Saving Sports: HoopsHD interviews NCAA COVID-19 Advisory Panelist Dr. William Schaffner

Since the NCAA tourney was cancelled in March every college basketball fan is dying to know when we will next get to see our favorite teams/players back on the court. The bad news is that we still do not know for sure but the good news is that there are some very smart people who are working hard to give us some much-needed guidance. Last week the NCAA’s D-1 Council voted to lift a moratorium on athletic activities which will allow schools to host voluntary workouts/training sessions. Yesterday the NCAA released a plan for bringing student-athletes back to campus called “The Resocialization of Collegiate Sport: Action Plan Considerations”: www.ncaa.org/sport-science-institute/resocialization-collegiate-sport-action-plan-considerations. The document was developed with the help of the NCAA COVID-19 Advisory Panel, which is comprised of NCAA Chief Medical Officer Dr. Brian Hainline, 7 leading medical/public health/epidemiology experts, and 4 college athlete liaisons. Earlier today HoopsHD’s Jon Teitel got to chat with 1 of those experts (Dr. William Schaffner, Professor of Preventive Medicine and Infectious Diseases at the Vanderbilt University Medical Center) about his work on the panel and the challenges involved in getting college athletics back on track.

What do you do as Professor of Preventive Medicine and Infectious Diseases at the Vanderbilt University Medical Center? I have a close relationship with the Tennessee Department of Health and the CDC and am very interested in vaccines and how they are applied to prevent disease.

In March the NCAA established a coronavirus advisory panel of leading medical experts and NCAA schools to guide its response to the outbreak of the pandemic: how did you get picked? I do not know: it is a labor of love and there is no compensation.

How do you balance the different factors of individual safety/public safety/college athletics/etc.? With difficulty. Intercollegiate athletics means that we must be attuned to what colleges are doing. It looks like the majority of schools will open this fall, which was not the case earlier this year. There are also intramural athletics so some of the same principles might apply to that. In team sports the athletes are not very different than members of a theater group or choral group where you have people acting or singing together. Basketball players work indoors so there are not any bright lines.  Some of the things we discuss might help particularly with residential colleges rather than community colleges.

How do considerations change as the rates of infection stabilize/decline/get reduced to near-zero after a vaccine is created? The principles remain the same but the implementation measures will change. From the time COVID was 1st discovered and we learned how it spreads the advice changes based on the knowledge we have. Laypeople would like an answer and something stable but as Ernest Hemingway said this is a “moveable feast”.

Does social distancing only apply to fans and athletes in non-contact sports as opposed to something like college basketball players who often spend 40 minutes/game within 6’ of their opponent? I am smiling because I was a track and field “athlete” who ran cross-country: I never had to worry about distancing because I was always far back of the lead group! We cannot anticipate being “safe”: we are trying to acknowledge that there is risk and then figure out how to reduce/mitigate/manage it going forward in the safest possible manner. If players wish to engage in a contact sport then they are willing to accept at least some risk, as do the coaches/trainers. The trick is to recognize that we live in a practical universe: it is not practical to give everyone a test every single day. You introduce factors such as self-screening, which offers a measure of security. You can take everyone’s temperature every day and ask questions of people you trust. You can spread people out 6’ apart during parts of practice, you can wear masks for some aspects of the activity, and do whatever you can to mitigate the risk. You can provide surveillance, have contingency plans, link closely to your student health service, do contact tracing, etc. We can recognize what the issues are but just going to college or staying at home means you are assuming some risk. We are all trying to move forward while recognizing there is a hazard. This was my week to go to the supermarket and I was gratified to see that almost everyone was wearing a mask appropriately. It was a very small survey of the pulse of Nashville but I saw that everyone was collaborating to reduce the risk, which is not always the case as we saw from the TV images during Memorial Day weekend and the demonstrators who were outside but standing next to other people for a long period of time over the last couple of days.

How much testing needs to be in place, and who is supposed to pay for all of it? We have several months before schools open up and we know that the testing capacity will increase between now and then. Some schools are considering testing all of their faculty/staff before students arrive and testing the general student body at certain intervals. Our medical center has testing that is rigorous/very accurate but we are working hard just to keep up with the clinical demand so we do not have the physical capacity to test all of the students. We would need to contract with a large commercial facility with the costs borne by the school, which might result in a higher tuition. Another strategy that some schools are considering is to get students tested at home within 2 weeks of when they arrive on campus and then get a certificate. That would give us a foundation on which to build and put the initial responsibility on the students and their families, which is another strategy that could relieve the pressure of arrival day.

Should NCAA student-athletes be allowed to play sports/fulfill their scholarship obligations if their fellow students have not yet returned to a traditional classroom setting? Sport is part of life and has been so since the 1st 2 cavemen tried to see who could run faster to a tree! It is an integral part of our society and of collegiate life in the US. Large survey courses could be given on line without losing too much but seminars/laboratories would require an in-person setting, although you could wear masks and arrange the desks to spread people apart. Every little aspect is being looked at: we are not stopping the educational enterprise and we ought to do what we can to facilitate intercollegiate/intramural athletics. We might have to modify things a lot at 1st: perhaps exclude spectators or spread them apart. However, you still have to think about things like transportation to the stadium, pregame parties, etc.

Since travel to sporting events involves physical distancing challenges, do you think that we need any changes made in connection with opponents/locations/travel? Everything is being considered but to hold a sporting event you need teams to meet in 1 place. Finance has to be part of this equation but I am not part of those discussions and they are barely mentioned within our panel. It relies heavily on testing: you contract with a commercial lab, ask people to sequester themselves before the game, have the visiting team come in late, define the bubble around the team and virtually isolate them, test everyone the night before the game and get the results the next morning, and if everyone tests negative then you can play the game. At the pro level managing the behavior of the individuals is easier because they are getting paid to play.

How do we address the concerns from the recent NCAA survey of student-athletes that a majority of participants reported experiencing high rates of mental distress since the outset of the pandemic? The 1st thing is to acknowledge that there is a problem because students deal with stress in a variety of ways. There are some elements of cabin fever, training has been impacted, and it has ruined the rhythm of their lives. You have to be aware of it and provide good counseling/information/support.

Do you think that the college basketball season will start on time this fall, and do you think there will be an NCAA tournament with fans next March? That is a crystal ball question but I will venture some cautious optimism. The vast majority of colleges will open up in a new way and I think that football will show the way. We will have all kinds of issues come up, including some that we did not consider in advance, and we will see how they change over the course of the season. I think that we will have a basketball season but do not ask me about the details because that remains to be determined. Our entire society will try to muddle through and balance the need for cultural/social/financial reasons with the medical/health impacts while trying to reopen. My metaphor is of a person walking across a tightrope: if we emphasize 1 thing over another then we will get shaky on the wire. We need to move slowly/carefully because there is no ideal answer. I was told of a pilot program this summer where a school tested every student and all of the results were negative…which led to some of the administrators wondering why they needed to conduct testing if everyone tested negative. Will you be satisfied with 85% or will you try to get all the way to 100%? Everyone will be attuned to who is getting sick/hospitalized this fall when we expect a surge: we will have to test for both COVID and influenza. The flu vaccine is not perfect but it can mitigate a lot of illness so there are things we can do to take some issues off the table. The NCAA has different divisions and some of the D-2/D-3 schools do not have the same resources as D-1 school so we will see variations on a theme.

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