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Week 4 Revealed the NFL’s Limitations in Containing COVID-19

A series of positive tests impacted two games and several teams, presenting the first stress test for the league’s safety protocols. It may not be the last one.

Getty Images/AP Images/Ringer illustration

At around 7:30 a.m. Monday, Patriots players and staffers gathered at Gillette Stadium to learn whether they would be getting onto the team buses to take them to the airport to fly to Kansas City. They were awaiting the results of their latest round of rapid tests, all of which would need to come back negative for the team to be cleared to travel to play the Chiefs that night. The rapid-result tests take about 15 minutes; bags packed, they patiently waited. The results came in: all negative, just like every rapid test and lab test administered on Saturday and Sunday.

So, off they went, hopeful, but not certain, they were in the clear. It had been two days since they and the Chiefs each had a player test positive for the coronavirus, leading to the postponement of their Week 4 game. It had been three days since starting quarterback Cam Newton tested positive for COVID-19. Contact-tracing efforts determined that roughly 20 Patriots players and staff members had been in close contact with Newton during Friday’s practice or in meetings before his positive test. As an extra precaution, they all traveled separately from the rest of the team, taking their own bus and flying on a separate plane for the three-hour flight to Kansas City. Still, it was a gamble: The likeliest first day for a person to test positive is not until five days after they’ve been infected. As the Patriots’ planes departed, the number of positive tests within the Titans stood at 20, up from a single positive test little more than a week prior, a reminder of how quickly the virus can spread once it’s present in a team, even with all the resources the NFL has to try to stop it.

“A lot gets done to play football games,” Patriots safety Devin McCourty said.

The Chiefs-Patriots game kicked off only 27 hours after it was originally scheduled. Kansas City won 26-10, held back only for so long by the New England defense while a combination of Brian Hoyer and Jarrett Stidham struggled in Newton’s place. It had been a disquieting week—the circumstances surrounding the game in Kansas City and the positive tests within the Titans organization constituted the NFL’s first coronavirus stress test—but the league got through it with its schedule mostly intact. The Titans-Steelers game, which will now be played in Week 7, was the only game rescheduled beyond this week, and even that adjustment was a fairly neat one. Four weeks into the season, the league is still on track to play a normal, 17-week schedule, but the past week was a reminder of how vigilant teams need to be about the virus—and a sign that even rigid adherence to the league’s safety protocols may not protect against future interruptions.

The isolated positive cases in New England and Kansas City might not have been as concerning had the NFL not been dealing with its first outbreak of coronavirus in Tennessee. On the morning of Saturday, September 26, the day before they played the Vikings in Week 3, the Titans got word that outside linebackers coach Shane Bowen’s test from the previous day had come back positive. Bowen, who’d been in meetings and at practice since taking the test, was removed from the Minnesota trip and sent home. Everyone else tested negative and boarded the two-hour flight to Minneapolis, then went by bus to the hotel and to the stadium the next day. Tennessee won, 31-30, with head coach Mike Vrabel calling the defensive plays in Bowen’s place.

The NFL has typically been testing teams six days a week, every day except for game day, so the Titans who were tested on Monday hadn’t been tested since Saturday. When those tests came back from the lab early Tuesday morning, Tennessee started to realize it had a problem. There were eight positives in that batch of tests, three from players and five from other members of the staff. Quickly, the league got in touch with the Vikings, and Minnesota and Tennessee closed their facilities, sending players home to self-isolate; they could only return for additional drive-through testing.

Vrabel maintained that the Titans had followed all of the league’s social distancing and testing protocols and said his team had just been unlucky.

“I’m not going to begin to try to understand or track down how a virus would spread,” Vrabel said. “We’ll have to continue to exercise extreme caution when we go back in, and no one is to blame.”

The NFL and NFLPA, however, sent investigators to Nashville to look into the Titans’ behavior. Compliance with COVID-19 protocols had been an issue since the start of the season, even though all positive cases before Week 4 had been isolated. There had been multiple strongly worded memos to owners, coaches, and team presidents threatening increasingly severe punishments for violations. Head coaches were prime offenders, mostly for failing to properly wear masks on the sidelines during games, something they still weren’t doing universally in Week 3, even after several were given fines of $100,000. During that week’s Chiefs-Ravens game on Monday Night Football, hours before the Titans would get their first batch of positive test results, Ravens coach John Harbaugh had pulled his neck gaiter down while yelling at an official; the referees union complained to the league about Harbaugh’s conduct. On the same night in Las Vegas, several Raiders players, including quarterback Derek Carr, were photographed maskless, resulting in $165,000 in fines. In the past two weeks, Raiders coaches and players have been fined $565,000 for violating COVID-related protocols.

The NFL had already threatened more fines, suspensions, and the potential forfeiture of draft picks for rule-breakers. And, in a Monday memo to team leaders, commissioner Roger Goodell again upped the ante for noncompliance by adding forfeiture of a game to the list of potential consequences. In the same memo, Goodell informed teams that the NFL would be installing cameras to monitor whether rules were being followed.

“Simply put,” Goodell wrote, “compliance is mandatory.”

