Keeping clubs clean and safe: We can’t afford to get it wrong
By MIKE HEGARTY and ALAN THATCHER
As squash clubs and federations make plans to reopen facilities – and some already have – I am publishing this article to make readers aware of the huge risks involved at every stage of such operations. The intention is not to scare anyone, but to arm squash’s decision makers with important information as the game works out how to end the Coronavirus lockdown and provide a safe return to competition for recreational and professional players.
The Coronavirus, we are told by many medical experts, is here to stay for a long time.
Therefore our safety protocols need to be thoroughly and fastidiously applied.
Any slips, any failures to maintain hygiene standards could lead to illness and death.
The WSF and PSA are working together to produce a set of guidelines to help clubs and federations conduct a safe return to play, for recreational player and professionals, while following government instructions.
Returning to play is not the priority; avoiding viral contamination is.
The author of the following paper, Mike Hegarty, from the Lexden Club in Colchester, is making a phenomenal contribution to this vitally important debate.
Later this week Dr Ferez Nallaseth will offer a multi-dimensional critique of the impact of the coronavirus and how it will determine plans to return to the courts.
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Some simple facts to begin with
MIKE WRITES: The coronavirus does not enter the body through the skin. Like any other surface, you can carry the virus on your skin but it won’t penetrate your body.
It’s safe to assume the virus will remain on surfaces for around three days, then the amount of it will start to drop off pretty rapidly.
It needs to get onto a mucus membrane to be able to get into the body. Eyes, nose, mouth, throat, lungs. If it’s on you and you touch your face or wherever, that’s how it gets in.
It does not automatically transmit from person to person just by being in close proximity. It has to be carried.
The virus is carried on particles. Most often these are ‘fomites’ – particles of material where the virus can settle. It will also transmit through aerosolised moisture particles, such as those from coughing or sneezing.
The virus is most likely to spread through contact. You get it on your hand, touch another surface like a door handle, it gets onto someone else, they touch their face etc etc…
How the virus moves
The virus ‘walks’ much better than it ‘flies’. It definitely can fly over short distances, though.
Once it’s in you, the virus multiplies in the respiratory tract. It doesn’t spread in the lymphatic or other circulatory systems. It relies on you ejecting particles it can attach to, such as through coughing or sneezing. Or wiping your nose or mouth for example.
A small dose of the virus might not be enough to infect you. The key phrases are ‘viral load’ and ‘infectious dose’ – meaning it has to be at a significant exposure for it to overwhelm your immune system and take hold. We are not talking about being completely virus-free. We just have to keep the ‘viral load’ down. The reason COVID is so infectious is because it doesn’t take much to infect a person, partly because there’s no immunity in the general population (herd immunity) and partly because it’s just a particularly nasty strain. But it still can’t infect you at a low enough dose.
So the two things you can do are, break the chain of ‘walking’ spread, and stay far enough away to prevent ‘flying’ spread.
‘Walking’ Spread
Viral particles will piggyback travel on other particles ejected from the respiratory tract and will be carried or settle on wherever someone coughs or touches etc after wiping their face.
Viral particles need to attach to other matter to travel around.
Viral particles are bound in place on other particles by lipids (fats).
Soap / detergent / hot water will break up those lipids and let you wash those viral particles down the drain.
Sanitiser will denature the virus to the point where it can’t infect anyone. Soap and water is still safer. Sanitiser evaporates possibly before it can ‘kill’ enough of the virus to lower the infectious dose, but it’s far far better than nothing. Killing the virus and leaving it in place isn’t as guaranteed as washing it away.
Stopping contact between surfaces with significant viral load is key to stopping the virus ‘walking’ around.
‘Flying’ spread
We know now that the virus can aerosolise. So it can be ejected from the respiratory tract by coughing / sneezing etc. The jury is out on heavy breathing but logic suggests it’s very probably a transmission route.
There is a significantly lower risk when outdoors as aerosolised particles will be blown away by the breeze and separated to below the infective dose. Indoors, we are looking at a bit of a nightmare.
Face masks limit the distance those particles will travel. We’ve all seen the numpties in supermarkets who have no clue how to fit and seal a mask to their face and spend most of their time pretending they are in a Steven Seagal movie.
