Study: March Madness 2021 played a role in COVID-19 transmission upticks – The Dallas Morning News

After March Madness had to be canceled in 2020, fans were undoubtedly excited to see its return in 2021, just a few months after the first COVID-19 vaccines had become available.

But the vaccines werent available to everyone by March 2021, so venues hosting the NCAA mens basketball tournament games required masks, encouraged social distancing, and capped attendance at lower limits to reduce the risk of COVID transmission.

Alas, a new study in JAMA Network Open reveals that the tournament still played a role in transmission upticks, at least in the counties where participating teams were from. The jump in local infection rates for those counties didnt last long about a month but the new research shows that big indoor events like March Madness games remain superspreader threats without widespread vaccination, even when officials are doing their best to reduce infections with other mitigation measures.

The new study couldnt show whether the increased infections occurred because of game attendance where mask-wearing compliance wasnt great, according to another study or because of private gatherings, such as home viewing parties and sports bar get-togethers. Most likely, it was a bit of both, and both can be prevented when nearly everyone is vaccinated.

Basically, the researchers compared infection rates in counties that had a university team playing in the NCAA tournament with those in counties of the same state that didnt have a team playing in March Madness.

They looked at infection rates per 100,000 people before and after the tournament from Jan. 28 through May 25, 2021 and considered the countys date of exposure to be the date of that countys university teams last game in the tournament. For example, the last game played by the Michigan Wolverines was March 30, so that would be the date of exposure for Washtenaw County, the county where the University of Michigan is.

Starting eight days after the last game date of a countys participating team, that county saw a 13% increase in COVID cases that nearby counties without a participating team didnt see. In other words, if the county had a team playing, their infection rates rose 13% higher than the rates of other nearby counties starting just over a week after the game. Eight days makes sense since thats how many days after exposure most people begin to experience symptoms from an infection.

Counties with competing teams saw a continued rise in cases until just over three weeks (24 days) after the game, when infection rates were 22% higher than other counties. Then infection rates for those counties began dropping back to levels similar to nearby counties. By a month after the game, counties with a participating team didnt have significantly higher rates of COVID than other counties did.

To make sure the increase really was related to gatherings for the NCAA tournament, the researchers also compared infection rates of counties that had universities whose teams werent playing in March Madness. Those counties infection rates didnt rise above rates of other nearby counties, confirming that only counties that were home to a March Madness team were seeing a jump in infections during March Madness.

The bottom line is that March Madness led to increases in infections among spectators, whether they were gathering in private or at the games themselves. While young college students attending these games have a low risk of severe disease and hospitalization, the risk isnt zero, and those students can pass infections on to more vulnerable members of society.

The study findings dont mean people shouldnt gather for exciting events like March Madness that help us feel like were gradually getting back to normal. Instead, people attending those events, or going to watch parties at homes and sports bars, need to be vaccinated and wearing masks.

In March 2021, the vaccines werent widely available for everyone yet, so many people didnt have an opportunity to get a vaccine, especially if they were in younger, healthier groups as most college students are. That means mask-wearing would have been even more important to reduce transmission rates. Yet a study from mid-August in JAMA Network Open examined mask-wearing at the NCAA mens basketball tournament, and what they found wasnt encouraging: about one in four spectators was not correctly wearing a mask during the games.

The researchers attended five March Madness games in Indianapolis between March 30 and April 5 to count how many people wore face masks. At the time, the indoor stadium had a 22% capacity cap for attendance only about one in five seats could be filled. The stadium required masks, as did the county and state, and signs and speaker announcements reminded attendees of the requirement to wear masks.

Six observers counted who was and wasnt wearing masks at the entrance gates, concession areas, arena seating, upper-deck seating, and exit gates. If the person had a cloth face mask or disposable surgical mask covering their mouth and nose including their nostrils and extending below their chin, the observers considered that appropriate mask wearing.

From observing 21,355 spectators, only 74% of them were correctly masked. Masks were more common among women, 81% of whom were correctly wearing masks. Among men, only 70% were correctly wearing masks. Those least likely to wear masks were fans in the upper decks, where only one in three people wore masks correctly. In the arena seating, only two out of three people wore masks. Mask-wearing was most evident at concession areas, where 83% of people wore masks correctly, and at entrances, where 80% wore masks.

Public health experts have estimated that at least 80% of people need to wear masks correctly to effectively reduce spread of COVID-19, the authors note in their study, and 74% falls well short. Rates in the upper deck and arena areas were even lower, and people were able to take off their masks to eat and drink in their seats. Yet people also cheer from their seats, and yelling is a sure-fire way to spew germs into the air that could be carrying the virus.

While the more recent study looking at county rates didnt consider who attended games, its a pretty good bet that people from those counties who attended the games were among those contributing to infection spread, given those low rates of mask-wearing. Mask-wearing quite possibly could have been even lower in private gatherings at homes or in sports bars and restaurants to watch the games.

Together, these studies have a clear message: Gatherings are prime opportunities for the virus to hop from person to person, even when hosting authorities, such as officials at the venues, are doing what they can to mitigate spread by requiring masks and social distancing. Back in March 2021, it wasnt possible for everyone to be vaccinated yet, but now that it is, it makes sense that so many concert and sports venues are now requiring attendees to show proof of vaccination to attend big events.

Tara Haelle is a Dallas-based science journalist who specializes in reporting on vaccines, pediatric and maternal health, parenting, public health, mental health, medical research and the social sciences. Her most recent book, Vaccination Investigation: The History and Science of Vaccines, is a starred Kirkus book. This piece was originally published in Medium, and many of Haelles stories can be found at tarahaelle.medium.com.

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Study: March Madness 2021 played a role in COVID-19 transmission upticks - The Dallas Morning News