Lessons From the First Covid Sports Season

Test. Isolate. The biggest risks are unexpected - except, of course, for undisciplined players. The money is going to suck until fans can come back. JL

Ben Cohen and Louise Radnofsky report in the Wall Street Journal:

Some leagues bubbled. Other leagues bumbled. The bubblers cocooned themselves in public-health paradises with ample testing, best practices and strict enforcement. The bumblers continued in the real world, survived Covid-19 outbreaks and plowed ahead despite mistakes that nearly toppled them. Testing is crucial. Act like you are in a bubble. Pandemic fatigue is real. The biggest risks are not the ones you expect. The financial outlook is bleak.

America woke on the morning of March 12 to a strange new world without sports. The NBA season had been suspended the night before. By the end of the day, March Madness would be canceled. Every other league and the Tokyo Olympics soon followed. People had become risks. Crowds had become threats. Sports vanished.

Exactly seven months later, on the morning of Oct. 12, something was happening that few predicted. LeBron James and the Los Angeles Lakers were celebrating a National Basketball Association title. Major League Baseball’s season was down to four teams battling for spots in the World Series. National Football League and college football games were being played with some fans in stadiums.

Some leagues bubbled. Other leagues bumbled. The bubblers cocooned themselves in public-health paradises with ample testing, best practices and strict enforcement. The bumblers continued in the real world, survived Covid-19 outbreaks and plowed ahead despite mistakes that nearly toppled them.

The sports industry’s first Covid season ended this week with the final game of the World Series. It was supposed to be a sigh of relief for a league that managed to play through some missteps. Instead, it became another spectacle of national pandemic chaos, filtered through the lens of sports. The Los Angeles Dodgers pulled star third baseman Justin Turner in the middle of the game after learning he tested positive—only to watch him flout isolation rules and celebrate the championship with his teammates on national television.

The leagues had both the resources and incentives to get back to work, and sports was months ahead of other industries that depend on gathering a lot of people in one place. Its successes and its failures generated a trove of data for the rest of the U.S.

Pandemic Play

Covid-19 forced sports leagues to rearrange their seasons.

Note: Timespans include the championships; NHL original championship date is an estimate.
Source: the leagues

The pandemic seasons taught America that learning to live with coronavirus is about psychology and economics as much as it’s about science. As cases surge around the country again, the lessons from sports include:

• Testing is crucial. Professional leagues were unanimous in deciding that more testing was better, and daily testing was best.

• Act like you are in a bubble. Demanding collective participation in safety plans is what made the bubbles work.

• Pandemic fatigue is real. People will ignore rules if they see a compelling reason—whether it’s weddings or winning the World Series.

• The biggest risks are not what you expect. Sports initially feared on-field transmission, but the real threats were off the field.

• The financial outlook is bleak. The economic consequences of the pandemic will outlast the virus.

“What we’ve all learned is that a lot of things are doable in a pandemic if you take the virus seriously,” said Ashish Jha, dean of the Brown University School of Public Health, about the way professional sports handled their return to work. “Every league that has pulled this off has taken a very deliberate, very aggressive approach.”

Bubble Mentality

The NBA, Women’s National Basketball Association, National Women’s Soccer League and Major League Soccer embraced a futuristic idea to finish their seasons: the bubble. They built ecosystems sealed off from the outside world, where residents agreed to abide by strict regulations, including quarantines and daily testing. The number of virus transmissions identified between thousands of people once those bubbles were firmly established: zero.

The reason the bubbles contained the virus so effectively wasn’t just because they sequestered people and limited outside contact, but because of the collective support for the policies enforced inside them. The bubble organizers negotiated protocols with representatives of powerful players’ associations. The players generally accepted the plans, abided by the rules and policed each other because they had an economic incentive to collaborate.

Vigilance was constant. “Every day resets to zero,” said WNBA commissioner Cathy Engelbert before her league’s championship. “There’s no resting on the protocols or past success.”

To some public-health experts, the bubbles looked like paradise. There was an abundance of tests. There was broad adherence to mask requirements. There were travel restrictions that were easy to monitor because re-entry required isolation. Food and shelter was provided according to the disease-prevention playbook. The cooperation of players for any required isolation and contact tracing wasn’t in question.

“If you take care of their basics, if you test everybody and if everybody buys into the system, you can make it happen,” said Charlotte Baker, a sports-injury epidemiologist at Virginia Tech.

Test. Then Test More.

The professional leagues all placed bets on the same big idea: the more testing, the better.

Tests weren’t just plentiful in the bubble environments. They were required. In the NBA’s bubble, even though players were sequestered from the outside world for months, they subjected themselves to nasal swabs every single day.

Sports leagues went to extreme lengths to secure a testing supply in the spring and had much greater access to tests than the general public. In July, when cases nationwide surged again, professional athletes in Florida had their tests processed in less than one day while other Floridians waited far longer.

The non-bubbled leagues tested less often at first, but soon learned that infrequent testing was insufficient.

An outbreak of positive tests for the Miami Marlins exposed how the league’s plans for playing almost every day but testing every other day, then waiting for results, wasn’t going to work. Baseball moved to daily testing.

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A similar outbreak chastened the NFL. Football initially tested every day but game day. The league added tests on Sundays after it missed a crucial opportunity to intercept an outbreak on the Tennessee Titans.

The lesson for everyone else isn’t necessarily to pursue daily testing for everybody at all costs—though that is the ideal frequency for organizations that want to contain an outbreak. It is that no professional leagues that could afford such plentiful testing opted for less of it.

Nobel Prize-winning economist Paul Romer praised sports leagues for what he called their “courage to take bold action.”