‘Walking’ spread is still far higher risk, but face masks diffuse the travel of viral particles. Outside of the medical profession it’s only a distance thing, nothing more.
That’s really about it for ‘flying’ spread. If you’re in the cloud you’re in the cloud. Keep it off your face if you can (and never touch your face) but if it gets there then there’s not much can be done.
If those ‘flying’ particles have time to settle then they become ‘walking’ spread and there’s more you can do with cleaning.
How to stop the virus spreading in squash clubs
‘Walking’ spread can be limited by regular cleaning. Get the virus off your surfaces.
Mandatory changing: Ideally this would be at the club door but the changing room will work, assuming you can get your club entrance as close to the changing room as possible. The changing room has to become the barrier between ‘outside’ (assume virus everywhere) and ‘inside’ (safe zone). Get everything that has been exposed to ‘outside’ off of people as early as you can. That will make your cleaning more effective inside the building. Reduce the amount of work that cleaning has to do.
Gloves are NOT the answer: They encourage spread because people are happier to touch things believing they themselves are ‘safe’. The virus can’t penetrate skin, so again regularly hand wash with detergent and wash the virus off.
There’s no science in the virus spreading through sweat: The virus multiplies in the respiratory tract. Sweat glands are totally separate. If people are off court and slobbing around, sweat is a fantastic indicator of how far and wide they can spread the virus if it’s on them but sweat itself doesn’t spread COVID.
‘Flying’ spread: There’s no way around this. If you’re on court with someone breathing heavily in a poorly ventilated box, you’re going to run through clouds of virus carrying particles. Mask or no mask etc etc the air isn’t moving. You’re getting covered in it.
A safe distance of two metres assumes nobody is sprinting around and breathing heavily. That safety guideline works in supermarkets but just does not work for squash.
You’re not going to be able to help being infected by the other person. That’s just a fact. You can definitely stop the spread to others.
Cleaning: Firstly, cleaning everywhere you’ve touched. Court walls can’t be cleaned. They are too porous, it’s an impossibility. But also porous materials will hold onto the virus a bit more than smooth surfaces. Door handles and other touch points can be cleaned.
Showering: There’s a lot of belief that showering encourages people to hang around so should be restricted. It won’t prevent ‘flying’ spread but it will be the best thing you can do to prevent ‘walking’ spread. If you’ve just come off court and are covered head to toe in virus-carrying particles, you may have been infected yourself but you just might not have … so wash all that nastiness off before it gets into you. Plus the risk to the rest of the public if you’re covered in virus and get in the car or worse, on the bus, is massive.
So realistically what works: Solo practice will work – as long as you can ventilate your courts and get rid of ‘flying’ spread between players… Cleaning can get rid of ‘walking’ spread.
As soon as two players get on court with each other the risk shoots up exponentially. You can maybe reduce spread to others outside of those two players but there’s just no getting around it.
How do clubs reopen?
You have to look at it in terms of squash amongst the wider population. An average club may have less traffic through it’s doors on a given day than one town bus. So it’s about the infection rate in the population rather than about individuals. Sorry, that’s horrible but if you look at squash from any other angle there’s no argument. We are the very highest risk of spread.
Because clubs can’t stop direct 1:1 spread, it then becomes about protecting the wider membership in line with government macro scale, population-wide measures.
It’s important to wait for a framework to be published from respective national authorities, but the plans I’m preparing for personally are:
Plan A is for clubs to be able to reopen with capped numbers in the building at any one time – so everyone is on a time limit. We don’t know what that numbers cap might be yet so it’s impossible to expand. But mandatory changing (keep the virus out), touch point cleaning (reduce the viral load), leaving or showering (stop the virus spreading) would be key priorities.
Plan B is for players to nominate two or three players in a ‘bubble’ they can play or train with. And that’s it. Nobody else. Any infection spreads among those players and is isolated from the rest of the membership. Squash is a massive risk so it’s a prevention. And it allows coaches to operate from the balcony.
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Coming up next this week: Dr Ferez Nallaseth looks at the wider implications of the coronavirus and how squash clubs should approach reopening facilities with the utmost caution and be aware of the risks to health.
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