How the NFL and CDC teamed as much as battle Covid-19

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How the NFL and CDC teamed up to fight Covid-19

The result is not final yet, but so far COVID-19 has beaten its peaks in the competition between COVID-19 and professional sports.

Given the highly contagious points of COVID and the close contact between players, it doesn't seem like professional teams stand a great chance. But so far the leagues are winning – big.

From the NBA's zero-fall bubble at Disney World to the NHL's hub cities to the widespread MLB and NFL efforts in the teams' hometowns, the sport has shown how different pandemic response plans work – and don't work .

A recent CDC analysis detailed what the NFL's fall 2020 season can teach Americans about how to deal with the pandemic.

Why is that important?

Professional sports leagues have proven to be an amazing resource for epidemiologists and public health researchers. Take the NFL for example. The 32 clubs faced major challenges during the pandemic when they started their season. The league based its safety measures on CDC standards, including frequent hand washing, wearing masks when possible, routine facility disinfection, and frequent testing.

The league was able to prevail due to its top-down structure, educational measures, Covid-19 test programs, containment plans and strict behavioral guidelines. These were implemented quickly and modified as needed, which has proven difficult or impossible across the country.

The NFL's reliable, well-maintained dataset demonstrated the effectiveness of containment measures, showing that even with good plans, cases can slide through the cracks and how those cracks can be patched to catch more of those cases.

The precautions of the NFL

The NFL faced major challenges early in its season during the Covid-19 pandemic. Their security measures were based on CDC standards and included all major stand-bys: frequent hand washing, wearing masks when possible, regular disinfection of facilities and frequent testing.

KINEXON contact tracing technology was added for an additional layer of security and trained personnel were available to meet all medical requirements. Robust contact tracing was also used to track and maintain potential exposures.

After a single club had 41 cases in late September, the NFL adjusted to even stricter standards, with league-wide testing, contact tracing, and risk assessment measures expanded. Clubs were also required to use what the report calls "intensive protocols" for 7 days after each positive test. This included meetings held exclusively as virtual or outdoors with security measures, removing exceptions to coverage guidelines, interrupting dining in the dining room, and introducing strict occupancy limits for areas such as weight and locker rooms.

The results

Out of 623,000 tests and 11,400 team and staff, there were 329 confirmed cases of Covid-19. As of October 15, there were 189 NFL players and staff counted as high-risk contacts for confirmed cases of Covid-19. 20 of these contacts later tested positive. Seven of the positive results were achieved after the league's mandatory 5-day quarantine period had expired.

Intense protocols reduced the number of close contacts (less than 6 feet for more than 15 minutes) by 60% and interactions longer than 2 minutes by 28%. Cases in October and November increased in line with total US cases, but were primarily attributed to community and household exposures. Despite increasing transmission rates in the community, the intensive procedures were able to reduce exposure in the facilities.

Worrying results

Observations by the NFL challenged one of the principles of Covid-19 mitigation: distances of less than two meters and exposure of more than 15 minutes were the guiding point for "close contact". The CDC's definition was tightened to 15 cumulative minutes over the course of a day rather than just a single encounter in October, but the new evidence suggests that this may still not be rigorous enough.

Logs from the NFL's KINEXON devices confirmed that 7 people tested positive without ever being within 6 feet of an infected person for more than 15 minutes per day. The report suggests that when defining high-risk interactions, additional factors such as the wearing of masks and the environment in which the encounter takes place must be considered.

A ray of hope

The report concludes that "the intense protocol was likely critical in preventing the transmission of SARS-CoV-2," allowing the league to include cases even if they occurred after the mandatory quarantine ended. The authors state that they see the potential for adapting such protocols to facilities such as schools, long-term care facilities, and other critical workplaces.

"Intense protocol restrictions," they write, "can be tailored to any setting to include at least more extensive masking and use of outdoor venues, as well as other restrictions on access, space volume, face-to-face meetings, and mealtime interactions."

Adding such protocols to other tools like vaccines and strong hygiene could help personal interactions and gatherings happen sooner rather than later.

Sean Marsala is a Philadelphia, Pennsylvania-based health journalist. He loves technology, usually reads, surfs the internet, and explores virtual worlds.

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