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Q&A: Dr. Allen Sills on CDC Scientific Paper Jointly Authored with the NFL on COVID-19 Lessons from the 2020 Season

On January 25, 2021, the Centers for Disease Control and Prevention (CDC) published a scientific paper jointly authored with the NFL on COVID-19 lessons learned from the 2020 season.

The new paper, titled ‘‘Implementation and evolution of mitigation measures, testing, and contact tracing in the National Football League, August 9–November 21, 2020,” shares the benefit of the NFL's COVID-19 mitigation strategy, with elements that the CDC paper says can be broadly applicable throughout society to limit the spread of the virus, including in long-term care facilities, schools and workplaces.

NFL Chief Medical Officer Dr. Allen Sills recently sat down for a Q&A to discuss the paper and how the NFL's lessons from its robust testing and contact tracing programs can translate to other areas of society.

What is the CDC's MMWR?

Dr. Allen Sills, NFL Chief Medical Officer: The Morbidity and Mortality Weekly Report (MMWR) is a weekly publication put out by the CDC that is widely considered to be the most influential public health publication in the world. It's a way for the CDC to communicate with medical officials, public health officials, and the general public about the latest findings that impact public health.

Why is the NFL's work relevant?

Dr. Sills: The study we're publishing in the MMWR represents the summation of our collaboration with the CDC throughout our NFL season. And it focuses on what we learned and what we think can inform others who are attempting to mitigate risk and resume activity during this pandemic.

PHS - CDC MMWR Infographic 2

How did the NFL collaborate with the CDC?

Dr. Sills: We had a productive working relationship with the CDC throughout the entire season. We were in regular dialogue so that we could learn from the CDC, and make sure we were following their best and most up-to-date guidance, but also so that we could share what we were seeing, what we were learning. We have 32 separate communities of people – players, coaches, and staff – across all of our teams that we tested and followed on a daily basis for six-months. That's an incredible snapshot into the state of the pandemic, into transmission, and into those measures that go into keeping everyone safe.

What does the new paper outline?

Dr. Sills: The paper is a summary of our testing experience – what we learned from testing everyone throughout our entire season on a daily basis, but also what we learned from our contact-tracing process. Through our daily investigations of positive tests, we began to have a much better understanding of when transmission of the virus could occur, and, most importantly, what steps could be taken to prevent transmission and keep everyone as safe as possible.

PHS - CDC MMWR Infographic

What is unique about the NFL's testing and contact tracing data?

Dr. Sills: We tested over 6,000 individuals every single day over a six-month period of time. So, we really had an opportunity to see how early we can detect infections, how many of those ultimately become symptomatic, and what measures might help us identify those people as early as possible. Our contact tracing data provided us a unique window into understanding: how the spread occurred and what steps can be taken to prevent that spread in a group environment.

How did the NFL's protocols limit the spread of COVID-19?

Dr. Sills: Our data show that by identifying high-risk close contacts we were able to prevent a number of new cases of COVID infection. Many individuals who were identified ultimately did become positive, and by keeping them out of the team environment, we avoided exposing other individuals. More importantly, once we began what we call our "intensive protocol," we saw a substantial and sustained drop in the number of close contacts that were seen on our proximity tracking devices. And what that meant was, we were able to create safer environments for everyone by keeping physical distance at all times.

PHS - Intensive Protocol Graphic

What is the paper's key takeaway?

Dr. Sills: Our paper and our season have showed that you can participate in day-to-day activities and stay safe at the same time if you follow some strict protocols and if you can quickly identify anyone who might be infected and remove them from the environment. So, the learnings that we're bringing forward are really independent of testing every day, or any of the technology that we used. It's more about understanding how people get infected and preventing those infections.

How are the NFL's learnings applicable beyond football?

Dr. Sills: The learnings we describe in our paper talk about things like the types of exposures associated with a very high risk of transmission of the virus. Those exposures can occur anywhere. They're not specific to football. We are also presenting data about how to best identify and isolate individuals who may be exposed, and then return them safely to that group environment. And along the way, we learned how we can evolve our protocols to put in the maximum amount of safety for everyone involved, whatever that group environment may be. Those are important lessons that we learned through our NFL experience, but can broadly inform the rest of society.

Read the MMWR: