A quick note from Dr. Troy Schott: I received this an email from Grapplearts Stephan Kesting. I thought it was excellent and a good set of guidelines that can be applied to all martial arts schools. You can find the complete post here. Below are the guidelines:
Guidelines for Opening Up Jiu-Jitsu Again During COVID-19
Stephan’s note: these guidelines were first published on Chris’s Facebook page, and with his permission I have taken the liberty of reposting them here. I have made some small formatting changes and added titles to some of the phases.
“What has compelled me to share these now are recent concerning posts from academy owners. These owners have decided to open up their academies without a specific strategy for mitigating risk.
I believe teachers are doing this in large part because they are frustrated about not being given a coherent strategy for reopening from the same health professionals that recommended that they shut down in the first place.
This sentiment is totally understandable. However, I strongly believe that reopening should not be approached in an all or nothing manner.
The guidelines below are based upon Trump’s 3-phase plan for reopening America.
The criteria for moving from phase 1 to phase 2, and from phase 2 to phase 3 are the same, namely that either confirmed cases of COVID-19 have been going down, OR the percentage of positive tests is going down if the amount of testing has been increased.
The criterion for getting into phases 4-6 is that there has been no local person-to-person transmission (‘community transmission’) of COVID-19 in the local jurisdiction over the previous 14 days.
These guidelines are just that. Guidelines. They are not intended to provide academy owners a specific strategy for reopening. I am not telling anyone what to do. I am just telling you what I think is the safest way to get the greatest number of people back on the mat as quickly as possible.
These guidelines don’t rely on antibody testing because of two factors…
- Currently the FDA has only approved a handful of antibody tests as being reliable out of the 100+ antibody tests available on the market today,
- We don’t yet have enough information about how accurate these tests are for asymptomatic patients. We can only trust them if you were previously sick AND had your COVID-19 status confirmed with a PCR test.
The take home message here is that a positive antibody test shouldn’t currently be seen as a passport to train outside of the phased system described below. Nor should a positive antibody test be used as proof that the person is safe from becoming infected with the virus.
I will be updating these as new information becomes available and posting them on my page. If you feel that these are informative, please share them.”
Glossary of Terms
RT-PCR (real time polymerase chain reaction): the test used to diagnose a person with COVID-19.
Serology: the test used to determine person has antibodies to COVID-19.
IgM and IgG: types of antibodies produced in response to COVID-19 infection that are tested for by serology.
Emergency Use Authorization: Authorization from the FDA to used unapproved medical testing devices in an emergency to diagnose, treat or prevent serious or life-threatening diseases and conditions.
Phase 1: Preparing Your Jiu-Jitsu Academy for Reopening (No Training)
The purpose of Phase 1 for jiu-jitsu academies is to give them time to prepare for Phase 2. Considerations include…
- Determining solo drill class schedule
- Determining number of staff members necessary to run each class (i.e. someone screening students for entry; someone assisting with routes on and off the mat, and enforcing locker room policy; and the instructor)
- Setting up hand sanitizing stations
- Marking the mats to allow for solo training and determining how many students the mat space will accommodate with the with each student restricted to an 8’ x 8’ square. The 8’ x 8’ spacing is an update from the previously published guidelines, which recommended 6’ x 6’. This is because while federal government guidelines have been consistently using 6 feet of separation as the standard for social distancing, this likely does not take into account the effect of heavy exercise on increasing production of respiratory aerosols.
- Determining routes on and off the mat
- Setting up online sign-ups for solo drill classes
- Setting up instructor-led solo drill (and/or grappling dummy) curriculum
Phase 2: Instructor-led Solo Drills
If the number of new daily COVID-19 cases has been decreasing AND/OR the percentage of COVID-19 tests coming positive is trending downward over the previous 14 days, the academy may open for instructor-led solo drills with 64 square feet of clearly marked mat space separating each student provided that:
1. Every person entering the academy has a normal body temperature for every class he or she enters
- The person taking the temperature should be wearing a mask as they will be in close physical proximity
- Avoid tightly spaced lineups while taking the temperature
- A forehead (temporal) or oral thermometer may be used (a forehead thermometer is better due to no contact)
- Normal temperature will be defined as less than 37.6 °C (less than 99.3 °F). Note that fever is normally defined as a temperature greater than 38 °C (100.4 °F), but it seems logical to have a lower temperature for BJJ given that the normal body temperature changes throughout the day, and a forehead thermometer scanner usually reads 0.5 to 1°F (0.3 to 0.6°C) lower than an oral temperature,which is what thresholds for fever are usually based on.
2. Each person entering the gym must confirm the following checklist items before entering the academy:
2a) No symptoms of COVID-19 within the last 14 days. Check for these symptoms:
- Fever
- Cough
- Shortness of breath or difficulty breathing
- Chills
- Repeated shaking with chills
- Muscle pain
- Headache
- Sore throat
- New loss of taste or smell
2b) No known contacts with anyone testing positive for COVID-19 within the past 14 days. Note that ALL healthcare workers caring for COVID-19 patients would fail this test.
