Sports world guarding against COVID-19, prepping for infections: ‘Not a matter of if’
Sports are back and new cases of COVID-19 are sure to follow.
That is not sensationalism. That is truth.
This is not a call to shut sports down. This is an attempt to understand what we’re dealing with.
“For right reasons, a lot of people are scared, confused, worried,” said Kurt Andrews, Sporting Kansas City’s director of sports medicine.
“It’s not a matter of if, it’s going to be when,” said Nick Kenney, head athletic trainer for the Kansas City Royals.
“I don’t care how strict a bubble you try to set up — cases are going to get in,” said Zach Binney, an epidemiologist at Oxford College of Emory University.
The Royals have begun summer camp in preparation for MLB’s July 23 opening day (the Royals’ opener is July 24). Sporting KC is scheduled to leave Sunday for Orlando, the last day possible to satisfy a required seven-day lead time before their first match at the MLS is Back Tournament.
Early indications are positive. As of midweek, neither team had reported any known cases, despite regular testing. That’s a stark difference from many college football programs (more on that later) and a sign that athletes and other employees have taken distancing and masks and other precautions seriously.
We are, in practical terms, not even at the beginning. No games for our teams yet. And the National Women’s Soccer League’s restart, to cite one example, has been rocky.
So we can’t yet know how this will go. Teams and leagues are deploying various processes to keep safe, all of them based on both science and estimation. Many issues are worth examining. We’ll get to as many as we can here.
One distinction Binney makes: The charge isn’t to eliminate positive tests, because that’s impossible. The charge is to eliminate outbreaks and keep case numbers lower with games than they’d be without.
That requires guesswork, but in a blog post Binney used an approximate 5 percent positive test rate so far in the NBA and NHL as a general guideline. Binney dropped that number slightly, so that if the leagues saw less than a 4 percent positive test rate while operating, it could be argued the process is working by not adding risk above what players would be experiencing without a return to competition.
One more distinction, and this is something like a chorus from epidemiologists around the country: By establishing various forms of a centralized bubble MLS, the NBA and NHL are giving themselves a much better chance than Major League Baseball, where teams will travel for road games and live and play home games in communities that in many cases are seeing surging case numbers.
“If you don’t go into the bubble, I think it’s likely that COVID-19 is going to rip through several teams in Major League Baseball,” Binney said. “So do you want that? There are no good options right now.”
Kenney has heard those concerns and does not dismiss the precariousness of players and other employees — including some who are elderly, or in other at-risk categories — moving through their respective communities.
But he said he would not feel safer in a bubble. He referenced mental and emotional health — a real thing, by the way, that doctors list as a negative factor of the bubble approach — and MLB’s heightened protocols.
Those include multiple daily screenings, regular testing of athletes and employees and anyone they live with, monthly antibody tests, isolation areas for presumed positives, mask requirements (except when on the field), staggered training schedules, mandatory cleaning of equipment after each use and distributed packs of hand sanitizer and disinfecting wipes for personal use.
Kenney speaks with audible confidence about how the Royals will operate at stadiums and while traveling, and with uncertainty about how the players will behave when they’re away from the team’s influence.
“(Protocols at the stadium are) not as important as how they handle themselves when they leave here, because they are (in the) ultimate structure here,” Kenney said. “But it’s like sending a kid to college. You can teach him all you want. But is he going to carry it over when he’s on his own?
“That’s our biggest concern: Will these guys be socially responsible to know their actions outside of the clubhouse, outside of the field, outside of the buses, outside of the hotel, outside of the plane? Are they taking care of their business that way?”
Andrews puts it like this: “Don’t do dumb (stuff).”
The bubble is the clearest difference between baseball’s approach and those of other sports, and MLS’ bubble is about more than keeping players out of grocery stores.
Teams will live on separate hotel floors. They will clean their own rooms and never directly contact anyone preparing or serving meals. They will have distancing requirements in meal rooms and even at training. Each room will have an air purifier.
Andrews acknowledged the difficulty in keeping so many from breaking the bubble, and wondered if Florida’s surging case numbers will be enough to scare players into staying at the hotel. Sporting’s luggage will include XBoxes and PlayStations, and each floor will have a game room.
That’s all well-intentioned, and we will soon see how effective these plans are. But certainty does not exist, except in the knowledge that positive tests will happen.
That’s when the true efficacy of these plans will emerge — catching cases early, and then contact-tracing not just those immediately exposed but the next circle of people potentially exposed.
Here’s one more complication: What happens if a player tests negative but shows symptoms? What if that player is a star? How aggressive and proactive will hyper-competitive athletes and teams be?
Because a negative test does not mean no infection.
“Let’s say it’s Alan Pulido and he’s presumed positive; well, he’s ruled out of the game,” Andrews said. “He subsequently isolates, does another test; it’s negative, does another test, it’s negative. So that presumed positive you presume is a false positive, but he’s missed the game.
“So how do you manage those situations? The league and all the teams have to err on the side of caution and not allowing people to play in the game if they’re presumed positive. But that’s probably going to be an issue that comes up eventually.”
No league has determined what would require a team to shut down. Kenney and Andrews said that’s true of their teams, too, and Binney said that’s smart — too many details, from raw case numbers to how close they’re clustered to environmental factors to hospital space and more.
But Binney would like to see at least one missing feature in leagues’ restart plans: an independent public health expert closely monitoring data and empowered to decide when and if a team or league hits pause.
As it stands, the people who would make that decision are the same people with a lot of money at stake.
“If you’ve only got four cases league-wide, that sounds great,” Binney said. “But if they’re all four within five days on the same team, you need to recognize that four is likely to turn into 20 if you don’t shut that down right now.”
OK, so those are the basics surrounding our professional teams’ efforts to start playing again.
We’ve separated the pros from the colleges because their situations are so different. We spent about a thousand words on the nuances of pro sports returning, and we can cover the advice for colleges in just one word:
Don’t.
Binney points to college sports’ lack of centralized authority, and the fact that the athletes are amateurs with little bargaining power. Clemson reported 37 positive cases and continued to practice. K-State reported 14 and shut down, one of many programs to halt workouts because of an outbreak.
“If you can’t do it for summer workouts when no other students are around, how the heck do you expect to pull off a season?” Binney said. “Yeah, I’m just really struggling to see it.”
The issues on campuses are even deeper than that. Ramogi Huma, executive director of a nonprofit advocacy group called the National College Players Association, pointed to a lack of athlete representation and information.
Huma cited a lack of transparency from universities about precautions and risks, and the added complication that politicians and college officials — not health experts — are the ones who are making decisions.
Many college athletes would elect to play, no matter what. Others might opt out. They should have access to more information in order to make more informed choices.
“I would say, weighing everything, I personally feel like this season at the very least should be postponed,” Huma said. “Maybe by next spring.”
Three completely different situations, then, in part because of three very different approaches.
Colleges administer varying levels of testing and precaution, with no recognized and unified protocols.
Baseball is controlling the controllables, and hoping trust covers the rest.
Soccer is leaving as little to chance as possible, hoping that makes up for playing in a pandemic hotspot.
They’re all guessing. Each approach is imperfect. We’ll soon see which is best, and if any are playable.
This story was originally published July 3, 2020 at 5:00 AM.