Implementation and Evolution of Mitigation Measures, Testing, and Contact Tracing in the National Football League, August 9–November 21, 2020

Abstract

this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr).The National Football League (NFL) and the NFL Players Association (NFLPA) began the 2020 football season in July, implementing extensive mitigation and surveillance measures in facilities and during travel and gameplay. Mitigation protocols* were evaluated and modified based on data from routine reverse transcription-polymerase chain reaction (RT-PCR) tests for SARS-CoV-2, the virus that causes coronavirus 2019 (COVID-19); proximity tracking devices; and detailed interviews. Midseason, transmission was observed in persons who had cumulative interactions of <15 minutes' duration, leading to a revised definition of highrisk contacts that required consideration of mask use, setting and room ventilation in addition to proximity and duration of interaction. The NFL also developed an intensive protocol that imposed stricter infection prevention precautions when a case was identified at an NFL club. The intensive protocol effectively prevented the occurrence of high-risk interactions, with no high-risk contacts identified for 71% of traced cases at clubs under the intensive protocol. The incorporation of the nature and location of the interaction, including mask use, indoor versus outdoor setting, and ventilation, in addition to proximity and duration, likely improved identification of exposed persons at higher risk for SARS-CoV-2 infection. Quarantine of these persons, along with testing and intensive protocols, can reduce spread of infection.The NFL consists of 32 member clubs based in 24 states. The NFL-NFLPA implemented a standard COVID-19 mitigation protocol in July that included mandatory masking; physical distancing; frequent handwashing; facility disinfection; restricted facility access; and regular, frequent testing of players and staff members (1). Contact tracing was performed by trained staff members and supported by KINEXON wearable proximity devices (https://kinexon.com) that were required to be worn by players and personnel when in club environments (2). Device recordings captured consecutive and cumulative minutes/seconds of interactions among persons within 1.8 meters (6 feet) of one another. When testing identified a new COVID-19 case, trained staff members conducted interviews to identify contacts *

SARS-CoV-2 Transmission Risk Among National Basketball Association Players, Staff, and Vendors Exposed to Individuals With Positive Test Results After COVID-19 Recovery During the 2020 Regular and Postseason

“…Among this group, despite their persistent positive test results, we observed no transmission events during at least 1480 patient-days of indoor, unmasked interactions. The high volume of exposure, combined with the nature of the contact 27 and subsequent evident lack of transmission, provides some of the best evidence to date in support of a symptom and time-based strategy. Thus, our results support observations that asymptomatic individuals who have met CDC criteria for discontinuation of isolation, but who have persistent positive RT-PCR test results with high Ct values, do not appear to be infectious to others.…”

Surveillance testing for SARS-COV-2 infection in an asymptomatic athlete population: a prospective cohort study with 123 362 tests and 23 463 paired RT-PCR/antigen samples

“…This is consistent with the experience of other conferences where daily testing (antigen or RT-PCR) alone did not prevent outbreaks. 10 11 There were several limitations to this study. We considered the RT-PCR test to be the gold-standard test, but false-negative and false-positive RT-PCR tests can occur.…”

Variation in SARS-CoV-2 bioaerosol production in exhaled breath

“…The Centers for Disease Control and Prevention (CDC) guidelines define a close contact as an individual who spent at least 15 minutes, over a 24-hour period, within 2 meters of an individual with COVID-19 (1,2). This definition has been widely used to inform contact investigations in community as well as in healthcare settings (3) based on a premise of average risk, though the empirical basis for this specific time window is limited.…”