Editor’s note: This story was first published on the 29th. of January, but was updated and republished after the LV Super Bowl, the final game of the 2020 season.

Chiefs quarterback Patrick Mahomes tested his barber on KOVID-19 to ensure a safe cut. Then it became a game of Uno for nightly entertainment.

Matthew Stafford, a former player for the QB Lions, spent a week in seclusion in a hotel, flew on a private jet to Minneapolis and started the game without a single attempt.

Browns offensive lineman Michael Dunn prepared for the start of the playoffs by practicing in a building parking lot. His girlfriend helped him by giving false signals.

Let’s go. The Broncos made a receiver of the coaching staff the starting quarterback in one day. Jets quarterback Sam Darnold did not visit his family for Christmas, according to NFL protocol. The league’s coaching staff had been preparing for a game for almost months, even when they were in adjacent offices in the team halls. And the two head coaches even watched the game at home while the interim coaches stood on the sidelines.

NFL players and staff took on the challenge of surviving the 2020 season, which began on the 7th. February ended with the LV Super Bowl. They have reprogrammed their time-honored football habits, outgrown their sense of competitive equality, and adopted a well-funded and supercharged version of COWID-19 moderation that the entire country can follow.

The results are better than we could have imagined. When the veterans met on the 28th. By July, the number of positive cases of the coronavirus in the United States had already reached 4.3 million in more than four months since the epidemic changed the nation’s way of life, and more than 140,000 people had died from the virus. (The national workload is now over 27 million cases). Many wondered if it was possible to finish a full season, and those concerns only intensified when the Titans were hit by an explosion in week four. But in the end, the NFL only postponed five of its 256 regular season games to let the explosions run their course, and rescheduled another 10 games, but none were canceled. How did the League do?

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With an investment of more than $100 million, the NFL Players’ Association and the NFL have implemented an infection control system so robust that numerous scientific papers with recommendations for use outside of football have been submitted – including one published last month by the Centers for Disease Control and Prevention (CDC).

The league’s overall positive activity rate is 0.076% since January 1. August – 726 infections out of 959,860 tests averaging about 7,500 workers per week – was well below the national average (6.8% for the same period) according to data collected by the Atlantic COWID-19 follow-up project. Although the U.S. is experiencing the worst public health crisis in a century, public reports say there have been three hospitalizations of NFL personnel: a coach, a player and a referee. During the season, our facilities and conditions for NFL teams were among the safest in these areas, Dr. Allen Sills, chief medical officer of the NFL, told ESPN.

The effort has been grueling, but may need to be repeated next season, at least in a modified form, depending on the introduction of the vaccine in the country and the number of viruses in the coming months. Nonetheless, the pandemic has sent a usually sluggish league into an innovation era that will affect it for years to come.

It took a concerted effort by all involved to come to an agreement to do things differently, said JC Tretter, president of the NFLPA and center of the Browns. Accept that you need to do things differently and do them well. And as we know at COVID, it can cost us money if someone doesn’t follow the rules.

The NFL story began in the midst of a pandemic that seemed suspicious to some in the public health community, said Eric S. Rubenstein, associate professor of epidemiology at Boston University’s School of Public Health. But ultimately, he said, the absence of serious and real illnesses shows that what they do is work for the people they care for.

Risk management

At the beginning of the pandemic, the fundamental question in professional sports was whether to play. Will this pose a threat to players, coaches and surrounding communities? Will it absorb the health resources intended for the weakest citizens?

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NFLPA Executive Director DeMaurice Smith fought this issue from an ethical and moral perspective. He said we don’t do anything at any cost.

Sills, the neurosurgeon the NFL hired in 2017 in the first place to administer its concussion protocols, said owners and commissioner Roger Goodell have assured him that if at any time I or any of our advisers feel it is unsafe to proceed, they are certainly prepared to take action against him.

More broadly, Sills added, part of the physician’s job is to help our patients cope with their illness or disability as they try to move on in their lives. That is the nature of medical practice. Sometimes it is a short-term, self-healing illness, there may be a short-term viral illness or a short-term back problem – such as a hernia. In other cases, it is a chronic disease. So our philosophy as physicians is that we want our patients to be able to enjoy the things that are important in their lives while controlling these conditions or reducing the risk of injury or disability. So I guess it’s the same approach here.

