Dr. David Chao
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Consensus opinion was the NFL would never start on time or be able to finish without a bubble. Even with football being a contact sport with tackling, blocking and sweating on each other, the naysayers have been proven wrong.
Based on the concept of viral load and how COVID is contracted, I held a minority opinion seven months ago that the league could indeed succeed.
Now that football is the only professional league to play all of its games, what are the biggest lessons the NFL has learned from their daily testing and contact tracing? How can we use that knowledge in our everyday lives? Certainly, COVID is not a hoax and we have to be careful but here are the top clear lessons from the test case of the NFL.
1. There is no need to dodge people down sidewalks or grocery store aisles.
Transient contact has not been shown to spread COVID in the NFL. “Meeting, greeting and eating” are the danger points of disease spread and if one is careful in these three main areas, we don’t need to live our lives in fear or jump away with surprise if you come around a store aisle and come within six feet of someone else.
2. It is safe to start sports youth sports.
There was not a single documented case of spread to an opponent on the football field while playing a contact sport. Players did not wear masks on the field and they did not use the special NFL designed face shield, yet there was no transmission of coronavirus across the line of scrimmage. The risks were on the sidelines, locker room and meetings. Provided that a sport can accommodate these off-field modifications, it is safe to start sports, especially since kids seem to be relatively unaffected. For example, based on the NFL findings, little league baseball is completely safe but the dugout is the concern and kids need to be spread out/masked.
3. Outside is key.
The NFL found no transmission outdoors including at practices. The point here is air circulation is key. Even indoor stadiums based on their large size did not increase the risk of COVID. Free flowing air to decrease the viral load seems to be the key.
4. Travel did not pose a risk.
NFL travel was not linked to increased COVID cases. Planes and buses were not found to be super spreader events. The theory of sharing air in a closed airplane did not prove to be a concern. The high air circulation on planes seemed to provide enough safety. Of course, the league used larger planes and more buses. No one is saying go maskless and sit three across elbow to elbow with strangers who are coughing but with normal precautions, travel seems to be safe based on NFL data.
5. Flexibility and being proactive are the keys.
The NFL showed incredible flexibility by changing COVID rules midseason and even moving games. Their shift to identifying high-risk close contacts and ruling then out for five days changed the landscape. It is important to take the precautions prophylactically and adapt. It seems their five-day quarantine for anyone exposed to coronavirus worked and perhaps schools and workplaces that now require two weeks after travel can show the same flexibility to adapt based on the NFL findings.
Kudos to the NFL. Dr. Alan Sills, the team doctors and the athletic trainers who basically took on second full-time jobs in addition to the rest of their normal work. The extra work teaches us more lessons about how to be careful with COVID.
The league showing unprecedented flexibility and allowing rules changes midseason was key. What the NFL learned in their “science lab” has implications for us in the everyday world. I hope we can follow the science.
Yeah its been political out of the gate all about control and violating peoples civil rights its downright criminal what these govt tyrants have done to ruin peoples business and lives .I remember the H1N1 ten years ago was also a novel c oronavirus nothing I mean nothing was done about it why well of course a different administration is in power. We have found out now these death numbers are not close to being accurate all the false positives on these tests and of course never heard a thing about this years flu cases very strange indeed. Fauchi who has not treated a patient in practice in decades he is just a political hack who sounds like a fool when he speaks.Most people who have gotten this survive just fine just like the flu it affects the elderly with underlying health issues the rest of us are just fine.
Well said, James…the politics behind this is criminal. Here in Maskachusetts, our Rhino Gov has singled-handily destroyed the restaurant business. We gave these tyrants an inch (15 days to ‘slow the spread’) and they kicked the door in and stole our individual liberties that I’m not sure we’ll ever get back…
We went from ’15 days to flatten the curve’ to…’you are going to wear 3 masks forever’.
Thanks Dr. Chao,
Excellent summary and as a fellow physician (IM and ER), I would agree completely with all of your points. I would added that not ONE single case of Covid illness has been linked to playing in an NFL, college, or high school game.
While I am not privy to the NFL’s protocols with regard to antibody testing, i.e., who has acquired immunity to Covid through demonstrated IgG levels, this data would be invaluable in calculating preventive strategy. This seems to be an area that we have also totally neglected as a country, and possibly in professional sports also.
After all, in Pfizer’s initial clinical trials for the vaccine, ALL anticipated participants were tested for existing antibody to Covid, and one of the exclusion criteria was having demonstrable antibodies, hence no reason to be given the vaccine.
We need to know in this country how many people have immunity now through vaccination AND exposure (whether they were clinically ill with covid or just exposed). It’s wasteful and needlessly risky to demand vaccination for people who are immune, but this oddly seems to be the government’s strategy.
Were I advising the NFL (I have worked as a college team physician also), I would urge antibody testing for ALL staff (not just players). Then I would suggest that those without any demonstrable immunity to be prioritized for vaccination, IF they desired it. Those with sufficient levels of IgG – we can assume they have have protection against both illness AND “asymptomatic spread” (something not demonstrated to exist in real world scenarios anyway). Testing one time (or even roughly every 8-12 weeks) for antibodies seems to make a LOT more sense medically, economically, and intrusively than testing your entire population for covid exposure 3-4x per week.
I would also advise any vaccinated persons and anyone with antibodies that there is NO medical need for them to wear a mask. It certainly doesn’t protect the wearer, and the science tells us it almost certainly doesn’t help the general populace if the wearer is vaccinated. When we vaccinated tens of millions of patients against small pox and polio, our govt did not tell everyone “well this probably didn’t do any good, since it’s only 95% effective, therefore you still have to hide in your house FOREVER!”
Thanks!
JWB
MD JD FACP
You forgot DBAP