19 risk assessment at the opening ceremony of the Tokyo 2020 Olympic Games. Microbial Risk Analysis.

National Institute for Occupational Safety and Health. (2015, January 13). Hierarchy of Controls. Centers for Disease Control and Prevention.

O’Grady, T. & Jordan, L. (2021). Creating a safe, return-to-sport environment in upstate New York during the COVID-19 pandemic. Current Sports Medicine Reports, 20(1), 5-6.

Parker, J., Boles, C., Leleck, O., Buerger, A., Egnot, N., Sundermann, A. & Bussmann, E. (2020). Advancing toward normal operations for arenas and stadiums. Toxicology and Industrial Health, 36(9), 718-727.

Pena, J., Altarriba-Bartes, A., Vicens-Bordas, J., Gil-Puga, B., Pinies-Penades, G., Alba-Jiminez, C., Merino-Tantina, J., Baena-Riera, A., Loscos-Fabregas, E., & Casals, M. (2020). Sports in time of COVID-19: Impact of the lockdown on team activity. Apunts Sports Medicine, 56(100340), 1-17.

Pinheiro, M. D. & Luis, N. C. (2020). COVID-19 could leverage a sustainable built environment. Sustainability, 12, 5863.

Piotrowski, D., & Piotrowski, A. I. (2021). Operation of gyms and fitness clubs during the COVID-19 pandemic – financial, legal, and organisational conditions. Journal of Physical Education and Sport, 21(2), 1021–1028.

Ramos e Corte, A. C., Grava de Sousa, J. P., Grava de Sousa, I. F., Garcia, R. M. & Stancati, J. (2020). COVID-19 safety recommendations for the reopening of the Dr. Joaquim Grava Corinthias training facility. Revista Brasileira de Medicina do Esporte, 26(5), 382-385.

Robinson, P. G., Foster, C. & Murray, A. (2021). Public health considerations regarding golf during the COVID-19 pandemic: A narrative review. BMJ Open Sport & Exercise Medicine, 7, e001089. bmjsem-2021-001089

Robinson, P. G., Murray, A., Close, G. & Kinane, D. F. (2021). Assessing the risk of SARS-CoV-2 transmission in international professional golf. BMJ Open Sport & Exercise Medicine, 7, e001109.

Romano-Bertrand, S., Aho Glele, L-S., Grandbastien, B. & Lepelletier, D. (2020). Preventing SARS-CoV-2 transmission in rehabilitation pools and therapeutic water environments. Journal of Hospital Infection, 105, 625-627.

Schumacher, Y.O., Tabben, M., Chamari, K., Dzendrowskyj, P., Bahr, R., Hassoun, K., Abbassi, A.K., Bensaad, M., Al Barghouti, B., Alishaq, M., Fadel, R.A.A., & Jeremijenko, M. (2021). Environmental surface contamination with SARS-CoV-2 in professional football clubs. Science and Medicine in Football.

Shurlock, J., Muniz-Pardos, B., Tucker, R., Bachl, N., Papadopoulou, T., Holloway, G.,… Pitsiladis, Y. P. (2021). Recommendations for face coverings while exercising during the COVID-19 pandemic. Sports Medicine – Open, 7(19), 1-8.

Sikka, R., Lincoln, A. E., Adamson, B. J. S., Epstein, J. A. & Krumholz, H. M. (2020). What’s important: Reopening lessons from the big leagues’ experiences with COVID-19. The Journal of Bone and Joint Surgery, 103(1).

Spigarelli, C. (2020). Understanding the hierarchy of controls through a pandemic. Professional Safety, 65(5), 20-21.

Suhs, T., Gerlach, D., Garfin, J., Lorentz, A., Firestone, M., Sherden, M., Hackman, K., Gray, T., Siebman, S., Wienkes, H., Vilen, K., Wang, X., Como-Sabetti, K., Danila, R., Smith, K., & Medus, C. (2021). COVID-19 outbreak associated with a fitness center - Minnesota, September–November 2020. Clinical Infectious Diseases, ciab653.

Tcymbal, A., Demetriou, Y., Kelso, A., Wolbring, L., Wunsch, K., Wasche, H.,… Reimers, A. K. (2020). Effects of the built environment on physical activity: A systematic review of longitudinal studies taking sex/gender into account. Environmental Health and Preventative Medicine, 25, 75.

Timpka, T. (2020). Sports health during the SARS-Cov-2 pandemic. Sports Medicine.

Tinaz, C. & Emiroglu, O. (2020). Reopening of tennis clubs and solutions for changing consumer habits in the COVID-19 era. ITF Coaching and Sport Science Review, 81(28), 25-26.

Tricco, A. C., Langlois, E., Straus, S. E., & World Health Organization. (2017). Rapid reviews to strengthen health policy and systems: a practical guide. World Health Organization.

Vancini, R. L., Andrade, M. S., Nikolaidis, P. T., Knechtle, B., Rosemann, T., Viana, R. B. & de Lira, C. A. B. (2021). COVID-19: It’s still a time for health professionals, physical activity enthusiasts and sportive leagues not to let guard down. Sports Medicine and Health Science, 3(1), 49-53.

Wackerhage. H., Everett, R., Kruger, K., Murgia, M., Simon, P., Gehlert, S.,… Schonfelder, M. (2020). Sport, exercise and COVID-19, the disease caused by the SARS-CoV-2 Coronavirus. German Journal of Sports Medicine, 71, E1-E12.

Watson, A. M., Haraldsdottir, K., Biese, K. M., Goodavish, L., Stevens, B., & McGuine, T. A. (2021). COVID-19 in US youth soccer athletes during summer 2020. Journal of Athletic Training, 56(6), 542–547.

Wicker, P., Hallmann, K., & Breuer, C. (2012). Micro and macro level determinants of sport participation. Sport, Business and Management: An International Journal, 2(1), 51-68.

Wong, A. Y., Ling, S. K., Louie, L. H., Law, G. Y., So, R. C., Lee, D. C.,… Yung, P. S. (2020). Impact of the COVID-19 pandemic on sports and exercise. Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology, 22, 39-44.

World Health Organization. (2021). WHO coronavirus (COVID-19) dashboard. Retrieved August 26, 2021, from

World Health Organization Regional Office for Europe (2020). Coronavirus disease (COVID-19) pandemic. Retrieved July 29, 2021, from

Zisook, R. E., Monnot, A., Parker, J., Gaffney, S., Dotson, S. & Unice, K. (2020). Assessing and managing the risks of COVID-19 in the workplace: Applying industrial hygiene