In the end, the NFL and NFLPA may have protected their employees and members better than if they had cancelled the season and dismantled all members of their home communities. Needless to say, they were highly motivated and spent millions of dollars to avoid losing the billions that a full 17-week season entails. (The total value of the NFL’s TV contracts in 2020 was nearly $10 billion).

When his season ended in January, Seahawks receiver Tyler Lockett expressed his uncertainty about living without the guarantees inherent in the league.

Given what we’ve been through all year, he said. We have to be challenged every day, try to stay away from as many people as possible, watch who is flying and who is there. Now we literally have to go back to the real world. It’s hard to be in the real world when you’ve been away from it for so long, and now you have to know where you’re going, who you’re going to see, who you’re not going to see.

Last spring, the league and union decided they didn’t want and couldn’t achieve the kind of bubble that would allow the NBA, WNBA, NHL and football to have modified seasons in the summer and fall. Instead, they assumed that some of their players and coaches would be infected and put in place a plan based on the principles put forward by health officials: frequent testing, physical separation, contact tracing and isolation of infected individuals, while committing to regularly send replacements if necessary.

The League has contracted BioReference Laboratories Inc. to establish a network of 32 on-site testing centers and five laboratories nationwide to ensure results of conventional nasal swab (PCR) testing within 24 hours. She bought electronic trackers from Kinexon, required everyone on the team or in the stadium to wear them, and partnered with the medical data company IQVIA to analyze this data in real time to detect cases of infections in the area. In most cases, Contact Tracers can download a complete set of contacts in an infected person’s environment within minutes of receiving a message with a positive result.

This season, the NFL used tracking devices from manufacturer Kinexon to accurately measure physical distance and make it easier to track contact. Zach Bolinger Sports Wire/Icons

When the League office reorganized its structure and brought in personnel from other departments to form the 18-member contact team, each team was required to designate an Infection Control Officer (ICO) to serve as the contact person. Teams remodeled their facilities to create a one-meter separation between players in locker rooms and weight rooms; teams in hot climate zones (like the Rams) built temporary outdoor meeting spaces to minimize the risk of atomization. Most teams doubled the number of buses they used during the trip and often added a second charter plane, all to ease the physical distance during the trip.

The pivotal moment came in September when the NFLPA insisted on daily testing throughout the regular season to maximize the chances of detecting an infection early enough to prevent it from spreading within the team. Newly recruited players were required to test negative for at least five consecutive days before being allowed to enter the team’s field.

I think if we don’t test every day, Smith said, this season won’t be what it was. We don’t find the success we’ve had in the time we’ve had to implement it.

The NFL and NFLPA have argued that they have not impeded public access by conducting nearly one million biorefinery tests. We have created a completely independent supply and logistics pipeline, Sills said when asked about the number of tests used. We have never been tested in any of the existing medical facilities or hospitals. … Our testing program is set up by an independent laboratory company with new methods of delivery and distribution.

The identification of positive cases was only a first step. The league’s COWID-19 working group not only tracked the source of each contamination, but also sought to identify trends that might discourage teams from engaging in risky behavior. Dr. Christina Mack, vice president of epidemiology and clinical evidence at IQVIA and consultant to the NFL, said some of the team’s earliest sources of transmission were in small meeting rooms, where people ate and drank together and even in the command center’s vehicle fleet. As the season progressed, all addresses were recorded in updated logs.

Seasonal adjustment

Four more mid-season rotations took place as the league made cascading changes to its schedule following the Titans’ explosion.

First, the NFL found that 90% of infections were visible when testing was done within two to five days of exposure. He also found, through contact tracing, several instances of data transmission in less than 15 minutes of exposure. With this information, he created a classification of close contacts at high risk to find other ways to minimize the chance of someone becoming infected and spreading the virus before presenting for testing.

