Sports Orthopedics
EDITORIAL

Corona Vaccinations: Why Athletes and Young People Are Important!

Impfen gegen Corona: Weshalb Sportler und junge Menschen wichtig sind!

The SARS-CoV-2/Covid-19 Pandemic is a challenge for society, the population, doctors and of course sports.

We see that the disease has a severe course in many people but heals without consequences. We also see, however, that the elderly have a higher mortality risk. Of course, we as fellow human beings are concerned when these people become ill, suffer serious damage or even die. So nobody wants old-age homes to be dangerous places.

But younger people can also suffer devastating effects from COVID-19.  In 5-10% of those infected, we observe a multisystem illness for a shorter or extended time with loss of performance, fatigue, myocarditis, pulmonary disease, neurological symptoms – and we don’t yet know whether or when these will heal completely.

Side Effects of Physical Distancing?

Essential survival factors in the pandemic include physical activity as well as psychological and social well-being. On the other hand, social interactions comprise physical contact and closeness, which makes the spread of disease possible. The principles of “physical distancing” (the WHO now uses this term, since social contacts are important) that is, wearing a mask and disinfecting hands, when strictly adhered to, make a considerable contribution to reducing the infection rate. But they have side effects.

When we speak of the lockdown, social chances, educational chances and sports activities are considerably limited, thus limiting the chances for the future of young people (2).

When adolescents from socially-deprived groups riot or grossly violate rules and regulations, it is intolerable, but perhaps it is also a symptom that, from their point of view, their future is unimportant to our society? It is much easier for the upper middleclass (to which we and our politicians belong) to bring their children through the lockdown in their one-family homes with garden, than in the tenements of the social hotspots. We must remember that about 50% of the children in elementary schools belong to socially-deprived groups and require assistance (4).

These few factors alone show that there are various aspects which must be weighted in political decision. But does this really work? Or does the irrationality sometimes seen in the debates show that this is only sometimes the case? But those making the decisions rely on the expertise of virologists and even an Ethics Committee, don´t they? That can’t be wrong, can it?

Political theory shows (see (3)) that the definitions of good or bad – beneficial or harmful  - must be discussed and negotiated in a democracy. Thereby, the interests of all stakeholders (another odd term) must be taken into account, or tension will result.

Sports and Vaccination

The discussion about sports and vaccination is a ruthless demonstration of this. The avoidance of deaths in old-age homes takes priority. For this reason, the Ethics Committee has recommended that vaccination of only the elderly takes precedence, then their nurses (but not the cleaning crew?) and emergency doctors, but not personal physicians, not teachers and definitely not athletes.

The justified criterion is the reduction in the number of deaths. But there are additional means which have only been hesitantly applied. Regular testing in old-age homes has been and still is being hindered in many cases, Ministries and funders were against the idea for a long time. Even help from the Army in following up positive cases was sometimes rejected – is ideology more important? The staff and materials in most Health Offices have also still not been improved.

We can conclude that data protection apparently has a much higher priority, and the masks demanded by experts last March in this journal have only been hesitantly accepted. The lockdown is then the logical consequence – certainly necessary, but to such an extent with lost schooling and a ban on team sports it is definitely coupled with emotional and physical damage. This affects our youth, but everyone else as well!

In the usual public moral debate, professional and current Olympic sports are viewed with distain and even amateur sport is expected take a backseat. The athletes are only out to satisfy their egos, while others fight for their lives. How one-sided an argument can be! It is easy for former Olympic winners (5), editors or politicians to dispense with the Olympic Games. It doesn’t affect their chances in life and someone who has won Olympic medals or has attained a secure position in life often finds it easy to dispense with anyone else’s chances.

The Potential of Sports and the Olympics for our Society

Young people have a potential which they need chance to develop and which should last for a lifetime. For young athletes, the way is long to develop their own motoric, social and psychological capabilities, to practice their sport and even engage in high-performance sport. Competitions are an important motivation, interrupting training means a greater risk of later injuries, loss of performance capacity and demotivation. Correspondingly, emotional disorders, especially in well-being and quality of life, occur during the pandemic (1).

The Olympic Games are a very high goal for young people. Sports, sports medicine and the International Olympic Committee bear a great responsibility to organize safe Olympic Games, because these give young athletes the possibility of gaining unique experience.

Sports has shown that hygiene concepts (6) can effective prevent the transmission of SARS-CoV-2 viruses. This was demonstrated for example at the European Rowing Championships in Duisburg, Belgrade (Serbia) and Posznan (Poland) in 2020, with more than 3,000 participants. It is similar for other types of sports which do not involve increased risk of infection in the pandemic.

If we first vaccinate the weakest and most vulnerable in the risk group, it is appropriate. If, due to (justified) concern because of the deaths, we deny others the moral right to a chance in life simply because they have the slightest risk of dying and we make things easy for ourselves, this is unfair and ignores the dilemmas we face in the pandemic.

Athletes thus have a right to engage in their chosen sport. As vaccination advances and there is more vaccine available, we have to take about promptly vaccinating young athletes without envy and because of the risks. Their chances in life are worth it. As a society, we cannot afford to ignore in public discourse the justified concerns of young people. One-sided prioritizations divide society rather than bringing cohesion.

References

  1. Ammar A, Mueller P, Trabelsi K, Chtourou H, Boukhris O, Masmoudi L, Bouaziz B, et al; on behalf of the ECLB-COVID19 Consortium. Psychological consequences of COVID-19 home confinement: The ECLB-COVID19 multicenter study. PLoS One. 2020; 15: e0240204.
  2. Bloch W, Halle M, Steinacker JM. Sport in Zeiten von Corona. Dtsch Z Sportmed. 2020; 71: 83-84.
  3. Howlett M, Rames M, Perl A (eds.). Studying Public Policy. Policy Cycles & Policy Subsystems. Third edition. Oxford University Press: Oxford 2009.
  4. Kobel S, Lämmle C, Wartha O, Kesztyüs D, Wirt T, Steinacker JM. Effects of a Randomised Controlled School-Based Health Promotion Intervention on Obesity Related Behavioural Outcomes of Children with Migration Background. J Immigr Minor Health. 2017; 19: 254-262.
  5. Sir Matthew Pinsent. https://twitter.com/matthewcpinsent/status/1348568766628696064 [10th February 2021].
  6. Steinacker JM, Bloch W, Halle M, Mayer F, Meyer T, Hirschmüller A, Röcker K, Nieß A, Scharhag J, Reinsberger C , Scherr J, Niebauer J, Wolfarth B und Sports Medicine Commission der FISA. Merkblatt: Gesundheitssituation für Sportler durch die aktuelle Coronavirus-Pandemie (SARS-CoV-2 / COVID-19). Dtsch Z Sportmed. 2020; 71: 85-86.
Prof. Dr. med. Dr. h.c. Jürgen M. Steinacker
University Hospital Ulm
Division of Sports and Rehabilitation Medicine
Leimgrubenweg 14, 89075 Ulm, Germany
juergen.steinacker@uniklinik-ulm.de