Sports Are Returning. Virus Cases Are Rising. How Many Is Too Many?

2 weeks ago

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It wasn’t supposed to happen this way.

The return of major sports in the United States from their coronavirus-caused breaks was supposed to coincide with flattened curves and reduced concerns about infection and death rates and hospitalizations.

Instead, cases are skyrocketing, and concerns are rising with them. The worry is perhaps most profound in Florida, the home of two Major League baseball teams and the choice location for the “bubbles” of the N.B.A., Major League Soccer and the W.N.B.A., and in Texas, home to two M.L.B. teams and the planned site of at least 60 baseball games in the coming months.

The leagues say their return-to-play protocols will minimize the chances of infection for both athletes and team staff members. But experts in infectious diseases say that while extensive planning and exhaustive manuals — the N.B.A. and M.L.B.’s guides are both 113 pages — offer plenty of guidance on how to eat and train and wash, some infections are inevitable, and the leagues don’t have a clear answer to how much is too much.

The challenge for those still plotting a return, experts say, is that much is ultimately beyond the control of any league, team or executive, all of whom are at the mercy of the rising national infection rates — and those in their home cities.

“I’m less optimistic about sports coming back as time goes on,” said Melissa Nolan, an epidemiologist at the University of South Carolina. “It’s hard to justify a resumption of sports when we are still struggling to open up basic services.”

In March, all it took was a single positive test to shut down the N.B.A. What will it take now? And will the steady drip of individual players deciding not to play soon turn into a torrent?

If the past 10 days are any indication, this is all about to get more complicated. M.L.B. teams will be hopscotching the country by the end of July, and already players are taking a pass. Ryan Zimmerman of the Washington Nationals said Monday that he would opt out of the season. His teammate Joe Ross, his former teammate Ian Desmond, now with Colorado, and Mike Leake of the Arizona Diamondbacks have also said they will not play.

The N.B.A. announced over the weekend that 16 of its players had tested positive in its first round of samples, and several stars already have said that they will stay home when the league restarts in late July. M.L.S., which has had 24 positive tests, could resume its season next week without its reigning most valuable player.

Several European soccer leagues have been able to restart their seasons, even those in Italy and Spain, which were being ravaged by the disease only a few months ago. The difference between Europe, and especially Germany, where the Bundesliga has been back in action for more than a month, and the United States is that those countries were far more effective in driving down infection rates.

“People want to know why we haven’t been able to have sports back sooner,” said Zachary Binney, a sports epidemiologist at Emory University in Atlanta. “It’s because we don’t have the virus under control.”

The result is a situation that appears to become more uncertain each day. “We are bringing sports back not without fingers crossed and pinning our hopes on the idea that things will go OK,” said Neel Gandhi, a colleague of Binney’s at Emory’s School of Public Health. “But the past week has shown we are still very vulnerable. We might be worse than we were a month or two ago.”

League officials have acknowledged that they are aware not all of their players are going to be comfortable with their plans to return to competition. Some athletes have expressed concerns about their own health, or that of a family member. Others wonder how much risk the virus poses to their long-term health.

The N.F.L. and its players’ union are continuing to negotiate all of these issues, and those discussions have included not only opt-out provisions but also — notably — a shutdown threshold, though nothing has been finalized. Unlike the N.B.A. and other leagues that are trying to complete or resume seasons interrupted by the pandemic, the N.F.L. still has some time.

Football players don’t report to training camp until the end of July in a normal year; by then, there should be some initial lessons from what other leagues have gone through, including those that have restarted or plan to in restricted environments — so-called “bubbles” — and those, like baseball, that will not.

Updated June 30, 2020
- What are the symptoms of coronavirus?
  
  Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
- Is it harder to exercise while wearing a mask?
  
  A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
- I’ve heard about a treatment called dexamethasone. Does it work?
  
  The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
- What is pandemic paid leave?
  
  The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
- Does asymptomatic transmission of Covid-19 happen?
  
  So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
- What’s the risk of catching coronavirus from a surface?
  
  Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
- How does blood type influence coronavirus?
  
  A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
- How many people have lost their jobs due to coronavirus in the U.S.?
  
  The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
- How can I protect myself while flying?
  
  If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
- What should I do if I feel sick?
  
  If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

The early reviews from inside the M.L.S. bubble have been positive. Teams began arriving in Orlando, Fla., last week. The San Jose Earthquakes were first because they had not been able to practice as a full squad in the team’s home market.

Tommy Thompson, a San Jose defender, said during a video conference Friday that players were largely staying in their rooms when they were away from the field. There, he said, they read, watch movies or play video games, and then gather for team meals inside the Disney resort the league has taken over for the next month. For the moment, players said, everyone is aware of the potential consequences of venturing outside the restricted areas under the league’s control.

“I feel as safe as I could possibly be,” said Chris Mueller, a forward for Orlando City S.C. “I feel safer here than I was at home.”

Still, the point at which a surge in infections on any team, or league, crosses some yet-to-be established coronavirus red line is still unclear.

Binney said if three or four players on a team test positive, the leagues should view it as a sign of an outbreak and shut down the team for a period of time. But how many teams have to be shut down for a league to call off its season isn’t clear.

“If you don’t set a red line you are giving yourself an excuse, when a lot of money on the line, to push it farther than you should,” he said.

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