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Rather than relying solely on distance and time of exposure, the approach included setting, ventilation level, and whether the exposure occurred with or without a mask. A short car ride without a mask would be z. B. high risk, but a long stay outside with masks is not. All high-risk contacts had to be isolated for five days, even if they tested negative and showed no symptoms. The change caused some teams to be significantly underqualified in games – especially in Week 12, when the Ravens lost a dozen players and the Broncos had to play without their best four quarterbacks – but it did end some transfer lines.

According to Sills, more than 40 high-risk close contacts ended up testing positive during the five days of isolation.

Second, the League has begun conducting genomic sequencing tests, a process that allows scientists to map the viral structure of an infection. In practice, this means that the League can know with a high degree of accuracy whether the team’s multiple infections came from the same source – and thus spread throughout the building – or whether they were contracted in different parts of the community. This information gave the NFL and the NFLPA the confidence to play, even when teams came back with multiple positive results in the days before games.

Third, the union adopted very strict protocols, including a ban on personal encounters, wearing blankets during drills, and requiring that all food be taken away.

Fourth, she was involved in the development of a more accurate point-to-point test with Mesa Biotech, which served as an additional safeguard on game days to obtain additional data before players were allowed to participate.

According to a document published by the CDC, all of these strategies have a scope far beyond football. These data were particularly relevant because nearly 40% of confirmed positive cases were asymptomatic during the course of infection.

Although the protocols used in the NFL required significant resources, the paper indicates that strategies such as taking into account the specifics of close contacts, in addition to time and duration, and establishing an intensive protocol are also applicable to other situations, including the primary workplace, long-term care facilities, and schools.

Virus has not crossed the line of scrimmage

Of course, playing football during a pandemic requires at least a little luck. In this case, the NFL took advantage of the unexpected fact that the games themselves – three hours of players at each other’s throats in a confined space – were not broadcast. According to Sills, there has not yet been a single infection in the NFL that can be attributed to an interaction during the game.

I am currently not aware of any broadcasts of sporting events around the world, he added. These things can be hard to prove when you don’t have as much testing and epidemiology as we do, but at least on the NFL side, we haven’t had success in our games. The virus hasn’t crossed the line yet, as far as we know.

The most likely explanation, according to Sills, is that players often communicate during games, but for an incredibly short period of time. Data trackers used during the games showed that most interactions lasted no longer than six seconds. Even when these contacts were added, Sills said, they didn’t have time to transfer, which varies by context, according to a study published by the CDC.

Including playoffs, 43.9% of the 269 NFL games that ended this season had official participation (118). Others had limited audiences, and friends and family were invited into the stadiums. Gary A. Vasquez – Sports in the United States Today

The size of the stadiums and the ability to circulate the air inside them, both outdoors and indoors, have also helped to reduce risks. The NFL was so confident in the science of stadium size that it allowed its teams to work with local and state authorities to allow a limited number of fans to attend games if they wished.

During the regular season, 19 teams brought 1,181,066 fans to games, including 197,313 for the Cowboys. The NFL has stated that no outbreaks based on attending NFL games have been reported in the country, but Rubenstein was among the many health officials who questioned the relevance of that statement. Tracking contacts during NFL games was largely left to overworked health officials who could not keep track of every infection.

Rubenstein said it was irresponsible to allow tens of thousands of people, in some cases, to gather for contests and add : Absence of evidence is not evidence of absence.

Between the start of training camp and the Super Bowl, at least 22 million people nationwide became infected with VIDOC-19, and nearly 315,000 died. According to Sills, there have been incredibly few serious cases among the union’s fully tested staff. The Jaguars, who knocked out Raikell Armstead, Broncos defensive coordinator Ed Donatel and referee Clay Martin were among the few who had to be hospitalized.

Initial fears of possible long-term damage to the heart have not been confirmed so far. Every infected player and staff member underwent a heart exam, but Sills said the number of cases was incredibly low, and fortunately we didn’t have anyone with a serious outcome.

The NFL, along with other professional sports leagues, produced a report that Sills says shows a similar trend across the industry.

