David Chao, MD: With Agreements In Place, It Is Now On Players to Comply

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What a difference a week makes. Exactly seven days ago dissenting tweets about protocol (like this from Drew Brees) were everywhere. 

Now that there is agreement between the players and the league it is time to hope for acceptance — and thus compliance — to what is safest.

We wrote last week that the arguments were silly and in the end, the players and league were aligned for the regular season. We also remained confident that the season will start on time — which has been stated on Clay Travis Fox Sports Radio show since March.

Certainly, the NFL/NFLPA didn’t just start on a COVID safety plan last week, but as expected, there has been significant progress in terms of getting agreement between the league and the union on the key issues.

The public focus has been on the elimination of preseason games, daily testing and opt outs but the really big issue is the agreement that contracting COVID can be considered a non-football injury (NFI) and players could lose salary. 

It became a foregone conclusion that the preseason games would go away. With the refusal to report early and the need for five days and two negative tests to enter the facility added to the practical delays plus the need for an acclimation period to reduce risk of injury, there was no time left for preseason games. No one loves the preseason contests but with the elimination, look for sloppiness in the early season games on and off the field.

Daily testing was agreed to but will only be for two weeks. It will drop back to the NFL requested every other day after that. If the positive test rate remains greater than 5%, daily testing stays. However, if after the initial 150-200 positive tests that we expect, there remains anywhere near 1 in 20 players being detected as new on a daily basis, that team would be in full quarantine and the league would face shut down.

A player opt out is available and Laurent Duvernay-Tardif the only player/doctor in the league has taken that path. He is doing it for unique reasons and I don’t believe there will be a lot of other followers. 

The agreement on the NFI issue is key for several reasons. No, I am not taking the owners side on this, but will explain why this decision is not the NFLPA caving in but the realization that this is best for all parties. Why else would the union agree to the potential of lost pay?

If a player tests positive, on return to the team, that is now consider NFI and unrelated to football activities with the potential forfeit of pay. However, players don’t get paid in the preseason except for a modest stipend and the anticipation is that positive players will be ready well before six weeks when meaningful games start.

If a player tests positive after the initial screens, the assumption is it was contracted through football activities and a player would not loose salary. However, there is a big agreed upon loophole. If a team believes a player contracted COVID from irresponsible behavior outside of the team including going to a crowded bar, they can enact NFI and not pay the player. 

This has caused some surprise from players tweeting “Can’t be serious (emoji)” and “Nobody said anything bout some clubs !!!” 

This shows a continued fundamental lack of understanding about the viral load  and how CoronaVirus is transmitted. My belief is the NFLPA agreed to this term in the belief it is best for it’s players and the game of football.

There is no question that players are more vulnerable to contracting COVID in the public away from the team facility (or even on game day) where everyone is tested. There was talk of fines to promote compliance, but that is like a parking ticket. This concession by the union gives teeth to the enforcement by losing salary. This shows the NFLPA leadership is vested in the importance of this concept. They recognize the vital importance to social distancing to have a season. It indicates a willingness to penalize a few of it’s non-compliant members for the greater good of the rest.

Great to see that both sides came to such quick agreement, but there is a big difference between that and acceptance from players. If players don’t buy into this concept, they will continue to jeopardize this season. This is where social media plays a role. A NBA player is in some “trouble” due to a picture indicating he was at a strip club while out of the bubble.  The ready availability of cell phone cameras might help as a deterrent. I hope it doesn’t just drive players to gather in private homes, which by the way has a 15 person attendance limit or a player still risks NFI if contracting CoronaVirus.

If players can agree, and comply, the 2020 season should be just fine.
Those are still big if’s.

Written by Dr. David Chao

David Chao, MD -- known digitally as Pro Football Doc -- is an expert contributor for Outkick. Chao spent 17 seasons as the team doctor for the San Diego Chargers (1997-2013) and is part of the medical team at OASIS in San Diego where he treats and specializes in orthopedic sports injuries, working with high-profile professional athletes from the NFL, NBA, and MLB.


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  1. Thank you, Doctor…looks like the NFL/NFLPA are moving in the right direction.
    But this NFI, which I wonder how many players even get the implications of, is going to be a big stumbling block once the season gets under way. Traditionally teams would celebrate after games, especially the younger, single guys. Not all states are in lockdown mode, so I could see quite a bit of NFI issues as the season progresses. Just a thought. Thank you!

    • I think it will be vital for the veteran players to buy in and set example and “peer pressure” the young guys to celebrate responsibly. I know it won’t be easy. Not sure how I would have handled it at the age of 23. Lol. Thanks for reading.

  2. Great stuff Doctor.

    I’m curious how the lack of practice and contact by NFL players going full speed will actually cause more injuries?

    Only 14 padded practices in 21 days this year. No preseason games or inter squad practices at full speed translates to what? Sloppy play. Sloppy dangerous play?

    Preseason games and early regular season NFL games have been hard to watch for several years, but now we have even less practice (none this year in the off season).

    Have injuries been going down in the last decade; or going up? Athletes stay in shape all year generally, but full contact can’t be duplicated.

    Practice prevents injuries?

    Especially the serious injuries that cost a player more than a few games and even a full season or more.

    • Really good question, Chris. While I agree reducing preseason games is probably better for overall player health, I wouldn’t think reducing practice time in pads would be the same. That time is controlled contact for players getting back into “football shape”. You can be in great physical condition, but full contact shape is a different matter altogether.

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