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

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The score isn’t final yet, but so far in the contest between COVID-19 and professional sports, COVID-19 is getting its spikes smacked.

Given COVID’s highly infectious points and the players’ close contact, it might not seem like professional teams had much of a chance. But so far, the leagues are winning – big. 

From the NBA’s zero-case bubble in Disney World to the NHL’s hub cities and the more widely dispersed efforts of MLB and the NFL in teams’ home cities, sports have shown how different pandemic response plans do– and don’t– work. 

A recently-released CDC analysis detailed what the NFL’s fall 2020 season can teach Americans about managing the pandemic.

Why does this matter?

Professional sports leagues have proven to be an amazing resource for epidemiologists and public health researchers. Take, for instance, the NFL. Its 32 clubs faced serious challenges launching their season during the pandemic. The league based its safety measures on CDC standards including, frequent hand washing, wearing masks when possible, routinely disinfecting facilities, and frequent testing. 

The league was able to enforce because of its top-down structure, education measures, Covid-19 testing programs, containment plans, and strict behavioral guidelines. These were quickly implemented and modified as needed, something that has proven to be difficult or impossible to do in the country at large. 

The NFL’s reliable, well-maintained data sets demonstrated the effectiveness of containment measures, showing that even good plans allow cases to slip through the cracks and how to patch those cracks to catch more of those cases.

The NFL’s precautions

The NFL faced serious challenges starting their season during the Covid-19 pandemic. Their safety measures were based on CDC standards and included all the main standbys: frequent hand-washing, wearing masks whenever possible, regularly disinfecting facilities, and frequent testing. 

KINEXON contact tracing technology was added for another layer of safety, and trained staff were on-hand to handle all medical needs. Robust contact tracing was also used to track and maintain potential exposures.

After a single club had 41 cases in late September, the NFL pivoted to even stricter standards with league-wide testing, contact-tracing, and risk assessment measures all expanded. Clubs were also required to use what the report calls “intensive protocols” for 7 days following each positive test. These included meetings being held entirely as virtual or outdoor with safety measures, removing exceptions to face covering policies, suspending dining in the meal room, and instituting strict occupancy limits for areas such as weight and locker rooms. 

The results

Out of 623,000 tests and 11,400 team and staff members, there were 329 confirmed cases of Covid-19. After October 15, there were 189 NFL players and staff members counted as high-risk contacts of confirmed cases of Covid-19. 20 of those contacts later tested positive. Seven of the positive results came after the league’s mandatory 5-day quarantine period ended.

Intensive protocols reduced the number of close contacts (less than 6 feet for over 15 minutes) by 60% and 2+ minute interactions by 28%. Cases in October and November increased in line with overall US cases but were traced primarily to community and household exposures. Despite rising rates of community transmission, the intensive procedures were able to decrease in-facility exposure.

Troubling findings

Observations from the NFL challenged one of the tenets of Covid-19 mitigation: that distances of under six feet and exposure for over 15 minutes were the guide point for “close contact.” The CDC’s definition had been tightened in October to 15 cumulative minutes over the course of a day instead of only in a single encounter, but the new evidence suggests this still may not be strict enough.

Logs from the NFL’s KINEXON devices confirmed that 7 people tested positive without having ever been within 6 feet of an infected person for more than 15 cumulative minutes per day. The report suggests that definitions of “high-risk” interactions will need to account for additional factors such as mask-wearing and the environment the encounter happens in.

A ray of hope

The report concludes that “the intensive protocol was likely critical in preventing transmission of SARS-CoV-2,” allowing the league to contain cases even when they arose after mandatory quarantines ended. The authors explain that they see the potential for protocols like this to be adapted to settings like schools, long-term care facilities, and other essential workplaces.

“Intensive protocol restrictions,” they write, “can be tailored to each environment to include, at minimum, more extensive masking and outdoor venue use and further restrictions in access, room volume, in-person meetings, and mealtime interactions.”

Adding such protocols to other tools like vaccines and strong hygiene could help lead the way to in-person interactions and gatherings returning sooner rather than later.

Sean Marsala is a health writer based in Philadelphia, Pa. Passionate about technology, he can usually be found reading, browsing the internet and exploring virtual worlds.

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