Most NFL players are candidates who have a relatively low risk of serious illness based on their age group and physical condition, especially after 69 players decided to retire before the season for medical or other reasons. (The Patriots led the league with eight players.) But the NFL has also demonstrated the effectiveness of a motivated and well-funded community in fighting the virus, as well as the importance of general compliance.

It’s not easy. But it’s not hard. We know exactly what needs to be done to protect people. When I say it’s not easy, I mean it has to be applied consistently every day to every member of the organization. If you don’t, you’re vulnerable.

Dr. Allen Sills, NFL medical director.

One of the things I’ve said repeatedly is that I don’t think it’s difficult to reduce risk, Sills said. It’s not easy. But it’s not hard. We know exactly what needs to be done to protect people. When I say it’s not easy, I mean it has to be applied consistently every day to every member of the organization. If you don’t, you’re vulnerable.

You have to pay it.

Like many other players, Mahomes has made a habit of cutting his hair before games over the years. This simple ritual required additional work in 2020. Before he barged in, he made sure his barber was tested for VOCID-19. The store would also be empty when he arrived, Mahomes said at the end of the season. (In the week leading up to the Super Bowl, two Chiefs players – center Daniel Kilgore and receiver Demarcus Robinson – had to be isolated for five days after their hair was cut by a barber who tested positive for COVID-19. Neither player was infected).

The post-game rituals are now largely gone. Some of these, like the jersey swap, have been replaced in creative ways; the NFL has partnered with Tide to cover the cost of shipping and swapping a jersey with another player. On a personal level, players and coaches have faced the same sense of social isolation as millions of others across the country and the world.

If I was dealing with boys and other people, even family, I had to avoid that as much as possible and keep it to a minimum, Mahomes said. He can’t hurt you. You’re used to dealing with people, enjoying things outside of football, enjoying things that don’t always go wrong and working every day. So we have to find other ways to do it.

One night in December, he escaped on the bridge of the Uno, home to his fiancée Brittany and his brother Jackson.

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After the NFL and NFLPA dropped the bubble concept over the summer, they agreed to allow players and coaches to live at home and play sports locally, and encourage them to avoid risky behavior. For example, sanctions were imposed if players participated in off-site group activities with more than three people. Ten Raiders players were fined between $15,000 and $30,000 for taking off their masks at a charity event, and Texas quarterback Deshaun Watson was fined $7,500 after attending a restaurant opening with dozens of other players.

This has led to players and coaches playing much more Uno and much less back table tracks. Lions defensive coordinator Corey Undlin, who missed the Week 16 game because he was deemed to have had close and risky contact with an infected person, said his routine has been the same for more than 170 consecutive days: I’m going into the building and I’m coming home. I live alone. I felt safe, but you never know.

Similar stories have happened all over the league this season. Darnold said his parents and sister flew from their home in Los Angeles to New York to spend Christmas with him. But before they could see it, they had to send back negative test results. The NFL has offered this service through its teams, both to protect its players and to address mental health issues that may arise during the holidays.

At the same time, Stafford was allegedly in close contact with a person who tested positive in week nine, requiring him to be isolated for five days. It meant spending Tuesday through Friday in a hotel room in Michigan, having food delivered to his home and not being able to practice with the team or visit his wife and children. Had he remained negative during this process, Stafford would have boarded a private plane to Minneapolis on Saturday, checked into a hotel and joined the team for Sunday’s game against the Vikings at U.S. Bank Stadium.

Last night, at his hotel in Michigan, Mr. Stafford received a call that one of his daughters was on her way to the hospital after falling from a high chair onto a granite floor. At first, his wife, Kelly, couldn’t find anyone to stay with the other three children. So Stafford left the hotel, got in his car and drove home.

On the way, he called the Lions’ general manager, Bob Quinn, to let him know what was going on and to confirm that if he went home, he would break his suspension early and thus would not be allowed to play against the Vikings. When he was about a mile from home, his wife found someone to stay with the kids. Stafford turned and headed back to the hotel without breaking isolation.

