Dr. Anthony Fauci’s keys to having an NFL season in 2020

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Dr. Anthony Fauci on the NFL trumps all today (no pun intended), but please take time to read a dozen Don Shula stories from storytellers close to him after the death of the NFL’s winningest coach last week. Also in the column: The schedule, the big favor the NFL did for ESPN, the virtual learning, the Dolphins quirks, the making of a new national team (hint: the coach wears Kangols), the new world of Greg Olsen . . . lots to read today.

This interview with Fauci, which was off and on and off and finally on late in the day Saturday, was done with the idea that I’d get a good picture of what the NFL faces in the coming months. I think I did—but that doesn’t mean it’s a clear picture.

“How can I help you?” Fauci began when we connected.

The question we all have, I believe, is whether it makes sense to aim for negative-testing pro football players to compete in empty stadiums starting in September. Fauci suggested stadiums might not have to be empty all season.

“I think it’s feasible that negative testing players could play to an empty stadium,” Fauci said. “Is it guaranteed? No way . . . There will be virus out there and you will know your players are negative at the time they step onto the field. You’re not endangering . . . Also, if the virus is so low that even in the general community the risk is low, then I could see filling a third of the stadium or half the stadium so people could be six feet apart. I mean, that’s something that is again feasible depending on the level of infection. I keep getting back to that: It’s going to depend. Like, right now, if you fast forward, and it is now September. The season starts. I say you can’t have a season—it’s impossible. There’s too much infection out there. It doesn’t matter what you do. But I would hope that by the time you get to September it’s not gonna be the way it is right now.”

It’s clear he thinks the NFL has time on its side. Not just because he sees the virus waning by Labor Day, certainly, but because of other factors that are calendar-friendly. One: The availability of tests should make massive testing by August and September easier. Two: We should be far more prepared to handle the disease as it loosens its grip on society, even with the prospect of a second wave hitting later in the fall. Three: Increased Antogen testing might increase the prospect that a significant segment of society—including, presumably, football players—could be made immune to the virus by plasma donations.

The biggest factor on the NFL’s side might be this: We’re going to be smarter about everything related to the disease in three months, when teams hope to gather for some sort of team training. Think of where we were two months ago today. On March 11, we were still dining out, still shaking hands, still driving to and from work. Three months from now, on Aug. 11, we really don’t know where we’ll be, because three months is an eternity in the race to conquer this virus.

Take testing, for example. I said to Dr. Fauci that if the 32 NFL teams tested players, coach and vital personnel twice a week, that would probably consume about 200,000 COVID-19 tests for the season. I asked Dr. Fauci if that might be reasonable by mid- to late-August, or a bit piggish?

“That’s a great question,” he said. “Right now, it would be overwhelmingly piggish. But by the end of August, we should have in place Antigen testings . . . You could test millions of people, millions of people. But again, we have to make sure that the companies that are doing these tests actually produce them. Which given the country that we have, such a rich country, I would be very surprised if we can’t do that.”

Football’s a different sport than many trying to figure a route back to play. With so much physical contact, I wondered, could the virus be transmissible more in this game than others, with players sweating on each other and gripping and tackling each other?

“Sweat does not do it,” Fauci said. “This is a respiratory virus, so it’s going to be spread by shedding virus. The problem with virus shedding is that if I have it in my nasal pharynx, and it sheds and I wipe my hand against my nose—now it’s on my hand. You see, then I touch my chest or my thigh, then it’s on my chest or my thigh for at least a few hours. Sweat as such won’t transmit it. But if people are in such close contact as football players are on every single play, then that’s the perfect set up for spreading. I would think that if there is an infected football player on the field—a middle linebacker, a tackle, whoever it is it—as soon as they hit the next guy, the chances are that they will be shedding virus all over that person.

“If you really want to be in a situation where you want to be absolutely certain, you’d test all the players before the game. And you say, Those who are infected: Sorry, you’re sidelined. Those who are free: Get in there and play.

And test more than once a week, if you can.

“If I test today, and I’m negative, you don’t know if I got exposed tomorrow . . . There’s no guarantee that you’re going to get exposed and be positive the next day. To give you an example, you’re probably reading in the newspapers that there’s an infection in the White House. I was exposed to that person. So I immediately got tested. I am negative. So, I’m negative yesterday. I don’t know if I’m going to be negative Monday. Understand? It’s almost an impossible situation. To be 100 percent sure, you’ve got to test every day. But that’s not practical and that’s never going to happen. But you can diminish dramatically by testing everybody Saturday night, Sunday morning, and say OK, only negative players play.”

Fauci said two weeks ago that it’s “inevitable” the virus will return in the fall, and it could make “for a bad fall and a bad winter.” That begs the natural question about how it could affect whether the NFL would be able to get in a full season.

“The answer is not going to be black and white,” Fauci said. “When I said there’s no doubt the virus is going to return, that is in response to some who have said ‘Oh, it’s just going to disappear.’ So, unlike the virus SARS, back in 2002, when we had an outbreak of about 8,000 people and close to 800 deaths, and then the virus just essentially petered out by good public health measures by the simple reason that it wasn’t efficiently or effectively transmitted from one person to another. In other words, it was not an efficient spreader. So that when you tamp down on it with public health measures, it actually got to the point where it disappeared.

“That’s not the case with this novel coronavirus. It is so transmissible, and it is so widespread throughout the world, that even if our infections get well controlled and go down dramatically during the summer, there is virtually no chance it will be eradicated. Which means there will be infections in the Southern Hemisphere, in South Africa, in Argentina, places like that. And with the travel, the global travel, every single day, of literally hundreds of thousands of people coming into the United States every day from all over, there’s no chance we’re going to be virus-free.”

No chance. Which leaves NFL teams under tremendous pressure to create pristine environments in places that, traditionally, are hardly pristine.

“As for the football season and what the fall is going to be: It will be entirely dependent on the effectiveness with which we as a society respond to the inevitable outbreak that will occur. So what are the options? If we let it just go, and we don’t have a good response, you can have an outbreak somewhat similar. Probably not as bad, because we got hit really with a 1-2 punch, particularly in New York City and New Orleans and Chicago. But we can expect an outbreak that would be serious. That’s if we do nothing. So it’s inconceivable that we would do nothing. What we’re saying is what is going to be the effectiveness of our response? . . .

“Now, even if the virus goes down dramatically in June and July and August, as the virus starts returning in the fall, it would be in my mind, shame on us if we don’t have in place all of the mechanisms to prevent it from blowing up again. In other words, enough testing to test everybody that needs to be tested. Enough testing so that when someone gets infected, you could immediately do contact tracing and isolation to prevent the infection from going to a couple of infections to hundreds of infections. That’s how you control an outbreak.

“So, practically speaking, the success or failure, the ability or not, to actually have a football season is going to depend on just on what I said . . . but what I’m really saying is it’s unpredictable depending upon how we respond in the fall.”

I asked this about working with President Trump, who has been pretty clear that he wants sports, and normalcy, to return to the country: How much does that have to whether football will be played this fall?

“No, well, you know,” he said, a bit cautiously, “I could only give my medical advice. If there’s infection out there, and I say I think that we should lock down or not, I’m just an opinion among many. Whether people listen to my public health opinion or override it, that’s out of my hands.”

Fauci said the NFL hasn’t reached out to talk to him. But if Roger Goodell or chief medical officer Allen Sills did, Fauci said he’d say much of what he said here. And this, about sports in the United States this fall and winter: “It is uncertain. You’ll have to play it by ear according to the level of infection in the community.”

Read more from Peter King’s Football Morning in America column here.