Weekend Reads: The CDC and the NFL

by Kevin Schofield

This weekend's read is written by the most unlikely of co-authors: the Centers for Disease Control and Prevention (CDC) and the National Football League (NFL).

Perhaps the most amazing thing about last weekend's Super Bowl is that it happened at all. Starting well before the 2020 season began, many predicted that the NFL would never be able to get through the season without succumbing to the COVID-19 pandemic. There were concessions, to be sure: The pre-season games were cancelled, international games were suspended, players could opt out of the season without violating their contract, and several games were delayed or rescheduled. But all 256 games were played within the regular 17-week season — an astounding accomplishment in the middle of a public health crisis.

Exactly how they pulled this off is the subject of a paper jointly authored by the CDC and the NFL's epidemiological and medical experts that walks through in detail the rigorous protocol that the NFL adopted, and the changes they were forced to make midseason.

The league began the season with a strict set of rules and procedures:

• Mandatory masking and physical distancing;
• Frequent handwashing;
• Facility disinfection protocols, and restricted access to team facilities;
• Players and staff tested six days per week;
• A strong contact tracing program, enhanced by proximity devices that were carried by players and staff and recorded the length of interactions where two people came within six feet of each other.

Until the last week of September, this worked well, and there were 10 or fewer positive COVID cases per week. But the week of Sept. 27, the NFL saw a big jump in the number of positive tests that aligned with the nationwide spike in COVID cases. Within a week, the league had introduced a new "intensive protocol" team for the seven days following a positive test by any player or staff with facility access, or if the team played against another team that had a player test positive on game day. The intensive protocol is credited with keeping the virus from spreading widely within teams.

Along the way the NFL made an important discovery: The combination of daily testing and robust, technology-assisted contact tracing provided new insights into how COVID spreads. Specifically, there were several instances where it was determined that the virus was passed between individuals during very brief interactions where the participants were either unmasked or only partially masked, shattering the widely held belief that infection mainly comes from prolonged close exposure (15 minutes or more, within six feet) to an infected person. This caused the NFL to modify its intensive protocol to reduce shorter-term exposures (more than two minutes) and to redefine what it considers a "high-risk contact" for the purposes of quarantining those who may have been infected.

The paper has a wealth of information about the NFL's protocols, and is an incredible resource for any other facility or institution looking to reopen — including schools, healthcare facilities, and other workplaces.

Implementation and Evolution of Mitigation Measures, Testing, and contact Tracing in the National Football League, August 9-November 21, 2020

The featured image is attributed to Brook Ward under a Creatives Commons 2.0 license (CC BY-NC 2.0).