Lions QB Matthew Stafford almost had to suspend COWID-19 protocol when a problem occurred at his home in early November. But fortunately this was prevented and he could play the game this week. Raj Mehta-USA TODAY Sports

It’s not something I take lightly, he said later. I understand that this is a pandemic and people’s health and safety is at risk, and I would feel very bad if I took this and infected a group of teammates or coaches or whatever. That’s what I understood. It’s not easy, but everyone in the league is doing it. I hate to be away from my family, you know, and finish practice, finish the game, kiss my daughters, kiss my wife. That’s what makes it worth it for me sometimes, and not being able to see them and hang out with them was really hard. But there are other people who do the same things I do.

You cannot play through COVID.

Unexpected phone calls and late night drama have become the norm for NFL general managers and coaches. The speed of testing varied from team to team, but in general BioReference’s goal was to provide results within 24 hours. The ICO team often received them in the middle of the night, usually with instructions to disseminate the information immediately. In an isolated incident in Week 13, the Ravens tested positive for WR Dez Bryant so early that he was suspended for the evening game.

Those calls at 3 a.m. when the tests are over? It was fun to see if you had a full house or if a few people were missing, Chiefs coach Andy Reid said.

On the third. In October, the Saints travel to Detroit to play the Lions the next day. Around 10:30 p.m., after arriving at the team hotel, the Saints learned that quarterback Michael Burton had tested positive since morning. Protocol required Burton to take an additional test, as did those sitting next to him on the team.

These tests were conducted just before 1 p.m., with coach Sean Payton and several other team members staying up until after 3 a.m. to get the results by 1 p.m., the scheduled departure time. Burton’s first test was false positive, the others were also negative, and the game started on time. Full of abandon but no sleep, the Saints lost 14-0 before coming back and winning 35-29.

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Like most coaches, Peyton wasn’t happy with a break in the routine, but he made his point: That’s how it is this season.

In fact, the entire NFL community has been forced to accept what would normally be considered extremely unfair competitive advantages. The 49ers confronted the Packers in week nine without most of their landing body and left tackle Trent Williams and lost 34-17. They then moved to Arizona for the last five weeks of the season after regulations in their home county of Santa Clara, California, prohibited them from continuing their business. They’ve lost four of their last five games.

The Broncos inserted rookie Kendall Hinton as quarterback just hours before the Week 12 game against the Saints, after learning the day before that starter Drew Locke and his three replacements had gathered for an unmasked film screening when teammate Jeff Driskel was contagious. The Broncos lost 31-3. The Ravens also lost a key AFC North game to the Steelers in Week 12 with quarterback Lamar Jackson among the 12 players who were ineligible for the game. The game was postponed until Wednesday as the NFL waited for the outbreak to be over. It was the second game of the season for the Steelers, which was postponed several times due to lightning strikes from the opposing team.

The Lions lost 47-7 to the Buccaneers in Week 16 after interim head coach Darrell Bevell, Undlin and three other assistants deemed risky at the tight end position. And the Browns were forced to play their first playoff game since 2002 without their coach Kevin Stefanski, who tested positive. (They won 48-37).

In many cases, the NFL has denied requests from teams for waivers until key players are allowed to play. Goodell’s massive rejection, codified in a letter to clubs in October, marked a break with the spirit of league equality that had long animated him.

Goodell has long tried to claim that the league in the NFL is real and that the results are not predetermined or even titled by the powers-that-be. However, priority will be given to the 2020 Games when they are deemed safe.

We had to persevere to get through this unique season and protect the health of players, coaches and others, said Jeff Miller, NFL executive vice president of communications, public relations and policy. There was no alternative. When this principle has been tested, we have applied it consistently and regularly. The clubs, coaches and players knew this, and it had to be so in order for the regular season to continue. Once we felt comfortable and convinced that the game was safe, we continued. Otherwise you create variability in this principle.

Kendall Hinton, a coach on staff and former QB at Wake Forest University, started under the Broncos in late November after four QBs were placed on the reserve/COVID-19 list. He went one on nine with two interceptions. AP Photo/David Zalubovsky

The actors, for example, didn’t argue.

