NFL’s medical chief says masks are the new seat belts

In the uphill battle to keep teams on track with COVID-19 rules this year, there is little doubt that one protocol has required a mind-numbing level of maintenance from the NFL’s league office halfway through this season. The reminders have come in the form of educational memos to stern warnings, from finger-wagging to conference-call shaming. And of course, those hefty headline-grabbing fines.

All for the masks.

“It’s a little bit like when seat belts came along,” said NFL chief medical officer Dr. Allen Sills during a league conference call Tuesday. “Overnight, you had to do a lot of education about why wearing seat belts was important.”

In a trend that has been a bane-of-existence facsimile of the outside world, the NFL has had to continue to implement exhaustive and repetitive lessons on why masks are still the first line of COVID-19 defense for every franchise. Case in point: Last weekend, more than three months into this season’s non-stop harping about masks, the NFL was again faced with a development that is going to lead to another round of warnings from the league office. Days after issuing a mandate to teams that players and personnel must mask up for pregame and postgame interactions, every franchise that took the field on Sunday broke the new rule in some way.

Steelers quarterback Ben Roethlisberger, pictured warming up before Sunday's game in Dallas, landed on the reserve/COVID-19 list on Tuesday. (AP Photo/Michael Ainsworth)

Some violators were more flagrant than others, but a simple review of postgame tape from Sunday’s matchups showcased that everyone failed the first test of masking up for postgame interactions. That failure also included multiple players in the Dallas Cowboys and Pittsburgh Steelers postgame scrum, which now takes on concern given that four Pittsburgh players were placed on the reserve/COVID-19 list Tuesday. That quartet of players included Steelers quarterback Ben Roethlisberger, who is the second starting QB in the AFC North to get placed on the list following the addition of the Cleveland BrownsBaker Mayfield.

“As kids, we’re taught that [postgame interactions] is an important part of the game, an important part of learning good sportsmanship. So it’s hard to change that overnight,” Sills said. “One memo is a difficult way to change an ingrained pattern of behavior that’s gone on for many years. What we’re trying to do is just show everyone the vulnerability and also show ways we can do it safely.”

Sunday’s result wasn’t a surprise, of course. Like so many other mask-related mandates, it’s clear the NFL expected the first week after the changes to have compliance issues. And it’s expected that the league will extend its first warning to teams about the less-than-perfect adherence in postgame exchanges Sunday, largely because league office and medical officials aren’t going to let this new mandate slide off the agenda.

It’s a scenario that is stacking up in a similar way to the beginnings of the NFL season, when the league strongly warned head coaches that proper mask placement on the sideline was a mandate and not a suggestion. When the coaches didn’t get that message, the NFL handed down some staggering fines and made an example that sent a message. Next up came players closely congregating together in social situations without masks. Warnings went out, and when Las Vegas Raiders players were caught in violation during a charity event, fines ensued. After that it was the Tennessee Titans, who had players failing to adhere to mask rules inside their facilities. A beefy fine and a very pointed conference call followed warnings.

For the NFL and its doctors and executives, this has been the cyclical nature of explaining to franchises what is in their best interests. First, they get educated. Next, they get educated and warned. And on the third strike, they get educated and whacked in the wallet. Eventually, the lesson is expected to sink in.

For those old enough to have lived through the implementation of seat belt laws in the United States from the mid-1980s to mid-1990s, Sills’ analogy to that pilloried enforcement era seemed spot on. Much like masks, it was a slow crawl toward safety — from ignorance to negligence to defiance. And then given a long enough timeline, it found a more sweeping acceptance. On a much smaller and quicker scale, that is what the NFL is shooting for with an environment trending toward masks being worn at almost all times. And much like seat belts, it is carrying some constant education repetition that is trying to pound it into the heads of teams that COVID-19 infection percentages dramatically favor those who are functioning in an all-masked environment.

“Certainly [the implementation of seat belts] was coupled with enforcement, but a lot of what motivated and changed people’s behavior was understanding the positive outcomes of wearing a safety belt,” Sills said. “Now that’s an automatic and a routine for all of us, but it certainly wasn’t when it first came out.”

While the league has repeatedly banged the drum about education being the chief goal with masks, there is little doubt that the enforcement end has been a significant driver for teams. Every time the NFL has handed down significant fines, it has sent a buzz through franchises. First when the NFL hit multiple head coaches and franchises with fines for broken mask protocols early in the season, and again in escalating responses to the Titans and Raiders. Much like those previous scenarios, the league’s financial and possibly even draft pick-stripping mechanisms will be in play if postgame adherence doesn’t improve.

“I think everyone is held accountable,” NFL vice president of operations Troy Vincent said on Tuesday’s conference call. “But we always start — we just want to change behavior. The intent is never to fine a club, fine a player. We’re just trying to — everyone has to work together. We typically start with a warning. We share with them what we saw [and] what that entails from an exposure standpoint. Eventually, we’ll have to hold people accountable, whether that’s the coach [or] whether that’s the players. But that is not the intent. The intent is really just to try to change or curb the behavior so that we can get through the season.”

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