If there was ever a doubt the NBA is a Black league, its head doctor is a man named Leroy Sims.
Yes, he’s Black.
Dr. Sims was the physician of the Golden State Warriors, so he was able to catch up with Stephen Curry at the All-Star Game in Atlanta where they discussed recent developments. Dr. Sims has been on calls with teams and players across the league, answering questions and presenting information. With the COVID-19 vaccines out, there’s been plenty of questions and information to disseminate.
As the NBA hits the one-year mark from its March 11 shutdown, Dr. Sims spoke with Yahoo Sports about that day last year, the incentives for players being vaccinated and the concept of “herd immunity.”
This interview has been condensed for clarity.
Q: With the March 11 anniversary coming of the work stoppage, do you have any recollections of March 11? And just how fast or how slow everything went that day?
A: Yes, I do. That was a particularly tough day, knowing the impact of what a positive test could mean, for our game. And we were so early on in the process, with where testing was, and masking and everything from a public health point of view. And we were just getting a lot of information very quickly. So knowing that we were in the position that we were in, things went, as you said, both fast and slow that day. But a lot of decisions had to be made. And really from the point that we did have to decide to stop play, we really just did what the NBA does. And we started looking forward to, what's coming, what information do we need? And how can we safely restart our season, should we get to a point that we can do that.
Q: In hindsight, was there anything that you look back and say, we should have done this a little sharper, we should’ve paid more attention? Or is it as you learn things and gather information?
A: I don't think we could have done anything differently from a league point of view. Obviously, from a medical point of view, having more information is always important. And so I always wish that we had more information and we have had more testing sooner, things like that. But in terms of background, we started tracking the coronavirus in January of 2020 because we have offices overseas in China. And I did my first brief for the NBA on Jan. 21 while we were in Paris for the NBA Paris game, so we were tracking this awhile and we had already started thinking through things that were important to get out to our organization in terms of handwashing, and [social] distancing and things like that. So that was something that we were tracking, and the NBA does a very great job of planning and contingency planning. There wasn't a knee-jerk reaction on March 11 by any stretch.
Q: It seemed like a prudent decision, especially considering almost right after that the world kind of stopped. Did you notice that you guys were the first big domino with everything in the world trying to contain it or at least domestically?
A: We did but also in terms of how we plan, it's a very collaborative process. Whether it was we were already talking to infectious disease experts and epidemiologists, and industrial hygienists, we do that for our spaces, whether it's our office buildings or arenas, we were already talking to other sports leagues and sharing information. Because over in Europe, soccer was being played. And we wanted to know what they were thinking about. And baseball was about to ramp up. We wanted to know what they were thinking. We collaborated pretty heavily and exchange information and share information. So, it was what was more surprising was how individuals in various sports started to speak up. And that was very heartening to see that. There's a rallying amongst the participants, but also a community amongst the people on the medical and business end in terms of making decisions.
Q: It's a year later, we have three vaccines now. Do you feel like you'd have to incentivize athletes in taking the vaccine, let alone getting them to be public about it?
A: I think the most important thing that I can do as a physician is to educate my patients, educate the public, and that is the campaign that we're on with the players. I want to make sure that they have the information that they need to make an informed decision. And that information has to be credible. And that's where I come in and give them the information from the clinical trials, try to break down how the vaccines work, kind of dispel myths, but also the message has to be credible about the messenger, as well. And that's where I come in and doing these presentations to the teams, each team I presented for half an hour or so. And being able to give them that information, hopefully be a trusted source, but then answer their questions. And the process of informed decision-making and informed consent in medicine involves telling people about the risks, the benefits, and any alternatives that are there. And so when we talk about the risks, we talk both about the risks associated with the vaccine — very small — but also the risks associated with the virus — a lot higher.
So that's my approach is to arm our players, our organization with the information that they need to make an informed decision. Then when you talk about incentives of vaccination, I think that's a conversation, too. And that's my last slide when I talk about what are the potential benefits, the realistic benefits personally into the community, but also in the larger context. But I think that also breaks for me along medical lines because you see that vaccination allows people certain freedoms. And we take our cues from the CDC there. And so I again reflect medically on what the positives come as a result of vaccination. I don't feel like I necessarily, as a doctor who's advising them, needs to dangle a carrot. I think I need to give them the information that they need to make a great decision.
