New England Patriots quarterback Cam Newton celebrates after defeating the...

New England Patriots quarterback Cam Newton celebrates after defeating the Las Vegas Raiders in an NFL football game, Sunday, Sept. 27, 2020, in Foxborough, Mass. (AP Photo/Charles Krupa) Credit: AP/Charles Krupa

For a summer’s worth of training camp and three weeks of the regular season, the NFL could not have imagined a better outcome. With only a handful of positive tests for COVID-19, all games were played and the focus was strictly on football.

But if this all seemed too good to be true, the events of the last 10 days proved that it was.

  • The Titans have had an outbreak of positive cases resulting in the shutdown of its practice facility and the postponement of last Sunday’s game against the Steelers. There were two more positive tests among players on Wednesday, meaning that Sunday’s game against the Bills is now in question.
  • Cam Newton tested positive for the virus last Saturday and was forced to miss a Week 4 game against defending champion Kansas City. The game itself was delayed from Sunday until Monday after another round of testing.
  • Patriots star cornerback Stephon Gilmore, who played in the team’s 26-10 loss to Kansas City, tested positive Wednesday and is now on the team’s COVID-19 reserve list.
  • A player from the Raiders tested positive on Wednesday.

With COVID-19 cases still not contained around the country, the NFL now faces a crisis that, if not controlled, may imperil additional games. The league gambled that it could play a full season without creating "bubbles" like the NBA and NHL, which successfully staged their respective playoffs. Major League Baseball is now in its own bubble for the remainder of its playoffs.

But that gamble is looking much shakier now that positive cases continue, even though the rate of positivity remains quite low compared to the general public. It’s not a surprise to health experts.

"Many of us in public health are watching what’s unfolding with the NFL holding our breath to see how what is essentially an experiment works out," said Dr. K.C. Rondello, Clinical Associate Professor, Public Health and Emergency Management at Adelphi University. "With the plan they have in place, frankly, outbreaks are inevitable. They haven’t created a bubble, and as a result, there are so many factors outside of their control that will influence how the season plays out."

The NFL and NFL Players Association agreed to an extraordinarily detailed set of protocols for coaches, players and team administrators, with daily testing required for all essential employees. But because the league is not operating in a centralized location, the potential for community spread of COVID-19 has increased.

And, unlike guidance from the Centers For Disease Control, which in most cases recommends self isolation for 10-14 days for people who have been in close contact with people infected by the virus, the NFL is more reliant on testing and contact tracing, in addition to the practice and game-day protocols. And even the testing program has its limitations, especially in cases where the incubation period for the virus can last several days.

"Those of us in public health are not surprised by this outcome, based on the plan they’re putting in place," Rondello said. "There are just too many unknowns. It was difficult enough to control the NBA when they had the bubble. Now imagine you have even less control than that. You’re talking about players, coaches, support staff, their families and all of those people have families and friends. When you look at all the people involved, (the risk) grows exponentially. It’s completely inevitable that, as a result, you’re going to have these outbreaks occur. That’s the price you pay for wanting to conduct a business as usual schedule."

Dr. Allen Sills, the NFL’s chief medical officer, said Wednesday that the league and NFLPA have investigated the ongoing Titans crisis and are now reviewing the Patriots’ situation.

"Any time we have a positive test, we go through a contact tracing protocol," Sills told NFL Network. " In reviewing that, we were given information that there were no high-risk close contacts (with Newton). There were some other close contacts that were identified. All of those close contacts were tested and screened for our protocol … and we also took the additional step of reviewing the video from inside the Patriots to look for compliance with mask wearing.

"We found that compliance was very high," he said. "That gave us comfort that, given the facts of no additional positive tests, given the apparent compliance of the team and given the way that the close contacts were labeled that we could move forward (with Monday’s game). This isn’t a decision we make in isolation. We take that data. We look at it with our experts in infectious disease and epidemiology and make what we think is the safest decision for everyone involved."

Commissioner Roger Goodell this week threatened teams with severe sanctions if they do not follow the protocols, and suggested the teams can potentially forfeit games if they are not in compliance. Fines and potential draft pick removal are also possible. Goodell also introduced enhanced protocols for teams with multiple positive cases, including face coverings for all players at all times, even in practice, a video monitoring system to make sure of compliance and requiring that all meetings take place virtually.

Rondello believes the league needs to take it a step further and require that all teams adopt the stricter protocols.

"That’s closing the barn door after the horse got out," he said of tightening protocols for teams with multiple positive cases. "There’s no reason they couldn’t adopt those protections preventatively to be proactive rather than reactive. I can’t think of a good argument why you wouldn’t employ those now, before there’s another Titans-type outbreak."

It remains to be seen whether the league get through this latest challenge and follow through on its ambitious plan to stage an entire season.

"There are some things they can do that they’re not doing," Rondello said. "Throw in the fact we are in a period of infection rate growth and the number of cases is climbing. It’s just a recipe that makes me pessimistic about getting to February uneventfully. Hopefully, I’m wrong."

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