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Why epidemiologists are pessimistic about a college football season

November 30, 2019 Atlanta - Georgia and Georgia Tech during the first half of an NCAA college football game at Bobby Dodd Stadium on Saturday, November 30, 2019. Georgia won 52-7 over the Georgia Tech. (Hyosub Shin / Hyosub.Shin@ajc.com)
November 30, 2019 Atlanta - Georgia and Georgia Tech during the first half of an NCAA college football game at Bobby Dodd Stadium on Saturday, November 30, 2019. Georgia won 52-7 over the Georgia Tech. (Hyosub Shin / Hyosub.Shin@ajc.com)

Credit: HYOSUB SHIN / AJC

Credit: HYOSUB SHIN / AJC

This week’s announcements by the ACC and SEC about schedule models tickled the hopes of college football fans that, just maybe, the season can be played and the rivalries can go forward. Georgia Tech fans joined fans of other ACC schools in analyzing the conference’s scheduling model, and engaged in banter with Georgia fans over the SEC’s decision to not play a non-conference game, meaning a temporary halt to the Tech-Georgia game.

With preseason camp scheduled to start in a few days, the possibility of playing games seemed as close as it has been since mid-March.

However, three public health experts in the state of Georgia aren’t optimistic for a variety of reasons, including the continued spread of the coronavirus and potential fissures within the testing system designed to ensure that only players free of COVID-19 can take the field.

“The athletes can do everything right; the coaches can do everything right, but when the community spread around them is so high, that bubble just isn’t going to stand up,” said Travis Glenn, a professor of environmental health science at the University of Georgia. “It just isn’t. So that’s the problem.”

The rate of community transmission is an initial concern.

“I think I was much more hopeful earlier in the year (for college football), that we would have a little bit more manageable control,” said Christina Proctor, a clinical assistant professor and colleague of Glenn’s in the College of Public Health at UGA. “And now that things have gotten worse, I’m very worried that it’s not going to happen. And I’m an avid fan.”

Test positivity – the percentage of COVID-19 tests that come back positive – is one marker that explains her pessimism. A higher rate indicates either that the virus is spreading or that testing hasn’t been widespread enough – meaning that people who unknowingly have the virus are infecting others – or both. The World Health Organization advocates a rate of 5% in order for restrictions to be relaxed. Nationally, the seven-day moving average as of Saturday was 8%, according to data collected by Johns Hopkins University.

Earlier in the summer, the positivity rate in Georgia dropped below 5%, according to the same data. However, as the state has re-opened and health measures such as mask wearing and social distancing have not been followed completely, the state’s seven-day rolling average was at 13%. It was 19% in Alabama and Florida, 16% in South Carolina and 6% in North Carolina.

“(The rate in Georgia) is higher than most people should feel comfortable sending their children to school, and that’s the same kind of scenario where people should be uncomfortable that they’re going to be able to keep their athletes in a bubble that’s going to last,” Glenn said. “That bubble is going to get pierced.”

Concerns about community spread are heightened given that football players will be on college campuses, where tens of thousands of students will gather from disparate locations.

Glenn acknowledged that athletic departments and coaches can limit their athletes’ exposure to a great deal, for example by encouraging them to enroll only in online courses and mandating mask usage.

However, “these are 18- to 22-year olds that are going to see other people,” he said. “They just are. And so that’s what’s going to make it really, really hard.”

Rutgers placed its entire football team in a 14-day quarantine last week when several team members tested positive for COVID-19. Players’ attendance at an on-campus party was the culprit, according to an NJ.com report.

“I think we’re going to see outbreaks on college campuses in the fall,” said Zach Binney, an epidemiologist at Oxford College of Emory University. “The football teams are not going to be fully insulated from that.”

Another concern is the testing guidelines by the NCAA, developed with multiple medical groups. The guidance recommends that athletes, coaches and support staff must be tested within 72 hours of competition, such as Wednesday before a game on Saturday, a protocol that the ACC will incorporate.

Binney cautioned of the possibility of a player contracting COVID-19 on a Tuesday and then taking the test Wednesday before the virus has incubated. By Thursday or Friday, the player becomes contagious, but, with a negative test result, continues to practice and is cleared to play on Saturday. In that scenario, he could take part in a game that Dr. Anthony Fauci, the nation’s leading infectious disease expert, called “the perfect setup for spreading” the coronavirus.

“If you’re a center, that could spread to your entire offensive line, but it would also spread to the opponent’s defensive line, and that means that they take it back to their campus, so now there’s the risk that you’re seeding new outbreaks around the country from college football,” Binney said.

From the perspective of the impact on rosters, the containment response to such a possibility could easily sideline many more players for both teams. The Centers for Disease Control and Prevention advises quarantining for anyone in close contact with an infected person, and its definitions for “close contact” include being within six feet of that person for at least 15 minutes, having direct physical contact with that person or having gotten that person’s respiratory droplets on you. The NCAA advises following those guidelines.

Consider how many teammates and opponents a running back who carries the ball 20 times or a linebacker who makes 12 tackles and plays special teams has direct physical contact with over the course of a game. If one such player slips through testing protocol with COVID-19, quarantining measures could gut both teams’ rosters for two weeks.

“I’m pessimistic about the possibility of college football,” Binney said.

The roster challenges aside, the actual health risks posed to players are also a concern. There is a notion that going forward with the season is worth the risk because college football players are healthy and young, and their health likely won’t be impacted significantly. That line of thinking ignores the fact that those players will also be around coaches and staff who are much older, as well as their families, and that many could have potential health risks, such as obesity or asthma. Also, Glenn noted, there’s much about COVID-19 that isn’t known.

He pointed out, for instance, that people infected with the coronavirus have often suffered recurring headaches after recovering.

“How long is that going to last?” Glenn asked. “We don’t know. So that to me is probably the more realistic ‘What should they be scared of?’ is that they’re going to have an additional set of injuries that they’re going to have to deal with for the rest of their lives.”

It’s possible that teams could make it through the season unscathed or with minimal interruption. But the reality is that it could only take a few individuals on a few teams to get infected and then practice and play in a game for the season to be severely compromised. That’s a long tightrope for a lot of people to walk.

It’s why, in videoconference interviews this week, Miami athletic director Blake James acknowledged that the ACC’s plan for an 11-game schedule is “probably very aspirational” and why Pac-12 commissioner Larry Scott, when asked his confidence level for the season, responded, “I don’t know.”

It’s not a hopeless situation. Testing availability, accuracy and turnaround time can continue to improve. The safeguards that the NCAA, leagues and schools have put into place appear to be good-faith efforts to protect athletes’ health.

It’s conceivable that the community infection rate can drop to safer levels over the course of the next few months, considerably lowering athletes’ risk of infection both while with their teams and away from them. College football likely can apply lessons learned from MLB and the NFL in coming weeks. Also, the scheduling models that the ACC, SEC and other leagues have constructed clearly were made with the idea that there will be disruptions.

But, it may not be enough, as much or more due to the environment that players will be living in than the game itself.

Proctor said she highly approved of the NCAA’s measures, “but it doesn’t work if you haven’t at least flattened or gotten manageable rates of community transmission, which we are not at currently in Athens-Clarke County. So that’s a real worry.”