“They recognized there was a very simple cost-benefit analysis,” he said. “The tests don’t cost that much, and the benefit that would show up for them in revenue far exceeded the cost. It was just as simple as that.”

The Biggest Risks Are Off the Field

The transmission rates between opposing players in outdoor sports such as football, soccer and baseball appear to be low. There hasn’t been a single documented case of infection linked to professional sports being played outdoors.

In late October, the Centers for Disease Control and Prevention published a report on the Marlins outbreak and its implications for the Philadelphia Phillies, the team they played while infectious.

“Throughout five professional baseball games, asymptomatic, unknowingly infected players and coaches spent more than a cumulative 11 hours on the field,” said the report, whose authors included doctors who guided MLB’s return to play. “No opposing team players or coaches or umpires became ill during the outbreak. Interactions outside of on-field play were likely the source of spread.”

That is why football teams find themselves worrying about another situation that is core to many workplaces: meals.

Notre Dame head football coach Brian Kelly said doctors attributed a team outbreak to the team gathering for a pregame meal.

PHOTO: KEITH SRAKOCIC/ASSOCIATED PRESS

“Not all contacts are created equal,” said Allen Sills, the NFL’s chief medical officer, who hasn’t seen evidence of on-field transmission.

Sharing a meal indoors, which means people are unmasked and often open-mouthed, was the reason Notre Dame coach Brian Kelly said doctors gave him for why 25 players suddenly tested positive in September. The team had skirted its own rules and held a large pregame meal together before playing the University of South Florida.

It was a reminder of an important lesson scientists have learned in the pandemic: Air is more dangerous than surfaces.

A hockey rink in Florida. A cycling studio in Canada. A dance-fitness class in South Korea. All were places where people had prolonged contact exercising indoors. In settings with strangers breathing, panting and emitting microscopic respiratory droplets on each other, 6 feet might as well be 6 inches.

Professional leagues tried to control that risk by reconfiguring every aspect of their players’ lives inside the bubble, including the food and shelter, which the leagues provided. In the WNBA’s so-called wubble, there was even child care for players’ children.

“You can create a safe hockey environment and create a safe rink and training facility, but what are these players doing in the other 18 hours a day?” said Isaac Bogoch, a University of Toronto infectious diseases specialist, who consulted on the National Hockey League’s protocols.

People Break Rules

At the climactic moment of the baseball season, In the middle of Game 6 of the World Series on Tuesday night, Major League Baseball ordered the Dodgers to yank Mr. Turner from the lineup after learning he tested positive. Mr. Turner entered isolation as his teammates secured the last outs. Pulling a player as soon as his result came in showed how zealously MLB wanted to be seen adhering to its plan.

As soon as the Dodgers won the championship, though, Mr. Turner ignored baseball’s protocols—and security officials—and rushed onto the field to join the celebration. He hugged teammates and posed maskless for a team photo with the trophy next to a cancer survivor.

“I don’t think there was anyone that was going to stop him,” said Dodgers president of baseball operations Andrew Friedman .

The message was clear. When temptations arise, people won’t always respect public-health restrictions.

A Confounding Disease

Utah Jazz center Rudy Gobert was the first athlete in a major American sports league to test positive. At the time, nobody really knew what the infection meant. Would he be hospitalized? Was he going to die?

As it became clear that the majority of young, fit, otherwise healthy athletes with robust immune systems would recover from Covid-19, sports leagues moved from panic to nuanced reopening strategies. Denver Nuggets center Nikola Jokic and Miami Heat forward Bam Adebayo were among the many NBA players who tested positive, recovered without experiencing symptoms and shined in the bubble.

But there were notable exceptions. Jamain Stephens, a 20-year-old defensive lineman for California University of Pennsylvania’s football team, died from a blood clot in his heart after he contracted the virus and was hospitalized, according to his family. Doctors still fear the potential for unknown long-term complications. Cardiologists have warned about heart inflammation from even mild cases of the virus which, if undetected, could prove fatal during high-intensity exercise.

The NFL, MLB and NBA screen for hidden heart damage before players are cleared to return. College football conferences have said they will, too.

Long Economic Tail

In early March, days before the NBA season was suspended and the U.S. went into lockdown, LeBron James was asked to contemplate the possibility of playing in empty arenas. “Impossible,” he said after one game. “I ain’t playing if you don’t have the fans in the crowd.”

It was possible, and Mr. James did play. He even won a championship in front of walls of virtual fans. The scenes inside baseball stadiums were equally bizarre: The human beings in the bleachers had been replaced by cardboard cutouts.

The past few months have taught sports that fans are important but not essential—at least for now. The games can be played without them. Being flexible and doing the unimaginable, whether it is a closed-door competition or shortening some baseball games to seven innings, paid off for the leagues.

But the economics of sports depend on getting fans back in arenas as soon as possible. What the leagues have done so far is spend money to lose less money. That isn’t a sustainable business model.

NBA commissioner Adam Silver has said that 40% of the league’s revenue comes from having fans in arenas. The pandemic will remain a financial calamity until it is possible to feel comfortable about people spending on tickets, buying hot dogs and beer and joining 20,000 other screaming fans indoors.

The NBA wasn’t planning to wait for a widely distributed vaccine to begin next season. It was hoping that advances in rapid testing would allow more fans back into arenas, and people around the league banked on starting again in February or March. But with hopes of crowded arenas dimming, the league is now targeting a return date around Christmas.

Sports are back now, but the economic recovery of sports won’t begin until fans are back, too. What is happening in October 2020 would have been unthinkable in March—and may be financially unfeasible if it is still happening in October 2021.

The ultimate policy takeaway from sports is that the most challenging months are yet to come.