Analysis

NFL reexamining COVID-19 protocols after sudden wave of positive cases late in 2021 season

IRVING, Texas -- The NFL had gotten through the first three months of its season with so few COVID-19 cases, and with so much normalcy -- full stadiums, less Zooms, fewer masks -- that it was easy to forget the pandemic was much of an issue at all.

But the virus has come roaring back, with around 100 players testing positive in the last three days. That is a record number of cases this season. Many of those players are fully vaccinated. According to the league, two-thirds of them are asymptomatic and the rest have very mild symptoms. That has forced a sudden reexamination at the NFL's Winter League Meeting of the protocols that have governed the league, with just four games to go in the regular season before the playoffs begin.

"We're entering a new phase of the pandemic, different than we've seen before," said the NFL's chief medical officer, Dr. Allen Sills. "We can't apply 2020 solutions to the 2021 problems we're having."

Commissioner Roger Goodell said there had been no discussion about postponing any games, including the game this Saturday between the Las Vegas Raiders and the Cleveland Browns, even though the Browns have been beset by a wave of positive cases, including to quarterback Baker Mayfield and head coach Kevin Stefanski. The NFL has given greater roster flexibility and expanded practice squads as a way to mitigate the roster hits from COVID-19 cases. 

But the face of the virus has clearly changed. Sills said that for the first time this season, the virus has begun spreading within buildings. That had not been the case earlier in the 2021 season, with genomic sequencing indicating that the positive cases had come from community spread, but were not being transmitted within team facilities.

What has caused the surge now? Sills pointed to a few reasons.

-- The new variant Omicron, which is highly transmissible, but also seems to produce a milder disease. Sills said the NFL had already isolated several cases of Omicron, and the advice from top epidemiologists is that Omicron is almost certainly driving the rapid spike in cases.

-- Immunity among vaccinated players and coaches is waning. That is not a surprise. The NFL conducted its own antibody survey from 572 volunteers among NFL staff. The findings showed that, as expected, even fully vaccinated people showed fairly low levels of antibodies the further out from their initial vaccine they were. However, boosters restored and got volunteers to higher levels of antibodies.

-- Seasonal variation means that all upper respiratory illnesses tend to be worse in the wintertime.

"At some point, you feel like you're fighting a ghost," Atlanta Falcons owner Arthur Blank said as he arrived at the meeting. "You don't know where to swing."

Representatives of the league and the players association have spent recent days discussing changes to the protocols to get through the rest of the season. The league is encouraging booster shots -- it is mandating them for coaches and staff and it was a point of emphasis in presentations to owners this week -- as offering the best protection. That is not a foolproof plan. Stefanski had already received his booster when he tested positive.

Still, it was clear that league officials felt some urgency to take action quickly as the reserve/COVID-19 list ballooned and to perhaps approach the new strain of virus in a much different way than it had been addressed since the start of the pandemic.

Among the options the league and union are discussing:

-- The possibility of allowing asymptomatic, fully vaccinated players who have tested positive to return to team activities with just one negative test. Currently, a vaccinated player needs two negative tests 24 hours apart in order to return before the end of the normal 10-day quarantine period. This would represent a step toward treating the virus as a less dangerous threat that the league must learn to live with. NFL officials were discussing the idea with public health officials, and it was unclear how quickly that change could take effect.

-- The return of masking, social distancing and virtual meetings within team facilities. Those familiar measures are part of the enhanced protocols which, Sills said, five teams are already in and they could be imposed unilaterally by the league. With transmission within facilities, it seems likely these adjustments will be made soon. Most importantly, the NFL says those changes work. The league studied five teams that had been in enhanced protocols and in four of the five, there was no further transmission of the virus.

-- Some members and officials from the players union are advocating for a return to daily testing for all players, whether vaccinated or unvaccinated. Right now, only unvaccinated players are tested every day. Vaccinated players are tested once a week. More testing for everyone would almost certainly reveal more asymptomatic cases.

League officials are resistant to the idea of daily testing.

"What testing doesn't do is prevent transmission, and we've known that always," Sills said. "That was true last year and it's still true today. As we look at how to respond, what we're trying to do is prevent spread within the facility and keep people from testing positive. Keeping people from testing positive takes us back to their immunity: getting the booster, getting their antibody levels up. Spread within the facility is more about these other measures. You have to rely on those other measures to make sure that we're not creating spread within our facilities."

With players and coaches continuing to test positive, and protocol changes still to be finalized, one thing was clear as the owners' meeting ended: The NFL is, for the second year in a row, in a race with the virus to the end of the season.

Follow Judy Battista on Twitter.

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