In many ways, the NFL entered its third COVID-19 pandemic last week. The first hit during the 2020 season when the league went through a 17-week vaccine-free schedule. The second took place in weeks 1 through 14 of the 2021 regular season, a battle against the Delta variant with protocols that incentivize vaccination. And now, said Dr. Allen Sills, the NFL’s chief medical officer, over the weekend, the league and the NFL Players Association are “fighting a brand new disease in a way.”
The Omicron variant entered the league at the end of week 14, resulted in an unprecedented surge of more than 150 positive cases in week 15, and resulted in the first three schedule changes of the season. The second and third of these games will be played on Tuesday evening, after which the league and union hope that the rest of the season can be played as planned. An early analysis of the league impact of the Omicron variant, which included significant transmission among vaccinated players but few to no symptoms for most, led to a revision of the protocols governing testing and return to play.
Will the changes work? Has the NFL prioritized the games over the health of players, coaches, and the surrounding community? Let’s take a closer look.
What circumstances led to all of this?
The NFL started the season with a vaccination rate of 94% for players and nearly 100% for football staff. Vaccinated subjects were tested once a week and those who remained unvaccinated were tested daily. In the first three months of the season, 110 players and 187 employees tested positive in six test periods from September 5 to November 27.
Towards the end of week 14, the league identified several positive cases caused by the Omicron variant. Vaccinated players were scheduled for weekly testing on Mondays according to previous protocols, and the results as of December 13th were staggering. A total of 37 players returned positive tests that day, and the pace continued. By the end of the week, more players had tested positive than in the past 14 weeks combined, as did several major cities, including New York, reporting similar increases. As of December 13, around 200 players across the league have tested positive for COVID-19, and by Monday evening were north of 150 on the COVID-19 / reserve list.
And all because of the Omicron variant?
Mostly, but not exclusively, according to the league. Preliminary data from genomic sequence tests suggests last week’s surge was “overwhelming” Omicron, Sills said.
Declining immunity and seasonality also played a role. The NFL recently conducted a voluntary antibody study on 527 employees and found clear signs of deteriorating immunity in those who had not received a booster. The league has since mandated that all Tier 1 and Tier 2 employees – including coaches and other soccer staff – receive a booster vaccination by December 27th. Players have been encouraged to, but are not required to, receive vaccinations and booster programs, as per the league’s agreement with the NFLPA.
What else is the NFL doing to address this surge in players?
Put simply, it has partnered with the NFLPA to reduce testing of vaccinated people and speed up the return process for those who test positive.
How does that make sense with such high infection rates?
It’s a fair question. Let’s make the changes one by one.
OK then. What about testing?
From above, it’s important to remember that the NFL, NFLPA, and the wider public health community are trying to evaluate Omicron in real time amid unprecedented speed. Nobody can say with absolute certainty which strategy will work best. These are all educated guesses.
With this in mind, the NFL and NFLPA decided to end the weekly testing of vaccinated players and coaches and introduce a random cadence not dissimilar to their drug tests. The new protocol does not specify how many such people will be tested per week, but does include “a sample selection based on position groups and personnel cohorts,” as decided by the League’s Health and Safety Bureau.
If a vaccinated player or staff member reports symptoms, they must also be tested.
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Wouldn’t this approach overlook many positive cases?
Simple math tells us that there will be more unidentified asymptomatic cases in NFL buildings as long as the omicron surge continues. But the type of previous Omicron cases should also be taken into account. Sills said more than two-thirds of the total positive cases were asymptomatic by week 15. Most of the remaining cases showed mild symptoms.
In an anecdotal example, Dr. Tony Casolaro, the Washington Football Team’s chief medical officer, said only two of the 23 players who tested positive last week had symptoms significant enough to miss training if it was a non-COVID-19 Disease acted.
The desired result is obvious: fewer tests in theory lead to fewer players being sidelined. The question is whether those with unidentified asymptomatic cases would still be contagious. Since March 2020, of course, much of the public health response to COVID-19 has centered around the dangers of asymptomatic or presymptomatic spread.
The NFL did not respond to questions asked Monday about the possibility. Zachary Binney, epidemiologist and assistant professor of quantitative theory and methods at Oxford College, Emory University, said that mild or no symptoms in general “correlate with lower viral load, which in turn should correlate with lower risk of transmission – but not zero risk”. . “
Sills said the NFL and NFLPA are “trying to test smarter and more strategically.” He added, “We have always said that we don’t really want to get people onto the pitch or into the locker rooms or anywhere when we think they are at significant risk of passing the virus on to see how.” people become infected. Point.”
How does the NFL know if vaccinated players have symptoms?
You are obliged to provide self-disclosure. “We emphasize personal responsibility,” said Sills. “We ask every person, player, coach or employee to be honest and report their symptoms.”
How will it be faster for marginal gamers to test logs?
Up to this point, vaccinated players and coaches could return if they tested negative twice with at least 24 hours in between, as long as they had no symptoms. Unvaccinated players who tested positive were given 10 days off. In most cases this was a distinction without a distinction. Only about 20% of the vaccinated players who tested positive were able to return in less than 10 days.
Since the end of last week, the new protocol no longer requires a negative test. There are now a number of new combinations of single negative tests and cycle thresholds (CT) that can theoretically bring a player back as early as one day after a positive test.
Can it really go that fast?
A day is tedious unless it’s an asymptomatic test found just before the infection ends. But early signs suggest that this protocol change could speed up the overall process, at least for some. Los Angeles Rams recipient Odell Beckham Jr. was released for return four days after testing positive. Rams cornerback Jalen Ramsey was evicted in six days. But many players, including Cleveland Brown coach Kevin Stefanski, had still not returned a week after testing positive. That’s why Stefanski missed the Browns catch-up game against the Las Vegas Raiders on Monday night.
Many teams had positive tests last week. Why were only three games postponed?
The league focused on outbreaks at the Rams, Browns, and Washington. Of course, players, coaches and fans of their opponents were not happy with the accommodation. But Sills said the decision to postpone their three games was based on medical, not competitive, reasons. In fact, after rescheduling, some players were able to test from within the logs, but most couldn’t. The Browns, for example, took the field Monday night with 18 players on their COVID-19 list, including quarterback Baker Mayfield and backup Case Keenum, who left Nick Mullens as their QB.
“Our job is to make sure we feel safe, that we understand the outbreaks that have occurred on these teams,” said Sills.[and] that we have put our arms around the broadcast and feel that we can safely get players, coaches and staff onto the field “before the game, after the league ordered them to hold virtual training sessions and meetings.
Shouldn’t they have given up?
No. The NFL told teams in July that losing money was an option if a game couldn’t be postponed and the outbreak came from an unvaccinated player. Neither of these situations meets both criteria.
What about the rest of the intense logs?
The NFL is urging teams to continue the new protocols at least until early this week. These include wearing masks in the team facility, holding virtual meetings when possible, and eating separately. Sills said the league will re-evaluate the intense protocols as the season progresses.
Will it all work?
The only honest answer is that nobody knows. Even with the new test cadence, other NFL players (47) tested positive on Monday than on the previous Monday (37). It seems that the new protocols will marginalize fewer people and accelerate the return of those who have been sidelined. However, there is at least some additional risk of undetected transmission within team facilities and reasonable variance in results on an individual basis. The Omicron variant has been in the NFL for less than two weeks. It is clear that the protocols will evolve.