Bio‐secure bubble during the COVID‐19 pandemic to host the Asian Football Confederation (AFC) Champions League: A retrospective observational study

BACKGROUND AND AIMS: To describe the COVID‐19 positivity rate among football players, team staff, and local organizing committee members participated in the Asian Football Confederation (AFC) Champions League (West) tournament organized with the Bio‐secure bubble protocol in place. METHODS: A retrospective observational study was carried out to include a total of 2184 participants during the AFC‐West tournament in Qatar, which was a 3‐week event (September 14–October 3, 2020). This event was undertaken under the Bio‐secure bubble protocol, which was developed and implemented for sports events in Qatar during the pandemic. Within 72 h of departure and upon arrival in Qatar, all participants underwent reverse‐transcriptase polymerase chain reaction testing (RT‐PCR) to diagnose COVID‐19. The test was considered positive based on the cycle threshold (cT) value which was <30, whereas, reactive if cT value was ≥30 and <40, and negative (cT > 40). RESULTS: Of the 2184 participants (528 players, 388 team staff, and 1268 local staff), 916 international participants were tested for COVID‐19 PCR upon arrival at the Hamad International Airport, whereas the local staff (n = 1268) were tested 2 days before entering the bubble. The mean age of the players was 27.5 ± 9.8. Fifteen teams participated and as many as 60 matches were played over 3 weeks. Most participants tested negative (95.3%) and 3.9% tests were inconclusive. During the entire tournament, the positivity rate was 2.7% among all participants. Of the total positive cases, 0.8% were positive before entering the bubble system. The remaining (1.9%) tested positive during the tournament phase (19 players, 16 team officials, and 8 organizing committee staff). CONCLUSION: Bio‐secure bubble protocol operated in a controlled environment presents a minimal risk of COVID‐19 infection for hosting international football events. This framework could be benchmarked to resume professional football competitions under unprecedented pandemic situations.