2c) Has complied with the following social distancing guidelines for the last 14 days:
- Staying at least 6 feet away from others during shopping at the grocery store or pharmacy
- Wearing a cloth mask covering the nose and mouth when out in public
- Avoiding “large and small gatherings in private places and public spaces, such a friend’s house, parks, restaurants, shops, or any other place”
- Working from home when possible
2d) Is neither a member of, nor lives with, a member of a population uniquely vulnerable to COVID-19 including:
- People 65 years and older
- People who live in a nursing home or long-term care facility
And people of all ages with the following medical conditions:
- Chronic lung disease (i.e. chronic bronchitis, emphysema, moderate to severe asthma, pulmonary fibrosis, cystic fibrosis)
- Serious heart conditions (i.e. congestive heart failure, coronary artery disease, poorly controlled high blood pressure
- Peripheral artery disease, history of blood clots in the limbs),
- Immunocompromised states (i.e. transplant recipients, persons being treated for cancer, and anyone taking any medication known to suppress the immune system)
- Severe obesity (body mass index [BMI] of 40 or higher)
- Diabetes
- Chronic kidney disease,
- Chronic liver disease
3. No more than one person is allowed into the locker room or bathroom at a time (it’s probably better if students arrived dressed for class or change in their car)
4. Hands must be washed or disinfected with hand sanitiser prior to stepping onto the mat after removing shoes
Phase 3: Possibility for Partner Drills and Sparring
There are two possibilities for phase 3 depending on the availability of widespread and rapid testing near that academy’s location.
Possibility 1. If there isn’t any additional COVID-19 testing capacity in the area in which the academy is located then there is NO CHANGE. We stay in phase 2 until either testing capacity increases OR the requirements for phase 4 are reached.
Possibility 2. If additional testing capacity will become available your area to test asymptomatic persons without specific risk factors for COVID-19 (meaning anyone can get a test for any reason). Easier testing is currently beginning to happen in Los Angeles and hopefully other jurisdictions will follow soon.
If testing becomes easier to obtain then instructors and students may begin sparring IF BOTH partners can confirm a negative COVID-19 RT-PCR test within the previous 24 hours (once the rapid version of the test is available in a testing center near the academy).
Note that it is unlikely that getting a daily RT-PCR test for COVID-19 will be logistically possible or affordable for most students for the foreseeable future. However, it may be possible to obtain such a test 1-2 times per week. This might make it possible for students wishing to spar to agree to 1-2 blocks of time per week for sparring immediately prior to which they could be tested.
Phase 4: Regular Classes with 50% Capacity
Phase 4 is an addendum specifically addressing the unique risk imposed by the very high levels of physical contact in Brazilian jiu jitsu.
The requirement for entering phase 4 is that there has been NO person-to-person transmission (aka community transmission) of COVID-19 over the previous 14 days within the county (if rural) or major metropolitan area within which an academy is located
All instructors and students meeting the criteria specified in Phase 2 above may begin partner training, including sparring.
Class size should remain below 50% capacity.
Students and instructors who live with or are members of a vulnerable population may return for separate classes of instructor-led solo drills (as specified in Phase 2).
Phase 5: Class Size Returns to Normal, Vulnerable Population May Return to Training
Phase 5 is another addendum specifically addressing the unique risk imposed by the very high level of physical contact in jiu-jitsu.
The requirement to move into phase 5 is that an additional 14 days go by after moving into phase 4 with NO cases of person-to-person transmission of COVID-19 days within the county (if rural) or major metropolitan area within which an academy is located.
The best case for this occurring is 28 days after the start of phase 3.
At this point instructors and students who are members of a vulnerable population (or live with someone in that population) may return to partner training, including sparring.
Class size may also return to normal.
Phase 6: Front Line Healthcare Workers May Return to Training
Phase 6 is yet another addendum specifically addressing the unique risk imposed by Brazilian jiu jitsu, and it applies to front line healthcare workers who are directly exposed to COVID-19 in healthcare settings.
The requirement to enter phase 6 is that there are NO local cases of COVID-19 (including those being treated in hospitals) over the previous 14 days within the county (if rural) or major metropolitan area within which an academy is located
At this point healthcare workers previously treating COVID-19 patients may now return to training.
Special situation: Students and instructors with presumed immunity to COVID-19
This applies to students/instructors who
- Were confirmed to have been infected with COVID-19 (via COVID-19 RT-PCR testing)
- Are now recovered
- Are confirmed to carry antibodies against COVID via an FDA approved tests.
Just testing positive for antibodies alone does NOT qualify for someone as ‘immune to COVID-19.
- Currently the FDA has given emergency use authorization to only a handful of the antibody tests (there are more than 100 tests on the market currently). Antibody tests are notoriously unreliable and the FDA has tried to identify the best of them because of the critical nature of the emergency.
- We don’t yet have enough information about how accurate these tests are for asymptomatic patients. It’s probably reasonable to have a fair degree of confidence only in antibody tests from people who were previously confirmed to have COVID-19 (using an RT-PCR test) AND were symptomatic.
The take home message here is that just having a positive antibody test by itself shouldn’t currently be seen as a passport to train outside of the 6 phase system described above.
All instructors and students tested for COVID-19 AND found positive for the virus, then tested for serologically AND and found positive for the antibodies, may train among themselves separately from the other students.
Links for More Information
Below are the source that Dr Chris Moriarty used in developing the above guidelines and referred to in the interview posted above.
Opening Up America Again – the 3 phase coronavirus recovery guidelines released by the Trump Whitehouse.
Pathophysiology and Treatment of Fever in Adults (from UpToDate.com) – a guide to determining if an adult has an abnormally high temperature (requires subscription for full access)
Fever Temperatures, Accuracy and Comparison (From the Unversity of Michigan) – which methods of taking a temperature are most accurate (keep in mind that for COVID-19 purposes methods that don’t involve physical contact are advantageous).
Symptoms of Coronavirus (from CDC.gov) – how to tell if someone might be exhibiting symptoms of COVID-19.
Social Distancing, Quarantine and Isolation (from CDC.gov) – what is social distancing and why it helps.
The FDA’s List of Emergency Use Authorised Tests – not all covid and antibody tests are reliable. Here are the ones that have been given an emergency exemption to be used by the FDA.
People Who Are at Higher Risk for Severe Infection (from CDC.gov) – how to figure out who is in the most vulnerable population.
Chris Moriarty’s Facebook Page – This is where Stephan became aware of his guidelines initially.