NFL’s updated COVID protocols are a step toward ‘a new phase of the pandemic’ in sports

There are now over 100 NFL players sidelined by COVID-19. One hockey team alone has had 30 cases. One NBA team has 10 players, more than half its roster, in “health and safety protocols.” In England, meanwhile, nine Premier League games have been postponed, and more could follow. Clubs are reportedly pushing for a temporary shutdown amid widespread outbreaks across the sports world unlike any it has seen before.

The Omicron variant has been detected in multiple leagues, and spawned what NFL chief medical officer Allen Sills called “a new phase of the pandemic.” League officials have spent the week trying to figure out how to confront it. “The dynamics of the pandemic have changed for us,” Sills said Wednesday. “And I think that’s going to cause us to challenge some of our previous assumptions and also update our strategies and our solutions.”

Among the proposed solutions were everything from daily testing to, reportedly, no testing for players who’ve received booster shots.

On Thursday, the NFL announced an initial round of changes that include tweaks to the return-to-play protocol for COVID-positive players. It wasn’t the overhaul that some believe will eventually be necessary as sports learn to live with a virus that, as Giants owner John Mara said, “seems like it’s never going away.”

The NFL’s tweaks were, however, what some experts see as an initial step toward a new approach across sports. It could someday include a willingness to let athletes play through COVID. It will, at the very least, involve finding expedited routes back to fields and courts after positive tests.

Experts: Leagues could consider greater changes than NFL made

Throughout the 2021 season, NFL protocols have required any player who tested positive — even those who were asymptomatic and vaccinated — to isolate either for 10 days or until they tested negative on two consecutive days. On Thursday, the NFL amended the latter option. In a memo to team executives and medical personnel, it outlined new protocols that could allow a player to return after one day of tests that either come back negative or reveal that the player’s viral load, a measure of infectiousness, has cleared a certain threshold.

The memo arrived a couple hours after multiple experts suggested to Yahoo Sports that the NFL and other sports leagues could consider even greater changes.

The NFL's updated protocols might be the first step toward a new phase of sports trying to play through COVID. (Photo by Chris Coduto/Getty Images)
The NFL's updated protocols might be the first step toward a new phase of sports trying to play through COVID. (Photo by Chris Coduto/Getty Images)

Zach Binney, an epidemiologist at Oxford College of Emory University, mentioned that one negative antigen test could be sufficient to clear a player. Antigen tests are less sensitive than PCR tests, which the NFL has used. They’d still ensure that nobody steps on the field with “a super high viral load,” as Binney said, but would allow players who are significantly less contagious to return.

Kathleen Bachynski, an epidemiologist at Muhlenberg College, suggested that leagues could adopt an adjacent strategy. With the Delta variant, she noted, “the highest risk of transmission is really the couple days before and the couple days after [infected people] either show symptoms or are first testing positive.” She pointed out that in South Africa, in line with this evidence, officials have advocated for halving isolation periods from 10 days to five for healthcare workers amid a dire shortage. Their reasoning, obviously, is far more serious than anything in sports, but the science that supports it is similar.

There has been a push in some sports circles to reduce isolation requirements, in part because many COVID-positive players remain physically capable of playing. Sills said Wednesday that two-thirds of cases in the highly vaccinated NFL this week were asymptomatic, and the others were “very mild.” Under previous protocols, however, very few players had been able to fulfill the negative test requirement and return sooner than 10 days after their initial positive, despite not feeling ill.

The goal of any protocol, Sills explained, is “to return someone when it’s safe for them, when they are no longer a risk to themselves or to others.” A hypothetical amendment that allows players to return after one negative antigen test or five days of isolation would, in theory, halve the amount of games missed by asymptomatic players while also reducing most risk of virus transmission within a team.

Will asymptomatic athletes be allowed to play anytime soon?

A more extreme plan — and one that experts remain hesitant to champion, but could accept in the future — would be to allow asymptomatic athletes to play on without missing any time.

Public health experts are nearly unanimously against any change that would reduce testing frequency, even as a means to indirectly allow vaccinated, asymptomatic COVID-positive players on the field. With Omicron surging, doing so would let the virus rip through many locker rooms.

But they don’t categorically dismiss an alternate idea:

  • Test all players daily, as the NFLPA has advocated, to prevent massive outbreaks within teams and reduce the risk of players spreading the virus to family members or the community.

  • Continue to require anybody who tests positive to isolate for 7-10 days away from work, attend meetings virtually, and avoid any close contact with anybody indoors.

  • But, allow them to return to practice and games if they and their team choose to, provided they:

    • Are vaccinated and remain asymptomatic

    • Wear a mask at all times except mid-play

    • Distance from all teammates, coaches and others whenever possible, including in the locker room and on sidelines

    • Travel in personal vehicles or on separate planes

Such a plan would, in theory, bring the best of both worlds. It would protect everyday citizens, family members, and even players and team staffers themselves — because daily testing significantly increases the chance of detecting a case before transmission can occur. It would also allow young, healthy players feeling unaffected by the virus to perform the most integral parts of their jobs.

Experts note that it would be more viable in some sports than others. In the NFL, there has been no evidence of in-game, opponent-to-opponent transmission of the virus, which is why the thought of allowing COVID-positive players on the field can be entertained in the first place. But, Bachynski said, “I don't think the potential transmission is zero there.”

Experts would be more comfortable with the plan in outdoor, socially distanced sports, such as golf and tennis, than in indoor, close-contact sports, such as hockey and wrestling. Football and basketball are closer to the latter end of the spectrum, while soccer — where face-to-face contact is very fleeting — would skew a bit more toward the former.

There are, though, still some concerns. The logistics of separating a COVID-positive player in team settings would be difficult. Science is also still unclear on whether exercising while asymptomatic but infected might carry risks. Bachynski and others have said that this is “unlikely,” but little-to-no data exists to confirm or refute that assumption.

Plus, experts argue, an unavoidable aspect of sports COVID protocols is public messaging. “I'm still a firm believer in the positive image professional and college sports can project to the general community,” said Cameron Wolfe, a Duke infectious disease professor who has advised major sports organizations throughout the pandemic. Especially in this moment, with many public health officials expecting an Omicron-infused spike in cases, a seemingly riskier policy would project a problematic image.

“When community transmission's high, and you have a novel variant, this is a time to be more cautious,” Bachynski said. “Both to protect the players, but also to set the right tone and send the right message about what we need to be prioritizing as a society right now.”

But as research clarifies infectiousness patterns, and as Omicron-specific data rolls in, and when, someday, infections begin to subside again, sports will be able to shorten isolation periods in line with science. At some point, they could even be eliminated. The NFL took a significant step in that direction Thursday. Bachynski estimated that, under the new protocols, “a decent percentage” of NFL players could begin testing out of isolation after five or six days, rather than having to wait the full 10 days.

This, seemingly, is how sports will begin to live with the virus. They won’t ditch testing. Instead, they’ll ease the (overly cautious at present) consequences for those who test positive.