After all, when the season started with the opening of the training ground in late July, we were in the middle of Covid-19 peaks across the country, and football is the very definition of a contact sport – contact is one of activities We were urged to avoid to avoid getting sick and delaying the spread of the virus.
Still, here we are: Super Bowl LV with Kansas City Chiefs facing Tampa Bay Buccaneers at Raymond James Stadium, Florida; 25,000 fans present, including 7,500 specially invited (and previously vaccinated) health professionals, sitting next to 30,000 life jackets. Fans will receive PPE kits with KN95 masks when they arrive at the stadium. And yes, even vaccinated fans will be required to use one.
It turns out that many of the lessons learned during a season’s experiment are useful beyond the battlefield and are applicable to society at large.
How we got here
Back in the summer, many wondered how football – with its tackles, huddles, heavy breathing, sweat and spit, crowded lockers and weight rooms, fan applause – could survive an entire season without causing left Covid-19 outbreaks , right and center.
Experts, both in sports and public health, had their doubts.
“Think about the size of the football lineup and the nature of the sport with contact in each move. … It may be unlikely that the NFL will get a full season,” veteran announcer Bob Costas said to Anderson Cooper and me during a city hall in CNN coronavirus at the end of July.
But bubbling was not in the cards. Dr. Allen Sills, medical director of the NFL since 2017, told me that “it was neither practical nor appropriate” to build a bubble like the one in the NBA. Although the entire basketball season could be played in one location, with football, it just wasn’t possible.
When the NFL decided to continue the season, Sills and other NFL officials faced the unprecedented challenge of making football as safe as possible for everyone, from the team to the players and their families.
“I feel it is the right thing to do to try to learn how to live with this virus. I really am, ”said Sills in July.
“This is a struggle that people are facing in all facets of life. Schools, companies, places of worship. Everyone is trying to find out, can we reopen and do some of our activities and still reduce the risk? And I think it is very important that we take the approach of trying to learn how to live with this pandemic in the best possible way, “he said at the time.
Therefore, in collaboration with the NFL Players Association, the CDC and other health experts and consultants, the NFL has developed a plan to move forward. It included mitigation and surveillance measures on the premises and during travel and games. These measures included wearing a mask; regular testing and genetic fingerprinting of the virus for positive cases; physical distance; proximity tracking devices that captured information about who spent how much time with whom; contact tracking; handwashing; and disinfecting the facilities and reprogramming the games, as well as educating employees, players and their families. In all, the plan covered about 11,400 players and employees from 32 teams in 24 states.
On September 10, when the Kansas City Chiefs kicked off the Houston Texans in the first game of the season, there were just under 6.4 million confirmed cases of Covid-19 in the United States, averaging seven days. more than 35,000 new cases a day. That seemed like a lot at the time, but by comparison, the country now exceeds 26 million confirmed cases, with an average of seven days of about 137,000 new cases per day.
But while the cases exploded across the country, the NFL remained relatively intact. According to the MMWR report, there were 329 confirmed cases of Covid-19 between 9 August and 21 November. That’s just 2.9% of the 11,400 players and staff tested – statistics any state would be proud of.
And when results unpublished until January 30 were tabulated, the NFL said, there were approximately 957,400 tests administered with an overall positive rate of less than 0.1%.
Only three people – a player and two team members – were briefly hospitalized and there were no deaths, Sills told me when I interviewed him again for this story earlier this week.
Lessons learned
A key component built into the NFL plan was flexibility – the ability to pivot for a new strategy if a Covid-19 outbreak arose.
“One of the things we all learned in the medical community about this pandemic is that it breaks the rules. It doesn’t follow what we think can happen. And so we had to really try to pay close attention to what our data is telling us and to be willing to bend, adapt and modify our protocols, “said Sills.
Was it a smooth sailing? No. An outbreak at the start of the season forced the NFL to examine the data and change direction slightly.
“In early September, we had an outbreak in Tennessee and we got a lot deeper into it and we tried to understand how the transmission was going despite our protocols,” explained Sills.
“That’s when we started to realize that it wasn’t just 1.8 m in 15 minutes,” said Sills, who noted that not all close contacts are created equal. “And then we started to stratify contacts into what we call high-risk close contacts and just regular contacts.”
This meant that the exposure they needed to limit needed to be expanded to what Sills called “eating, greeting and meeting”.
“Meeting indoors: even if you are more than 6 feet away, if you stay in a poorly ventilated room for a long period of time, if someone is positive, there may be transmission within those rooms. Eat together: Most people do not wear a mask when they are eating. And then say hello: just social interactions outside the premises. When you interact in the community, if someone is positive and you are going to cut your hair or have a massage at your home, “he said.
In response to this new information, several changes across the league have been implemented. The first involved a stricter restriction for seven days when a positive test result was received; the second was the most frequent test; and the third was the expansion of contact tracking and transmission risk assessment that focused on identifying high-risk contacts.
But now, in addition to time and distance during an exposure, high-risk contacts have also taken into account the use of the face mask (including the type and fit) and ventilation of the environment in which the exposure occurred.
“We created this four-part matrix, which said, let’s think about, what is the ventilation state of the exposure? What is the state of the mask of individuals?” Said Sills. “We would also consider how much cumulative exposure time and distance. If you are failing in two or more of these categories, this is what we consider a close contact at high risk.”
The biggest lesson of all, according to Sills? “I think the biggest thing we have learned, which is not shocking for us in the medical profession: universal masking works. It is the most effective strategy we have.”
Beyond football
While the NFL certainly has more resources than most other organizations, the lessons that emerged from the big experiment can potentially be used in other situations.
“When you summarize everything, it’s not the fact that we test every day. It’s not the fact that everyone uses a sophisticated proximity tracking device everywhere they go. What prevented transmission was the use of a mask , personally avoiding meetings, staying outdoors, not eating together, reporting immediate symptoms, isolating anyone who is exposed. None of the things I just mentioned requires a lot of resources, “said Sills.
In other words, they are the same basic rules that we have known since the beginning of this pandemic – with more evidence than ever that they really work.
It’s a lesson you can apply this weekend, regardless of the team you support. Play it safe; do not turn your Super Bowl meeting into a super spreader event – mask, keep physical distance, make sure there is plenty of air circulation and do not dip twice in the guacamole.
Andrea Kane and Nadia Kounang of CNN Health contributed to this report.