SARS-CoV-2 transmission during rugby league matches: do players become infected after participating with SARS-CoV-2 positive players?

<p><b>Objectives</b> To examine the interactions between SARS-CoV-2 positive players and other players during rugby league matches and determine within-match SARS-CoV-2 transmission risk.<br/><b>Methods</b> Four Super League matches in which SARS-CoV-2 positive players were subsequently found to have participated were analysed. Players were identified as increased-risk contacts, and player interactions and proximities were analysed by video footage and global positioning system (GPS) data. The primary outcome was new positive cases of SARS-CoV-2 within 14 days of the match in increased-risk contacts and other players participating in the matches.</br><br/><b>Results</b> Out of 136 total players, there were 8 SARS-CoV-2 positive players, 28 players identified as increased-risk contacts and 100 other players in the matches. Increased-risk contacts and other players were involved in 11.4 +/- 9.0 (maximum 32) and 4.0 +/- 5.2 (maximum 23) tackles, respectively. From GPS data, increased-risk contacts and other players were within 2 m of SARS-CoV-2 positive players on 10.4 +/- 18.0 (maximum 88) and 12.5 +/- 20.7 (maximum 121) occasions, totalling 65.7 +/- 137.7 (maximum 689) and 89.5 +/- 169.4 (maximum 1003) s, respectively. Within 14 days of the match, one increased-risk contact and five players returned positive SARS-CoV-2 reverse transcriptase PCR (RT-PCR) tests, and 27 increased-risk contacts and 95 other participants returned negative SARS-CoV-2 RT-PCR tests. Positive cases were most likely traced to social interactions, car sharing and wider community transmission and not linked to in-match transmission.</br><br/><b>Conclusion </b>Despite tackle involvements and close proximity interactions with SARS-CoV-2 positive players, in-match SARS-CoV-2 transmission was not confirmed. While larger datasets are needed, these findings suggest rugby presents a lower risk of viral transmission than previously predicted.</br></p>