Reported COVID-19 Incidence in Wisconsin High School Athletes During Fall 2020

Phillip Sasser, MD, MS, Timothy McGuine, PhD, LAT, Kristin Haraldsdottir, PhD, Kevin Biese, MA, LAT, Leslie Goodavish, PA, Bethany Stevens, Andrew M. Watson, MD:

The purpose of this study was to describe the reported incidence of COVID-19 in Wisconsin high school athletes in September 2020, and to investigate the relationship of COVID-19 incidence with sport and face mask use.

Methods: Surveys were sent to athletic directors of all Wisconsin high schools regarding sports during September 2020. The association between reported case rates in athletes in each county and the county general population were evaluated with a weighted linear model. Multivariable negative binomial regression models evaluated the associations between COVID-19 incidence and sport type and face mask use by players, adjusting for the county COVID-19 incidence for each school.

Results: 207 schools that had reinitiated sport reported 270 COVID-19 cases among 30,074 players, for case and incidence rates of 809 cases per 100,000 players and 32.6 cases per 100,000 player-days, respectively. The case rates for athletes in each county were positively correlated with the case rates for the county’s general population (β=1.14±0.20, r=0.60, p<0.001). One hundred fifteen (55%) of cases were attributed to household contact, 85 (41%) to contact outside sport or school, 5 (2.4%) to school contact, and 1 (0.5%) to sport contact. No difference was identified between team and individual sports (incidence rate ratio (IRR)=1.03 [95% CI=0.49- 2.2], p=0.93) or between non-contact and contact sports (IRR=0.53 [0.23-1.3], p=0.14), although the difference between outdoor and indoor sports approached statistical significance (IRR=0.52 [0.26-1.1], p=0.07). 84% of schools required face masks while playing. For those sports with >50 participating schools, there were no significant associations between COVID-19 incidence and face mask use in cross country (IRR=0.71 [0.2-2.2], p=0.52), football (IRR=1.6 [0.6-5.1],

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Notes and links on Dane County Madison Public Health. (> 140 employees).

Molly Beck and Madeline Heim:

which pushed Dane County this week not to calculate its percentage of positive tests — a data point the public uses to determine how intense infection is in an area.   

While positive test results are being processed and their number reported quickly, negative test results are taking days in some cases to be analyzed before they are reported to the state. 


The department said it was between eight and 10 days behind in updating that metric on the dashboard, and as a result it appeared to show a higher positive percentage of tests and a lower number of total tests per day.

The department said this delay is due to the fact data analysts must input each of the hundreds of tests per day manually, and in order to continue accurate and timely contact tracing efforts, they prioritized inputting positive tests.

“Positive tests are always immediately verified and processed, and delays in processing negative tests in our data system does not affect notification of test results,” the department said in a news release. “The only effect this backlog has had is on our percent positivity rate and daily test counts.”

Staff have not verified the approximately 17,000 tests, which includes steps such as matching test results to patients to avoid duplicating numbers and verifying the person who was tested resides in Dane County.

All 77 false-positive COVID-19 tests come back negative upon reruns.

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