The guys want to be there, Tretter said, and that’s one of the hardest things this year. Men’s play through injury, illness, and this year, it’s impossible. You can’t play through COVID. It’s not safe for the people around you. And there is a choice, or the choice is taken away from the player, can you do that? Not by a long shot. And it’s a hard no when you’re around.

Could we see a rehearsal in 2021?

The severity of the pandemic has made long-term predictions difficult and often has heartbreaking consequences. At this point, all that can be said of the NFL is that a return to normal seems a long way off. Soon it will not only be a health and safety issue, but also an employment issue.

What the post-COVID world looks like – if there is a post-COVID world – Smith of the NFLPA said. We can all imagine it, the only question is when we will get there.

The answer to this question depends largely on the pace of national immunization. Given the current trajectory and priorities, it’s hard to say whether NFL players will be vaccinated by the time training camp begins this summer, and whether the LLPOA will agree to make vaccinations mandatory. (This week, the CDC reported that about 34 million of the 328 million people in the country have received at least one dose of the vaccine.) Nevertheless, current national recommendations recommend continuing to wear masks after vaccination, keeping a distance and avoiding large gatherings indoors.

This means the NFL and NFLPA will have to decide whether to return to the 2020 protocols and hold traditional off-season workouts and mini-camps at team facilities or implement a second consecutive virtual off-season. Referring to the success of the 2020 season, the league is already pushing for a permanent review for the mid-season.

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In 2020, players spent their free time working out in their own gyms, biking and using the training groups the NFL provided to teams.

According to Tretter, there is always a balance between preparation and rest, and what we are seeing more and more in science is how important rest is to shaping the body. Because we’ve had so many injuries for so long that we have guys coming back so soon after a season, even though we know it’s not good for them, it’s just not good.

I think you can prepare like we did [in 2020]. I understand coaches, asking coaches if a practice should be cut is like asking the cookie monster if there should be less cookies. The answer will always be no, they want more. That’s just the way it is, so it’s not surprising. Ultimately, it’s about building a better program that works for everyone and makes the sport safer and our players healthier.

Mr. Tretter also mentioned the need to switch from face-to-face meetings to virtual meetings during much of the season to demonstrate that off-season work does not need to be done on-site. Of course, the coaches disagreed on the effectiveness of these virtual meetings. Patriots coach Bill Belichick said his biggest conclusion from the 2020 minutes was the limited value of virtual meetings and the maximum value of face-to-face meetings and gatherings. Meanwhile, Stefanski of the Browns said we found a way to cover the ground. … It’s not a replacement for physical work, but I think it’s the best.

In early January, Mr. Stefanski stated that it had been months since the Browns had a face-to-face meeting.

Hotel accommodations during training camp may also be exceeded, Tretter said. Another change that the public probably won’t see, but will affect the players, is the fact that we weren’t in the hotels this year, he said. We came back with our families. We were able to go home and be with them, whereas otherwise we would have been in a hotel. I think it’s something we’ve always done, just because we’ve always done it that way. There’s really no reason for that.

Will the 2021 season be the same as the 2020 season? And how is the NFL moving forward with the modification of the COVID-19 protocol? Rich Barnes-USA Sports Today

At the same time, the NFL has largely moved away from its first major off-season tournament, the Scouting Combine, which took place in early March. Instead, the league asked teams to conduct drills on campus on pro days. Examinations are performed virtually and health checks are done in local facilities whenever possible.

Smith said he expects many of the league’s innovations for 2020 to be things that we will pay close attention to and try to make systemic and timeless. But for now, it seems clear that there will be no choice. These renewals and subsequent iterations will be needed to get through the spring, summer and possibly early fall.

We’re all optimistic that these sets of minutes will be filed with the Smithsonian at some point and fairly soon, Miller said of the NFL. If not, we will create a set of rules that will evolve. We will stand ready and do what needs to be done.

NFL reporters Rich Cimini, Brady Henderson, Mike Reiss, Michael Rothstein and Adam Teicher all contributed to this story. All COWID-19 data are derived from data collected by the Atlantic COWID-19 Observatory.

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