Even with perfect enforcement, however, the league’s protocols can’t completely guard against an outbreak because of the incubation period of the virus. The NFL’s safety measures balance the need to prevent virus spread against the need to have players available, and to do that, they’ve accepted some risk that their rules can mitigate but not eliminate the threat of the virus.

A person who gets infected with the coronavirus won’t test positive immediately; the average incubation period is about five days and the maximum is 14 days. That means someone who is exposed to the virus on Sunday and tests negative on Monday, Tuesday, Wednesday, or even later is not necessarily in the clear. According to Dr. Michael Mina, an assistant professor of epidemiology at the Harvard T.H. Chan School of Public Health, an infected person whose viral load is low enough for them to test negative is generally less contagious than someone who has tested positive, but it’s still possible for them to pass it on. Viral load can also increase over the course of a single day, so someone who isn’t very contagious on a Friday morning may be more contagious by Friday afternoon.

It’s in those cracks where an outbreak can sneak up on any team, even one that follows the NFL’s protocols perfectly. It’s in that span between the time of exposure and reaching the average incubation period when the virus represents an invisible enemy that testing alone isn’t guaranteed to contain. That’s why, as the Patriots headed off to Kansas City on Monday morning, they weren’t sure they were out of the woods.

“You’re worried and you’re anxious with all those thoughts of what COVID-19 brings,” McCourty said. “But, I would say we had a lot at our disposal to kind of get through everything.”

With testing as frequent as it is for NFL teams, Dr. Mina told me he thinks it’s reasonable to release exposed players from quarantine between five and seven days post-exposure. The CDC’s guidelines still call for a full 14-day quarantine, but Dr. Mina said that releasing anyone who is negative after the average incubation period is a practical alternative that is still responsible.

“Is it perfect? Is it as good as telling people to completely quarantine for the full 14 days? No. But it really does cut risk down tremendously, so it’s a cost-benefit analysis in this case,” Mina said. “I do think that there is a role for testing out of quarantine early. By seven days most people, almost everyone who will become positive, has already become positive on a test so if you’re still testing negative it’s probably very unlikely that you will become infected or that you will turn positive after that.”

NFL protocols do not call for seven days, though, or even five. A plane full of Titans who’d all tested negative had still seemingly spread it among themselves, and Tennessee did not stop getting new positive cases until Monday, over a week after the first positive test. At that point, the Titans had had 18 members of their organization test positive over the course of 11 days, with new positive cases coming up on six straight days. There was some positive news in that none of the Vikings players who’d been exposed to the Titans had tested positive, indicating that the game itself had not been a super-spreader event, but the travel itself was the main concern.

With no new cases for a second straight day on Tuesday, the Titans would be able to get back into their building on Wednesday and keep their Week 5 game against the Bills on as scheduled. Several teams have been impacted by positive tests in Week 4: The Steelers and Ravens lost their normal bye week to accommodate the rescheduled Titans-Steelers game; the Vikings had to temporarily close their facility; the Chiefs now have to play three games in 11 days due to their postponement; and the Patriots had to face the AFC’s top team with their backup quarterback. Overall, the league is charging forward largely on schedule, but the optimism—some might say complacency—that came from three weeks of keeping the virus almost totally at bay has been pierced, both for the teams that have had to make adjustments and others who know that they could have to soon enough, especially if they’re not careful.

“We haven’t talked about COVID for a long time, and then now that it hit, you say, ‘OK guys, make sure you’re still [following the protocols], because sometimes you can get lackadaisical about it because it’s not happening,’” Colts linebacker Darius Leonard said last week. “It was definitely a wake-up call—not just for Tennessee or the Vikings, but the whole NFL.”

Saturday in Green Bay, currently one of the worst COVID-19 hot spots in the country, Packers coach Matt LaFleur asked fans to wear masks and cited the positive tests in Tennessee, New England, and Kansas City as reason to “be very cautious and mindful about what they’re doing out there.”

“We’re not invincible to this,” LaFleur said.

That same afternoon, waiting for test results and the knowledge of when his team’s next game would be played, Chiefs safety Tyrann Mathieu perhaps summed up the stress of uncertainty best on Twitter:

Mathieu probably didn’t mean it literally, given the circumstances, but beyond the health and the logistical concerns, players have begun to feel the emotional weight of going through this COVID-inflected season.

Mathieu and the rest of the Chiefs and the Patriots got through the game. After the loss, Bill Belichick was typically gruff in his video press conference, grunting through both an N-95 mask and a fabric neck gaiter. “We’ve done everything right, we’ve done everything we’re supposed to do, so it’s in the hands of the medical people,” he said. This season was always going to be a high-wire act requiring intense discipline and unusual flexibility. After the past week, it’s one of increased scrutiny from the NFL and pressure on teams to comply with safety guidelines.

The league has now faced its first major test in containing the coronavirus and got through it with games mostly on as scheduled and transmission between teams seeming to have been avoided. Just before the Patriots left Kansas City on Monday night, ESPN reported that their lab tests taken that Morning had all come back negative, a good sign, though not the final one they’ll need to know they’re in the clear. As they boarded their flights back to New England, any sense of relief was still premature. If Week 4 showed how the NFL responds to a COVID-19 flash point, it also showed that it can’t be sure when the next one might come.