Q: When you make presentations to these players, everybody comes from different backgrounds. And they have different questions about vaccines, the history of vaccines, the Tuskegee experiment, all these different things that they might not even know fully about, but they know that it's somewhat related to vaccinations. What are some of the bigger, common questions that you've heard in these presentations?
A: One question is how do we know about the safety of the vaccine? And I dig into the details of the data. I talked to them about the medical and scientific history behind RNA and mRNA vaccines that stretch back to 1989. I talked to them about our experience with the coronaviruses that have led to outbreaks like SARS in 2002-2003 and MERS in 2012. And then I go into the data that these guides deal in data and statistics all the time. And so I do believe that it resonates with them, too, to have that information. But then I stick around to answer the questions. And so one of the questions will be how do we know about the safety? Here's the safety that you know: This is how many people were in clinical trials. These are the reactions to the vaccine that we’ve seen, very low. And then I talked to them about where we are right now in the United States in terms of vaccine doses. This wasn't the case when I was presenting in February, but right now we're over 90 million doses have been given and over 25 million people have received both doses. So that concept of data, we have all of this information, because we're following these people who get vaccinated.
They ask questions about what happens if we get vaccinated? How will that change? I remind them that I don't like the policies. I'm not the policy guy, right in terms of what our health safety protocols look like for them. But I do talk to them about things that they can anticipate. But at the same time, the CDC is advising the general public. And CDC guidance has to be viewed in the context of our business and what we're doing, and how it makes sense. But great questions. I've gotten really, really great questions from them, I get the question of when can we be vaccinated, which is also a really positive sign for me. I think a lot of them want to know the impacts to them. If I get this shot, is it going to impact my performance? Is it going to impact my body, which is the way I earn my living, right? So I have to be able to decode the medicine, the science and the data for them. But when I'm giving these presentations, and when I'm talking to people about the vaccine, I'm on my home court. Medicine is my home court, and I get nothing but a thrill out of being able to present this information, which means I have to do my research and my homework, but also giving it to them and breaking it down in a way that they can understand.
Q: What does herd immunity look like with the players themselves? Will a certain percentage of players need to take it for the league to achieve some level of herd immunity or is that even feasible?
A: So herd immunity is an infectious disease concept. It's not something that you can measure through a clinical trial. But the number that's tossed around for herd immunity is somewhere upwards of 75-80% of people being immunized. And herd immunity refers to immunization either through having been infected with the virus or through vaccination. And so that is, I explained what herd immunity is, and I explained it this way. Herd immunity is where one sick individual can only infect on average less than one person and say if I have coronavirus, and it's 10 of us in a room, I can infect the person to my right. But the two of us can't impact anyone else. So in essence is 80% protected, fewer than one person infected by me, that's herd immunity. So I try to give them that context. But as people move, you have people coming in and out of given spaces and players being around, it's hard to set that number and say, this is the target. But what we try to think about is to be reflective of what the definitions that we're hearing coming from the Department of Public Health, the CDC, WHO, which again, it's probably in that 80% range of people being immunized, again through either having been previous infection or current vaccination.
Q: I'm not sure if you saw Jared Dudley on Twitter where he said the FDA hasn't approved the vaccine yet but he didn't present it with the context of it being approved for emergency use given the circumstances. Have you had to answer that particular question with players to delineate between both?
A: Absolutely. It really is semantics. In order for a drug or a vaccine to be “approved” by the FDA, it necessitates two years of phase three data. So because we can't be at that point for Pfizer, they started their trials in March last year, they're right now at one year, Pfizer still has to get another year of data. And once they have that two years, they can submit it for formal approval. But we're in a pandemic, and we're trying to operate quicker and having therapeutics that are available and vaccines that are available. So you go the other route of how can we get this out? And the mechanism for that is emergency use authorization, which is the data is found good enough to put in circulation, but you don't have enough to have satisfied the definition of being approved because you need that post-clinical trial two-year period of data that's gathered and submitted.
Q: One of the players said it was explained to them that a vaccine was being developed even before COVID-19 got here. I'm assuming that just means different forms of this virus, and not this virus specifically. Is that what the player was referring to?
