Titans' COVID-19 outbreak: What you need to know

The NFL’s first coronavirus storm has arrived.

Three Tennessee Titans players and at least five staff members have tested positive for COVID-19. Two team facilities have been evacuated. Sunday’s game between the Titans and Pittsburgh Steelers would appear to be in jeopardy. A week of uncertainty is ahead.

Yahoo Sports consulted a variety of sources, including Emory University epidemiologist Zachary Binney, to break down a complicated situation. Here is what we know, what we don’t know, what we expect, and why the NFL responded as it did.

The NFL logo is seen on the side of the NFL Network building in Culver City, a westside neighborhood of Los Angeles on August 24, 2020. - A rash of COVID-19 results that forced multiple NFL teams to adjust their weekend training plans were false positives due to "isolated contamination during test preparation," the lab responsible said August 24, 2020. (Photo by Chris DELMAS / AFP) (Photo by CHRIS DELMAS/AFP via Getty Images)
The NFL has its first in-season coronavirus outbreak. (Chris Delmas/AFP/Getty Images)

What do we know about the Titans’ outbreak?

On Saturday morning, Titans outside linebackers coach Shane Bowen entered COVID-19 protocol. Bowen did not travel to Minnesota for Sunday’s game against the Vikings. The rest of the team did, and played as scheduled.

On Tuesday morning, the NFL announced that three Titans players and five Titans staffers (reportedly not including Bowen) had tested positive. The team shut down all activity at their facility. The Vikings, who played the Titans two days earlier, also shut down all in-person team activities.

In what appears to be a corresponding move, the Titans placed defensive lineman DaQuan Jones, long snapper Beau Brinkley and practice squad tight end Tommy Hudson on the COVID-19 reserve list, though they did not specify whether any of the three players had tested positive.

What happens next?

The Titans and Vikings will continue to undergo regular testing. The individuals who tested positive will be isolated.

The teams will work with the league, the NFLPA and doctors to “evaluate close contacts.” They’ll proceed based on those contact tracing investigations. Practices and in-person meetings will be suspended indefinitely in the meantime.

Why do team facilities need to be shut down?

Because there is no way of knowing who else has already contracted the virus. Continuing business as usual would risk further spread within the Titans and/or Vikings.

Two characteristics of the virus complicate matters, and make shutdowns necessary:

1. There is a lag time between the administration of a COVID test (the actual nasal swabbing) and the test result. That lag, in the NFL’s case, is usually 12-24 hours. In those 12-24 hours, a person who has COVID doesn’t know they have COVID, but is capable of infecting others.

2. People who have been infected don’t test positive until days after they’ve contracted the virus. The virus’ incubation period is usually 3-7 days. In layman’s terms, that means that an NFL player who contracted the virus on Sunday would almost certainly test negative on Monday, and would likely test negative on Tuesday. He would likely test positive for the first time on Wednesday at the earliest, and possibly not until Thursday, Friday or Saturday.

Have any Vikings tested positive?

No, not yet – at least not that we know of. As explained above, that’s expected. It doesn’t mean no Vikings player contracted COVID during Sunday’s game against the Titans. If any did, positive test results would likely begin appearing Wednesday at the earliest.

Did the Titans play a game with players who had COVID?

Yes – but they didn’t know it at the time.

This is where the incubation period and testing lag make things tricky. A coach could get tested on Friday morning, meet with, yell at and converse with players all day Friday, and get a positive test result Saturday morning. That would mean the coach was positive, and likely infectious, all day Friday (and perhaps some of Thursday as well).

Now, let’s say that coach infected five players on Friday. All those players would have been tested Saturday. All of them would have returned negative tests Saturday night or Sunday morning (again, because the virus takes time to incubate). They would have played Sunday. They likely wouldn’t test positive until Monday, Tuesday or Wednesday.

Will we likely see more Titans positives?

Yes. If other players and staffers contracted the virus at the same time the eight already-known individuals contracted it, they could test positive Tuesday or Wednesday.

The other worry is that, between Saturday (when the last round of pregame testing occurred) and Tuesday (when the eight positive tests were confirmed), those eight people likely had contact with teammates and co-workers. All eight were reportedly part of the Titans’ traveling party. They shared a locker room, a sideline, a team bus, a team plane, meeting rooms and so on.

And if they did spread the virus to other teammates, because of the incubation period, those teammates might not test positive until later this week. That’s why the Titans won’t be able to practice for at least a few days, and it’s why their Week 4 game could be in jeopardy.

