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“Is MLB Going to Be Able to Pull This Back?” Health Experts Break Down Baseball’s Plan

The league wants to come back in July. Medical professionals say that’s possible—but have plenty of concerns about how it could happen.

Getty Images/Ringer illustration

No matter how it looks—umpires in N95 masks, players standing six feet apart in the dugout, no fans in the stands—a sportsless nation cries out for American baseball. By July, the current target for a rescheduled Opening Day, Americans will have been under social distancing protocols for nearly four months. Even if Katie Casey’s boyfriend can’t provide them with the whole peanuts-and-cracker-jack experience, by that point just having a live Yankees–Red Sox game on TV would be close enough.

Actually pulling that off, though, will require a titanic logistical undertaking. League owners and the players association face a potential gridlock over health, economic, and labor issues: MLB sent the MLBPA a 67-page proposal on May 15 detailing how the league could return to action; the MLBPA issued a response last Thursday. From the tenor of the talks, it’s clear that everything about the 2020 season—from the truncated draft to empty ballparks to the universal DH—has to be made up essentially on the fly. Still, there are tens of thousands of jobs and billions of dollars on the line. As strained as player-owner relations are at the moment, there’s an inexorable incentive for both sides to come together for some solution, any solution, as long as we get pro baseball in the United States this year.

But even if MLB and MLBPA do reach an agreement on safety and testing procedures, it doesn’t mean those safety protocols will work. And whether those protocols work is critically important. Not only does player health depend on it, but the economic future of the game requires both an Opening Day this summer and a World Series this fall.

I asked Abdul El-Sayed, an epidemiologist and the former health commissioner for the city of Detroit, whether we know enough about COVID-19 to plan for games in October and November. “Yes, we do know enough about the virus,” El-Sayed says, “to know that we can’t make decisions five to six months in advance.”

One thing baseball has going for it compared to other major team sports—football, basketball, and so on—is that the actual gameplay isn’t particularly conducive to COVID-19 transmission. “An outdoor sport like baseball where [players are] not breathing heavily in each other’s faces seems like a good candidate for a sport that can return,” says Laura Albert, an associate professor of industrial and systems engineering at the University of Wisconsin whose research includes the optimization of emergency and public health systems.

While Albert isn’t worried as much about the in-game component of MLB’s plan to return in July, though, she has other concerns. Namely, even if the league prohibits sunflower seeds, tobacco, and spitting, there would still be plenty of scenarios during which a player with the virus could spread it to others. “There will be positive cases and there will be transmission between players,” she says. “And I anticipate it happening on airplanes and buses, in the locker rooms or bathrooms. It’s not totally clear how we can change those spaces to be safe if there’s a bunch of people using them.”

MLB clubhouses are confined, air-conditioned spaces where viral transmission is a much greater concern than on the field itself. Clubhouse safety measures have been one of the big headline items in MLB’s original proposal, and reports indicate that facilities would “be restricted to limited groups of essential personnel.” Players would be advised to show up to the park in uniform, and would not be allowed to shower in the locker room or use team hydrotherapy equipment after the game.

At present, there’s no evidence that COVID-19 can be transmitted through hot tubs or pools, so denying players a postgame ice bath might seem like an overreaction at first. But the problem isn’t the showers, tubs, or lockers themselves; the goal of having players arrive in uniform and leave without showering is to keep them from lingering in the clubhouse environment. “It just makes sense to get people out of the locker rooms quicker,” Albert says. “Just the act of showering and breathing—if somebody is positive, their breath will eventually get in the air, and the longer you’re with somebody who’s positive, the higher the risk of transmission.”

The same goes for travel. The current proposal calls for each team to play home games in its own city, which means planes and buses would still be essential to putting on the season. Players would travel on charter flights and private buses that would be disinfected between trips, but just like clubhouses, those vehicles would force their inhabitants to breathe recirculated air for extended periods of time.

“I know a lot of places have stepped up cleaning measures, which are great, but you’re still moving people about with an infectious disease that can have asymptomatic transmission occurring,” says Thomas J. Duszynski, the epidemiology education director at the Richard M. Fairbanks School of Public Health at Indiana University–Purdue University Indianapolis. “So I would expect to see cases.”

