Growing clusters of coronavirus infections in youth sports, coupled with pandemic fatigue, are complicating the battle to control new cases across Massachusetts, health department directors say.
They say the hurdles, coming as the number of cases soar across the state, are making their job of tracking down close contacts of infected residents exponentially more complex than earlier in the pandemic. That’s reflected in recent state data indicating that the source of infections in about half of new COVID-19 cases is a mystery — a troubling trend because without knowing how and where people are getting infected, it’s difficult to prevent further infections.
“We have younger people who are out at work, socializing, sports with their kids, going to church,” said Peabody’s health director, Sharon Cameron. “We are seeing a lot of cases having multiple contacts.”
In hopes of reversing the rising tide of infections and hospitalizations, Governor Charlie Baker on Monday announced tighter restrictions, closing most businesses by 9:30 p.m. and reducing the limit on indoor gatherings to 10 people.
Unlike months earlier, when most residents reported close contact with only two or three other people in the days before they tested positive or developed symptoms, many of the newly infected acknowledge such contact with a dozen or more, local health directors say. Some admit to as many as 30.
Plenty of others are just not answering the phone or providing less-than-truthful responses to contact tracers, health directors say. (Close contact is defined as up to 15 minutes, cumulatively, within 24 hours, and within 6 feet of someone, even if both people are wearing a mask.)
“You ask who else lives in the home and they say nobody, and yet you can hear children in the background," said Sigalle Reiss, president of the Massachusetts Health Officers Association and Norwood’s health director. “People are not being forthcoming with close contacts, and it really relies on a case being forthcoming and honest about activities."
The state’s data on recent COVID-19 clusters indicate more infections are linked to youth sports than many other activities and areas, including colleges, schools, restaurants, and food courts. Baker shut down indoor hockey rinks last month until at least Nov. 7 after regulators linked dozens of cases to organized hockey. On Monday, he said he would have a “lot more" to say about sports-related infections this week.
Local health directors are worried. And they’ve been imploring the Baker administration for several weeks to tighten rules on youth sports, particularly basketball, as they see team infections mount.
“In Orange, they quarantined the whole woman’s field hockey team recently, then we had issues with both youth soccer and youth basketball teams,” said Phoebe Walker, director of the Cooperative Public Health Service, a regional health district in Western Massachusetts that encompasses 15 Franklin County communities, including Deerfield and Erving, which is next door to Orange.
Public records from the cooperative indicate two recent infections in a youth basketball team spread to 14 more people, for a total of 16 infections including some not on that team.
“We are seeing major secondary and tertiary infections,” Walker said.
In Framingham, public health director Samuel Wong said infections linked to ice hockey teams had been a leading concern. But the city has recorded cases tied to baseball earlier this year and soccer, which is played deeper into the fall.
“We are not talking about school-based sports,” Wong said. “These are privately run leagues and clubs, and teams travel to many communities to play.”
Consistent rules about youth sports across the state are imperative, the health directors say, because teams often travel, which raises the risk of spreading the virus. Basketball, in particular, is a growing concern.
“I am definitely worried about basketball,” said Cameron, Peabody’s health director. “There is really no way to play that game without being physically in contact with people.”
A spokesman for the state’s COVID-19 Command Center declined to say whether the state plans to further tighten restrictions on youth sports, or basketball in particular. But the state’s rules issued Oct. 4 allow sports deemed “high risk,” such as basketball, to continue as long as organizers modify play and practice “as much as possible” to keep players spaced 6 feet apart for the majority of a game or practice.
“The Command Center continues to monitor the data and will make decisions regarding group activities, like youth sports, as necessary that will ensure the health of players, parents, and others involved in sports," said center spokesman Tory Mazzola. "We continue to expand our contact tracing network and capabilities by hiring and training more tracers, which is a critical resource to help understand where the spread is occurring and identify clusters.”
In the interim, local health leaders say they are focused on staying ahead of new clusters linked to youth sports. In Andover, public health director Thomas Carbone is planning Zoom information sessions with local sports programs and coaches to highlight the importance of following state rules.
“The organizers and coaches are going to be really important in helping to stop that spread," Carbone said. "This is an outlet for these student athletes, and you want them to have that but be as safe as well. It’s a balance.”
While the sheer number of overall new infections is still measurably lower than April’s peak of 2,000-plus cases a day, local health directors say the complexity of tracking a dozen or more cases for each newly infected person is taking its toll.
“It’s a level of intensity that’s not really reflected in the numbers,” said Cameron, of Peabody.
She said most people have been complying with quarantine and isolation rules, but she is encountering a growing number of younger residents shrugging them off because they feel they can’t miss two weeks away from the office in quarantine.
In Framingham, the health department is also encountering more residents, particularly those in lower-income jobs who need to work, not complying with quarantine and isolation rules. Wong said the city is stepping up its support with rental assistance, food programs, and financial aid to help them comply.
Walker, the health director in Western Massachusetts, said they have recently had problems with some employers not being honest about employee infections that appear to have occurred during lunch in company breakrooms.
“It’s clear the vast majority of people are being really careful,” Walker said. “But we are concerned about seeing so many more contacts as it gets cold and people are getting closer than they should, and they are not vigorous with mask wearing, and it’s turning out to be devastating.”