A: So what I talked to them about is people revert to the catchphrase, this was a rushed, process, or the vaccine was rushed. And I tell them we've been working on mRNA technology for over a decade. But also, in terms of mRNA technology, this was being looked at for cancer treatment, it was being looked at for Zika. Johnson & Johnson developed a similar type of vaccine for Ebola. And so, just I just remind him that some of these processes were already in place. And when we got to the point of having a pandemic, that there was a change in direction of applying this technology to this novel coronavirus.
Q: Is there a difference in a player taking a vaccine for himself compared to taking the vaccine and endorsing it on a public scale? Can you recognize sort of the fine line that a player may walk if he doesn't want to be out in public, but he understands, internally, it may be important for him to take?
A: There’s a lot of nuance with this vaccine. But that nuance ... we're talking about walking the line of public/private, getting vaccinated and sharing it or telling people you have COVID. That's private health information, that stuff is protected by law. And so I think what's really important is, number one, the decision to be vaccinated. Because you're protecting yourself, and we want to make sure when you look at the numbers of people who've been infected, hospitalized and die, and in particular in the Black community, I need us to be vaccinated at the end of the day. The decision to be more public is one that we would love for people to do. But I don't want that process or that ask to derail people from the decision to be vaccinated. I could have gotten my vaccine and not shared or just tell people I've been vaccinated and not show pictures or the video of it. But what was first and foremost was clearing the hurdle of deciding to be vaccinated. I was hesitant. I had my questions and concerns when I was emailed by our hospital saying that I was eligible to be vaccinated, and we were going to do it in a month. That was in mid-November. And I was like, I'm not ready. I have questions. So that other people have that same position, I completely understand the historical context, the current context. And so I would love for people, yes, to be partners and outspoken about this. But I think that that misses the point. The point is, if you told me I could get 100% compliance with people taking the vaccine, but we might not get anybody to be a spokesman from a medical doctor point of view, give me that. Then we can work on finding people who will be more public, but from the medical point of view, I need people to be vaccinated. And then from there, we can have a discussion about PSAs, PR and that thing. But I think with the numbers of infected and dying, hospitalized, the most important thing is that we get people vaccinated.
Q: The Ben Simmons and Joel Embiid contact tracing came up, and everybody said this is why you shouldn't be having an All-Star Game. My initial thought was this is why you can have one because the protocols are working. Did you look at that as being sort of like confirmation for success?
A: Yes, it was a testament to how our health and safety protocols work. And the efforts that we go through to make sure we're keeping the individuals and the collective safe and protected. That's the charge for me, the Hippocratic Oath, “first do no harm.” And we're trying to make sure that we help and it does sting when people have to enter into quarantine or isolation quarantine because they've been exposed, isolation because they've been infected. But we think through all of the scenarios, and I do think that it worked in this case, which is great. And ultimately we do know that some of these situations in the future could be mitigated through vaccination.
Q: What do you imagine you will be focused on a year from now?
A: It really remains to be seen, because there's so much coming in the future. We have to look through how the rest of our season looks, resuming our season next year, the Olympics. So there are those things, but really what I'm going to be looking at is my lane. I'm going to be looking at the medicine, how are we doing in terms of infections, not just COVID, but the flu. Are we going to have another victory with the flu?
What are we doing in terms of testing? Do we need to test the way that we're doing? What are we doing in terms of gatherings? Are we allowed to have people in our buildings, working people in terms of fans in the building? And it seems that COVID will just fall in as another thing to add to medical considerations for our players, our buildings, traveling staff, etc. I'm hoping that we're having a lot of people vaccinated which will be very helpful. And that we can start to do more planning, in terms of our events, in terms of our businesses, in terms of focus on public health. And I do hope that at the end of all of this, there is a vigor about public health, that doesn't put public health in the background. And there's going to be a catch-up, too, many people who haven't been able to get the medical care that they need because of the pandemic, whether that's cancer screenings or routine medical, physical exams. People who may be behind on their routine vaccinations of childhood that we catch them up, that we build on this momentum and we don't lose it. So that's why I see life a year from now of making sure we don't lose the gains that we've made with COVID but also with public health.
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