Protecting, Maintaining and Improving the Health of All Minnesotans

January 15, 2021

Via Electronic Delivery

Representative Kristin Robbins

225 State Office Building
St. Paul, MN 55155

Dear Representative Robbins,

Thank you for your January 6 letter regarding Executive Order 20-99 requiring youth, age eighteen and
younger, to wear a face covering while participating in sporting events.

We all want to keep kids, coaches, and officials as safe as possible during practices and games. We
know that this looks different in a pandemic, and that adjustment can be hard for kids and their families.
Our goal is to allow Minnesotans to benefit from sport participation while reducing the risk of COVID-19
transmission.

From June 1 through December 26, there were 9,457 confirmed COVID-19 cases which we believe are
affiliated with sports activities. This is an increase of 8,005 cases (over three and half months) from the
1,452 that were reported through September 9. The number of people recommended to be quarantined
has risen from 3,348 in September to 18,111 in late December. Further, because this number only
counts the household contacts, and does not include contacts on the team or other social contacts, the
number of people recommended to be quarantined is significantly underestimated. The science shows
us that large groups, small spaces, and sports create serious transmission risks, particularly when people
are exerting themselves without wearing face coverings.

The guidance to require masks while participating in sports was developed in consultation with youth
sports associations and with the advice of medical experts. The sports face covering requirement draws
directly from the recommendations of the American Academy of Pediatrics (AAP); a group well-
positioned to advise on the health of children. State guidance provides the limited exceptions where
AAP identifies a hazard to the wearer such as in water sports, wrestling, gymnastics, or cheerleading.
The guidance allows for face coverings to be temporarily removed while wrestling because AAP
identifies that it could become a choking hazard. The mask requirement is also consistent with a number
of other states where masked winter sports, including hockey, have been successfully underway for
weeks.

We have learned a lot about transmission of COVID -19 and the effectiveness of face coverings since the
World Health Organization (WHO) published its initial guidance in May 2020. While the WHO states that
individuals should not wear a mask when playing sports or doing physical activities, such as running,
jumping or playing on the playground, so that it doesn’t compromise breathing, it also advises that

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people always consult and abide by local authorities on recommended practices in their area. The
guidance goes on to say that in countries or areas where there is intense community transmission of the
virus and in settings where physical distancing cannot be achieved, WHO and UNICEF advise decision
makers to apply the following criteria for use of masks in schools (either in classes, corridors or
communal areas) when developing national policies:

• Children aged 5 years and under should not be required to wear masks.
• For children between six and 11 years of age, the decision to use a mask will vary from place to
place, and will depend on several factors, such as the intensity of transmission in the area where
the child lives, local norms that influence social interactions, the child’s capacity to comply with
the appropriate use of masks and availability of appropriate adult supervision, and other factors.
• Children and adolescents 12 years or older should follow the national mask guidelines for
adults.

In addition, the Center for Disease Control (CDC) does not preclude wearing masks, though they
acknowledge it may be challenging to wear while playing, especially for younger children. The American
College of Allergy, Asthma and Immunology notes there is no evidence that wearing a face covering
makes asthma worse.

We acknowledge that it may take a little while for some kids to get used to masks while playing sports. If
someone is having difficulty, they should discuss their situation with their health care provider and
coach. The youth sports associations are communicating to their teams and coaches to start practices
slowly. Moreover, sports associations from other states with similar rules have reported that there were
no negative consequences related to wearing masks and the players adapted quickly.

MDH takes safety very seriously and has included extra guidance to help. Teams and coaches can help
each other in this transition. Athletes should continue to be aware of their breathing and exertion, and
take breaks when needed, especially if dizzy or light-headed. It is also important that a face covering be
changed immediately if it becomes saturated with moisture. As in all circumstances, people who cannot
safely wear a mask due to a medical condition, should not wear one and should consult with their sports
association on what options they have if they don’t mask.

We appreciate that some of these sports do still allow for close contact between players; however, we
continue to try to find the balance between the well-being of our community and reducing transmission
of COVID-19. Our approach of requiring masking to the extent feasible is an effort to reduce both
transmission between the players as well as the overall transmission of COVID-19 in the community. The
masking guidance is in addition to other mitigation efforts that still need to be in place across all sports,
including social distancing wherever possible (sidelines, before and after practice/games, etc.),
screening for symptoms before practices and games, encouraging frequent testing for COVID-19, and
limiting the number of people attending in-person. This multi-layered approach is needed so that all
Minnesotans can enjoy participating in sports activities.

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We appreciate your concerns and for taking the time to share them. We appreciate your partnership as
we respond to the COVID-19 pandemic and appreciate the support of the Legislature and the Governor
as we navigate these unprecedented circumstances together as Minnesotans. Our staff would be happy
to discuss these questions further if that would be helpful.

Sincerely,

Jan Malcolm
Commissioner

CC: Governor Tim Walz

Minority Leader Kurt Daudt
Representative Barb Haley
Representative Jeff Backer
Representative John Heinrich
Representative Sondra Erickson
Representative Matt Grossell
Representative Rod Hamilton
Representative Duane Quam
Representative Eric Lucero
Representative Shane Mekeland
Representative Paul Anderson
Representative Dave Baker
Representative Brian Daniels
Representative Peggy Scott
Representative Glenn Gruenhagen
Representative John Poston
Representative Dean Urdahl
Representative Tama Theis
Representative Peggy Bennett
Representative Paul Novotny
Representative Joe McDonald
Representative Lisa Demuth
Representative Bob Dettmer
Representative Spencer Igo
Representative Jerry Hertaus
Representative John Burkel
Representative Donald Raleigh
Representative Marion O’Neil
Representative Josh Heintzeman