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All sports were discontinued in 2020 with the arrival of COVID-19. Since then most have been reinstated, albeit without spectators. However, several countries have put together a number of different risk-mitigating strategies to allow spectators back into stadiums. This position statement gives an outline of the minimum requirements that should be considered upon the return of spectators at live sporting events.

Sudden cardiac adverse events remain an area of concern in sport. The precise risk for netball athletes is unknown but the annual incidence of sudden cardiac death in sports is reported at 0.5-2 cases in 100 000 young competitive athletes between the ages of 12-35 years. Cardiac screening in the sport and exercise medicine context aims at identifying pathologies associated with catastrophic events when combined with physical activity. There is an ongoing debate relating to the standardisation of the pre-participatory medical assessment (PPMA). World Netball (WN) commissioned a cardiac screening policy (13 March 2022). The minimum PPMA recommended by World Netball is a history, physical examination, and a resting 12-lead electrocardiogram (ECG). ECGs should be interpreted in accordance with athletespecific ECG interpretation criteria. Expansion of sports cardiology experience and infrastructure, in combination with universal emergency response planning for sudden cardiac arrest, is intended to safeguard athlete health and player welfare in WN.

The lockdown regulations due to the coronavirus pandemic (COVID-19) that broke out towards the end of 2019 and continued to spread throughout most countries in the world had a negative effect on the sporting community. The South African government eased the lockdown rules to Level 1 from 21 September 2020. In Part 2 of this Position Statement of the South African Sports Medicine Association (SASMA), the authors address the position regarding the safe return to sports for athletes who were infected by the virus. An update on clinical manifestations and multi-organ involvement, testing for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), prolonged positive real time polymerase chain reaction (RT- PCR) and the role of quantitative real time polymerase chain reaction (RT-qPCR) in informing return to sports, grading of disease severity, individualised management of infected athletes and graduated return to play guidelines (GRTP) is provided. The authors also share thoughts on athletes with disabilities, immunisation, the using of masks during exercise and utilising biologically safe environments (BSE). Finally the SASMA Guidelines for Safe RTP in Level 1 lockdown during SARS-Cov-2 are introduced.

The COVID-19 pandemic initially led to the shutdown of all sport at a high cost to both the economy and athlete health. As risk-mitigating protocols evolved and were implemented, the playing of sport returned slowly to normal. The introduction of COVID-19 vaccinations enhances the means of protection and risk management for all. This South African Sports Medicine Association position statement provides recommendations for the vaccination of athletes.