Because someone can carry and spread the virus for several days before developing symptoms, one trip could infect an entire team before anyone tests positive. “Everybody who’s in that bus is exposed to the air, or to the lungs, of somebody who may have just got it,” El-Sayed says. “Now it may be that they’re not shedding virus by then, but then three days later, they get on the bus again. Right? And herein lies the problem. So if you’re just isolating that one player, that one player has now shared a lot of very tight space, like in a bus, with somebody.”

In that sense, no amount of safety protocols could be enough to contain COVID-19 in a group setting. Duszynski cites a recent CDC report that says as many as 35 percent of COVID-19 carriers could be asymptomatic.

“What we know right now, or at least what the data is showing us, is that two days before symptoms, you’re able to shed virus enough to infect someone else,” Duszynski says. “So you feel fine. You act fine. You have no signs and symptoms, and you’re able to infect others. So that becomes a really difficult challenge to get our arms around in public health.”

The original MLB proposal called for 10,000 tests per week. The MLBPA’s counter went even further, requesting daily testing for the players. Such an expansive program invites two questions: Would daily testing keep players safer? And can MLB get enough tests to do so without depleting supplies for the general public?

“You can always test more, but at some point, you’re not going to get any extra value for the test,” Albert says.

“If folks are being tested three times a week, they’re being tested every two and a half days,” El-Sayed says. “You’re talking about half the median incubation period. And I think that would be a pretty safe space to do it. … You could make an argument for testing every day, although, that has to be balanced against the fact that we just don’t have unlimited tests. You have to ask if testing every player in Major League Baseball every day is the wisest use of testing right now.”

Going through hundreds of thousands of COVID-19 tests in a season amid national testing shortages could make MLB look like Marie Antoinette, which is a public relations problem the league anticipated. According to MLB’s proposal, all of the league’s testing would be conducted at a central facility in Utah, using tests manufactured by the league. Furthermore, the league is offering to test essential workers in MLB markets free of charge.

Whether MLB would be hoarding a valuable and scarce resource is to some degree a matter of perspective. Albert cites Germany’s testing infrastructure as evidence that tests don’t have to be a finite resource: Because Germany adopted an aggressive testing and contact tracing system from the start of the pandemic, it’s already experiencing the recovery Americans are waiting for, and a fraction of the loss of life. But Albert notes that the failure to implement such a system in the United States changes the equation in this case. “It’s been frustrating that we don’t yet have that capacity,” she says. “But I hope we can take a step back from that and realize that testing capacity is not fixed. The tradeoff is in some sense artificial. The league has a lot of money behind it and could really expand testing capacity. That’s what we’d like to see, so that there really aren’t tradeoffs where baseball players getting tested means there are fewer tests for first responders.”

Until and unless MLB’s test-manufacturing drive puts a dent in the public shortage, this remains an ethical issue. And even if MLB has a net positive effect on public testing capacity, it would still be diverting resources to a nonessential industry. “In a time when testing itself is limited in the global market, any test that Major League Baseball is taking off the market, it’s taking off the market from some other place. And so the question is, is this the best use of a test?” El-Sayed says. “And I would argue probably not. Because it is Major League Baseball and because it’s a powerful institution, it’s going to be able to marshal the resources it needs to get the testing it needs. And because these things usually evolve into a question of political economy and power, it’s going to be taking tests away from people who are the least likely to get tests in the first place.”

Then there’s the question of what would happen if and when a player tests positive. According to The Athletic, the MLB proposal says that “individuals who test positive must self-isolate, with daily communication and remote care from the club medical staff, including follow-up testing.” Yet the time players spend together both traveling and in the clubhouse would make it unlikely that only one player would be infected and isolated. “Ideally, you’d like to quarantine the whole team or half the team,” Albert says, “and at that point, you can’t really bring baseball back.”

The next best option, per Duszynski, involves a detailed contact-tracing protocol. “I don’t know that just isolating that single player is the right answer at this point, because of the amount of contact that player has with the mountain of people that it takes to pull one of these games off,” he says. “It’s not just the other players on the bus. It’s all the support staff and even stadium workers and things like that that we have to think about.”

