An application for a medical exemption does not guarantee that an individual may enter a building or other indoor space without a mask. According to the Colorado Department of Education:
A prescriptive set of accommodations is not possible, as the needs of each individual and the circumstances of each activity vary. However, accommodations may be divided into several broad categories:
There are a wide range of masks available, including many designed specifically for athletics created by major sporting equipment manufacturers. These are often made of moisture-wicking fabric and are designed to be comfortable under higher respiratory effort. Prior to considering participating without a mask, individuals with concerns should consult with their physician and try several different models of mask.
Indoor sports pose a higher risk than outdoor activities, and activities that involve regular close contact (e.g. volleyball) are higher risk than those where close contact is less frequent (e.g. track and field). In addition, athletic activities which emphasize coordination and explosive strength (e.g. baseball/softball) may be more tolerable while wearing a mask than activities which require longer periods of sustained exertion (e.g basketball).
Reducing the number of individuals at risk
An unmasked athlete who is unknowingly infected with COVID-19 will create high quantities of infectious aerosol that can travel far beyond 6 feet, particularly in an indoor setting. In addition to other participants, spectators and others in the indoor space are placed at risk. A school or club may consider excluding spectators and other non-participants from the indoor space where unmasked play is occurring.
Maximizing other protections
Maximizing ventilation, including by opening windows and doors, operating HVAC systems at the highest setting, using MERV-13 or higher grade filters, and thoughtful placement of fans, will help reduce the risk of transmission to other individuals in the arena. Increasing spacing between participants (both active and inactive) and between unmasked participants and spectators may also reduce the risk of COVID-19 transmission. However, ventilation and spacing will not fully eliminate the extra risk posed by an unmasked participant, particularly to other participants.
Allowing for informed choice of other participants
Because an unmasked participant who is unknowingly contagious with COVID-19 places other participants at high risk of contracting COVID-19, the rights of other participants to a safe environment may be impinged by an unmasked participant. This may be particularly important in the case when other participants who would be exposed to the unmasked have medical vulnerabilities or have family members with vulnerabilities, that place them at higher risk of adverse outcomes if they were to contract COVID-19. If one or more individuals in an event are unable to wear a mask, participants from both their own team and other teams should be given the opportunity prior to the start of competition to make a personal decision, or a decision as a team, about whether an unmasked participant would place them at unacceptable risk. If individuals or a team choose not to participate due to this risk, leagues should endeavor to make schedule and standing adjustments so that non-participating individuals or teams are not punished.