March 10 2020 An Open Letter Regarding the COVID-19 Outbreaks and the 2020 National Championship Dear AMTA Board and Community, As has been brought to public attention in these recent months, in a unique set of circumstances our community, and the world at large, is facing a quickly escalating outbreak of Severe Acute Respiratory Syndrome Coronavirus 2 Disease (COVID-19). Although in an estimated majority of cases (>80%) the disease presents with only mild symptoms, the disease has been known to present with more serious, life-threatening symptoms in many patients, especially those of older age or with pre-existing health conditions (1,2). As a result, numerous health agencies, including the CDC (2), the NYS Department of Health (3), and WHO (4), have all recognized this situation as an emergency, and have emphasized the need for communities where the virus is spreading to take protect measures in order to limit the spread of the disease to vulnerable members of the community. The disease outbreak in the US is currently not well-contained, and cases continue to increase exponentially (Figure 1). In order to ensure the containment of the outbreak, and slow its growth throughout the community, a rapid response to the disease is necessary. The CDC has issued recommendations for universities to consider postponing large events and gatherings, per the recommendations of local health officials (5), and has recommended that the organizers of large events take proactive measures against COVID-19 spread, or consider cancelling large events, per the recommendations of local health officials (6). As has been reported by numerous US universities this past week, several academic institutions are implementing policies to limit travel to competitive events, and have restricted campus events to small numbers of attendees. The upcoming second week of ORCS tournaments, as well as the upcoming 2020 National Championship, pose a unique situation for the AMTA community. To the students competing in college mock trial, these tournaments are the climax of the competitive season, and success at these tournaments provides many benefits to the teams who compete. However, it must be the first priority of the community to protect the health and safety, both of the competing students, as well as the US community as a whole. Although, at this time it is impossible to predict the future trajectory of the COVID-19 outbreak in the US, it is critical that the AMTA community works openly and transparently to develop a coherent plan for the 2020 NCT championship tournament. While it may be premature at this time to cancel or postpone the event, there are notable risks that the tournament potentially could pose: 1. At any mock trial tournament, students spend the weekend in close proximity to one another, both during trials, as well as in hotel lodging. This environment promotes the spread of disease. March 10 2020 2. According to current estimates, the SARS-CoV-2 virus responsible for COVID-19 has an estimated median incubation period of 5 days, and this period can last as long as 2 weeks (7). While sick students can be encouraged to remain home, a student may not know they are sick until several days after infection. 3. The NCT tournament is an extremely important tournament for teams. If it continues while the disease is rapidly spreading, teams may choose to compete despite the risks. It is critical that in moving forward with the NCT tournament, the AMTA board and the tournament hosts with Loyola University remain up-to-date with the status of the COVID-19 outbreak in the US, the recommendations of the CDC and local state health officials, and consult expert opinions on the situation in order to make safe and informed plans about the 2020 NCT. In addition, it is critical a plan for the NCT is developed as soon as possible, and modified as needed with the development of new information and data, in order to allow teams to make safe and unbiased decisions moving forward. With proper planning, transparency, and caution, it will be possible to ensure the safety of the AMTA community from spreading the COVID-19 disease. Figures (1) - Confirmed COVID-19 cases in US during the 2020 outbreak (Jan 21-Mar 9). Data from 2020 Coronavirus Outbreak in the Unites States, Wikipedia (2020). March 10 2020 References (1) - Wei-jie Guan et al., Clinical Characteristics of Coronavirus Disease 2019 in China, NEJM (2020) (2) - Centers for Disease Control and Prevention, People at Risk for Serious Illness from COVID-19 (2020) (3) - NY State Department of Health, Novel Coronavirus (COVID-19) (2020) (4) - World Health Organization, Coronavirus disease (COVID-19) situation report 50 (2020) (5) - Centers for Disease Control and Prevention, Interim Guidance for Administrators of US Childcare Programs and K-12 Schools (2020) (6) - Centers for Disease Control and Prevention, Get Your Mass Gatherings or Large Community Events Ready for Coronavirus Disease 2019(2020) (7) Lauer et al., The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application, Ann. Interem. Med. (2020)
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