Contact tracing would entail identifying every person whom a player had contact with over the previous few days and testing and/or isolating them. This would be a daunting process, but one that the extreme distancing measures—such as confining players to their hotels on the road—would make feasible. More relevant to broader public health, contact tracing would be the best defense against a scenario in which a player infects someone outside MLB’s testing sphere, like a delivery driver or flight attendant, who could then go on to infect others.

“It’s definitely going to take an army of people to do that for public health, but it’s those gaps provided by MLB or any large entity that we worry about the most,” Duszynski says. “Those are really going to be hard to track back and shut down.”

MLB’s return, whenever it happens, is already being heralded as a sign of things returning to normal. Indeed, as much as baseball fans miss the game itself, that touchstone to a more comfortable time is a huge reason why even a limited season is such an attractive proposition. But MLB has already accepted that if the league is going to have a prayer of making it to the World Series this year, the game won’t look, feel, or sound the same as it has in the past.

“Our lives are not going back,” Albert says. “They’re not returning to what they were like before, and there’s not one way we could really control the spread of COVID-19—there’s many things we have to do. And so it’s great that the leagues are embracing this. It’s not window dressing. I think it’s important for us to get used to these things.”

There’s a limit not only to what MLB and the MLBPA can do to ensure that the game is safe, but also to what they can know and predict. It will certainly be difficult for such a powerful industry to comprehend that idea, but it will be necessary for the baseball world to understand and embrace it. Given how COVID-19 works, the data on infection rate leaves investigators and public officials to work on a lag.

“We’re not dealing with linear dynamics here. That’s the hard part that I think is confounding so many of our best efforts to respond reasonably,” El-Sayed says. “You’re talking about exponential growth. Everything that we see today is information about the dynamics of the virus two weeks ago. And so all of a sudden you could be having exponential growth dynamics that only start showing up after it’s too late for you to act to stop them.”

As much as everyone is tired of having the course of the country and the economy determined on a fortnightly basis, Duszynski says that’s about as far ahead as we can responsibly plan right now. He’s open to the idea of MLB coming back—but only if the league is willing to stop the season if conditions change. “If they go down this road and start to play games, which personally I hope they do, and we see a shift in that science that says, ‘Hey, wait a minute, the disease is getting worse again,’ is MLB going to be able to pull this back?” he says. “Are they going to be able to shut it down and still survive?”

Both El-Sayed and Duszynski believe that it’s possible that a leaguewide infection could progress to the point where MLB simply can’t press on.

“God forbid a player dies because of this,” Dusynski says. “What kind of ripple effect would that have through Major League Baseball?”

As much as the public derided Tampa Bay Rays ace Blake Snell for voicing concerns over his health, there’s a nontrivial possibility that a player could suffer career-ending or even fatal complications from COVID-19, to say nothing of support staff, coaches, umpires, and players’ families. Even if the risk to any healthy individual between 20 and 40 is small, 1,410 players suited up for MLB teams last season—there’s a real risk of someone getting seriously sick among that group.

“I think that was a message that public health didn’t quite get right at the initial onset of this pandemic, that young people have nothing to worry about,” Duszynski says. “That simply isn’t the case. Young people we’ve seen hospitalized. We’ve seen young people die from this disease.”

With such stringent safety guidelines in place, it’s possible that MLB could start back up and run through the World Series without major incident; that’s certainly the league’s intention. But assuming anything right now is foolish, and MLB has to consider the circumstances under which it would stop. If not, the consequences could be dire, in both humanitarian and economic terms.

“My fear in this moment for the economy is not continued blackouts,” El-Sayed says. “My fear for the economy is brownouts. It’s that you start up too early and you destroy the public’s trust in our capacity to start up at all, because it doesn’t go well. Institutions are not made to start and stop like this. … The signal that sends, the impact that has, not just on the institution and Major League Baseball, but just the headline: ‘Major League Baseball starts up and then it has to shut down again.’ That’s devastating.”

But absent an effective and widely distributed vaccine, and absent the kind of government intervention that has allowed Germany and South Korea to begin to reopen safely, MLB and its partners can only do the best they can with the evidence they have. Is it safe to play baseball? Not even health experts know for sure. It’s dangerous for anyone else to pretend that they do.