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The NFL says it expects to hold its season on time, with fans present. The league’s executive vice president/general counsel, Jeff Pash, said on multiple occasions during a March 31 conference call that the league is expecting that normalcy to remain and the season not to be delayed.
That is increasingly unlikely, and appears both an unrealistic and unsafe goal by the NFL at this juncture. California governor Gavin Newsom rejected the idea that the NFL, or any league, could return to play games in front of fans in August or September.
The NFL already decided on April 6 to move to a fully virtual draft after proposing a 10-person war room setup on that March 31 conference call, evidence that what they expect and state they plan to do is subject to rapid change.
As reported by the LA Times’ Rong-Gong Lin, Santa Clara executive officer Jeffrey Smith does not see that as a possibility either, saying he does not expect, “any sports games until at least Thanksgiving, and we’d be lucky to have them by Thanksgiving. This is not something that’s going to be easy to do.”
That would mean 49ers cannot play games, even in an empty stadium. There is every reason to believe those analyses by Newsom and Smith are actually conservative estimates.
In a phone conversation with Amesh Adalja, M.D., Senior Scholar at the Johns Hopkins University Center for Health Security, and member of the NCAA coronavirus panel, Adalja told KNBR that the only thing that can provide certainty of safety for a mass gathering event like a concert, movie, or sporting event, is immunity or a vaccine.
Could that be by September? No.
“We’re not going to have a vaccine at that time,” Adalja said.
Adalja said there are currently at least two vaccines in phase one clinical trials, which is “the quickest we’ve seen that happen in history.” But that doesn’t mean you should expect a viable vaccine any time soon.
Vaccines need to be tested in multiple phases which ensure safety, effectiveness, proper dosages, and testing enough subjects in trials to understand the risks involved. Usually, Adalja said, that takes about a year, “if you went as rapidly as possible and assume that there were no complications in the clinical trials.”
But that doesn’t incorporate the reality of manufacturing this vaccine on a monumental scale. As Adalja said, “with this pandemic, basically the entire world needs to be vaccinated. So, it is going to be a major manufacturing challenge.”
Adalja’s said that an 18-month window of widespread vaccine availability is “probably optimistic and could really only be achieved under the best conditions happening all the way through all the clinical trial data.”
There’s also the problem of the nature of coronaviruses fall and winter. Adalja said that we could experience something of a break in the summer if the virus is altered by our environment, but that coronaviruses have a tendency to flare up in fall and winter months. He reaffirmed that a vaccine is the only way to stop this type of virus, which he said won’t be available for over a year.
“It will likely find the fall and winter months conducive,” Adalja said. “There is no way to stop from from having a reappearance in the fall. That’s just what coronaviruses do. They peak in the fall and winter, and they decrease their transmission in the summer. The only way to stop this virus is with the vaccine.”
But what about herd immunity? What if enough of us get the virus, and then we can go on living normally?
That would be require about 60 percent of the population contacting the virus, Adalja said, based on COVID-19’s transmission characteristics. More importantly, to achieve that, we’d be collectively sacrificing the most vulnerable portion of our population. The United Kingdom abandoned its plan to create herd immunity that way because, as Adalja pointed out, you cannot compartmentalize a portion of society, and you may well overrun hospitals as you wait for that immunity to develop, letting thousands die by design.
But what about MLB’s plan? Why can’t we just put teams in a bubble together? Aside from the fact that it would require total compliance on the part of players, coaches, staff, etc. to not come into contact with their families for, in MLB’s case, four-plus months, there are numerous logistical challenges.
In terms of sports like tennis or golf, where social distancing can be practiced, Adalja said, there is viability for them to return, without fans, sooner rather than later, in a relatively safe fashion. But contact, or close-quarters sports like baseball, soccer, football, basketball, etc. don’t fall into that category.
Rapid, almost instant testing wouldn’t be viable because of the virus’ incubation period of 14 days and the potential to test negative even when carrying it.
Unless the leagues were to only use immune players, everyone would have to accept the risk that they could catch the virus. That would mean not rostering, or temporarily sidelining your best lineup.
In MLB’s plan, that would not affect the season, and it’s why expanded rosters would be used.
“There’s no way that they can play this season without risk of coronavirus transmission, unless they only use players that are already immune and don’t have fans, and all of the people that are on the sidelines are also immune,” Adalja said. “So there is going to be some level of risk.”
That could actually be the right approach for these leagues, Adalja said, but it will require a substantial, open discussion about what an acceptable level of risk is, especially with many coaches, staffers and front office people in the high-risk groups. Players would effectively have to accept the risk they could catch the virus by playing. Would insurance companies cover them if they do? That’s all unclear.
So when might we actually be getting mass gatherings, like sports back with fans present?
“I think it’s probably going to be next summer,” Adalja said. “Mass gatherings, I think, are really going to require a vaccination in order to be completely safe and not overly burdensome to healthcare systems.”
Richard Gleason, M.S., is a senior lecturer at the University of Washington, who is a Certified Industrial Hygienist (CIH), Certified Safety Professional (CSP), a Certified Hazardous Material Manager (CHMM) and a Certified Environmental Trainer (CET). Gleason said in a phone call with KNBR that it’s unlikely between now and September that we would be able to institute proper testing and vaccine production.
Gleason suggested that major sports leagues may have to take a similar approach to that of the Japan 2020 Olympics, which was postponed to 2021.
What do we do until then? How do we get back to normalcy? What about the restaurants, local businesses, etc.? Adalja said a change in how the public perceives risk will also be necessary. Until there’s a vaccine, people have to be willing to catch the virus in order to go to any event.
It will be a “layered” approach, Adalja said. Start by expanding hospital capacity, ensuring adequate numbers of staff and equipment (ventilators, protective equipment like masks, gloves, face shields, etc.). Increase rapid diagnostic testing, preferably rapid testing in all available health locations like doctor’s offices, urgent care centers, hospitals, etc. Fund health departments so case contact tracing (finding out who COVID-19 positive patients have been in contact with) is viable for a large swathe of cases at any given time.