“I would expect to see more cases,” Binney says. “And I think trying to play on Sunday, just six days after, that’s a gamble.” It’s also a major competitive disadvantage to play after a week without practice.

What are the chances Titans players infected Vikings players?

We don’t know. This is an unprecedented situation. We don’t know how risky a football game is from a virus transmission standpoint. We don’t yet know who the three positive players are – or, more important, what position they play.

“This is an experiment that the NFL has accidentally run,” Binney says. “We’re gonna see. But it also matters who these players are. ... If they are scrub linebackers who only were in there for two or three plays, that’s less of an issue than if it was the starting center. Because it’s about the amount of contact and the duration of contact.”

All we know is that inter-team transmission was possible. The tests that came back positive were likely administered Monday morning. That means those three players could have been infectious Sunday during the game. But they also might not have been.

“Keep in mind, these could have been people who became infectious anytime in the last couple of days,” Binney says. “Because that Monday test was actually really covering from Saturday morning to Monday morning. It's capturing a 48-hour period.

“Here's what you can safely say: If you assume they got tested on Saturday morning and Monday morning, you can say, nobody was probably infectious Saturday morning. And you can say that eight people were probably infectious Monday morning.”

Could a player be infectious before testing positive?

Experts can’t say with certainty, but most believe that the point at which a person becomes infectious is around the same as the point at which they become capable of testing positive.However, because of the aforementioned lag time between test and test result, a player could be infectious before he knows he has tested positive.

When will we know whether Titans players infected Vikings players?

“If every test from now ’til Friday came back negative for the Vikings, I would feel pretty good,” Binney says. “That doesn’t guarantee [no infections], because the virus can take up to 7-10 days or longer to show itself. But if there were widespread transmission on the team, the most common time to show would be earlier than that. So if you got through five or six days and nobody was showing up? I would feel fairly confident that they escaped any transmission."

How could the NFL reschedule games?

Per a report from ESPN’s Adam Schefter, the NFL intends to play the Titans-Steelers game as scheduled on Sunday, or possibly Monday to allow for additional testing. That, of course, could change if more positive tests arise over the coming days.

If games need to be postponed, the NFL has a few options. It could always create a “Week 18” for all COVID-affected games; push back the start of the playoffs by a week; and eliminate the extra week in between conference championships and Super Bowl.

Or, it could get creative. For example: The Titans have a Week 7 bye. The Steelers have a Week 8 bye. The Steelers play the Baltimore Ravens in Week 7. The Ravens also have a Week 8 bye.

So, the NFL could do some shuffling. The Week 7 Steelers-Ravens game could be moved to Week 8. The Week 4 Titans-Steelers game could be moved to Week 7. The Ravens would get their bye in Week 7. The Titans and Steelers would both get their byes this week.

So, how did all of this happen?

We don’t know much about Bowen’s situation beyond him entering COVID-19 protocol.

We also don’t know how the virus spread. There are two main possibilities. Either A) Bowen has it and infected his colleagues, or B) the eight other people who tested positive on Monday all contracted the virus from somebody outside the facility.

“It depends on the degree of contact [Bowen] had with these people,” Binney says. “If these were primarily close contacts of the coach ... if the three players are linebackers, then I think you can go ahead and make that assumption [that they contracted the virus from Bowen]. If the three players are a quarterback, a running back and a wide receiver, then I start to wonder.”

What lesson can the NFL learn from this?

That mask-wearing and physical distancing are crucial, even in the absence of known positive tests. Because you don’t know about positive tests until after the fact. And you can’t retroactively change behavior from 24 hours earlier once you do know. The Titans situation will serve as a reminder.

“These results confirm the need to remain diligent in implementing all of our health and safety protocols to the fullest extent,” NFL commissioner Roger Goodell wrote Tuesday in a memo to teams. “This includes not only our testing program, but facility maintenance, wearing of PPE by players and staff, and carefully regulating behavior and contacts outside of the club facility."

Dr. Allen Sills, the NFL’s leading doctor, was clear on the league’s strong mask rule, saying this month on the NFL Network:

“As we’ve said all along, the tests are not what keep us safe. The tests are simply a report card or a measuring stick to show how we’re doing with all our other risk mitigation efforts. And we know that one of the biggest exposure times is if someone is yelling or speaking really loudly, that’s when you can really project a lot of aerosolized droplets into the air. So, again, tests are not perfect. And even though everyone tests negative, that doesn’t mean someone couldn’t possibly be infected. So we want to make sure we do all we can to mitigate that risk.”

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