What a sports fan should know about the coronavirus

(Jeremy Harmon | The Salt Lake Tribune) Larry H. Miller Sports and Entertainment employee Samuel Barlow washes his hands at a hand sanitizer station at Vivint Smart Home Arena ahead of a game between the Jazz and the Raptors on Monday, March 9, 2020.

I miss sports dearly. Don’t you?

And not just the games. I hadn’t realized how sports filled in the little gaps in my days. I’d turn on a game while writing, or use a game as an excuse to connect with friends and family. I’d just idly think about some player’s statistical anomalies as I fell asleep. All of that was gone.

Sports are returning now, though; and naturally, there are questions. I thought I’d do my best at wrapping up the plans, the dangers, and what researchers can tell us about attempts to return fans to arenas.

When are teams returning to play?

In Europe, soccer leagues have resumed for the past few weeks.

In America, the National Women’s Soccer League was the first to return, playing a tournament here in Utah, with most games at the Real Salt Lake/Utah Royals academy in Herriman. MLS will follow with a tournament in Orlando, Fla., that begins July 8.

MLB will begin play on July 23, eschewing the “bubble” strategy. Instead, teams will travel to each city in a 60-game schedule, then play the playoffs. Minor League Baseball canceled its season Tuesday (Sorry, Utah, no Bees games).

The NBA will begin its end-of-season run July 30 in Orlando, with eight games before beginning the two-month playoffs.

Meanwhile, the NHL has yet to announce when its season will resume, but plans to in late July or August. The NFL hasn’t announced its intentions either, but currently plans to start the season on time in some fashion.

What are the leagues doing to keep athletes safe?

Interestingly, Dr. Anthony Fauci has been supportive of these efforts to return to play. He’s commented most extensively on the NBA plan — which is also the plan with the most available details.

“It is really quite creative what they’re really trying to do and I think they might very well be quite successful with it,” Fauci said in an interview with The Athletic’s Shams Charania about the NBA’s plan. “They really wanted to make sure that the safety of the players was paramount.”

It’s true. NBA players and staff are currently being tested every other day for the virus, with both a nasal and throat swab. They’re doing individual workouts, cleaning the ball religiously in between. On July 7, when NBA teams start arriving at Walt Disney World for training camp, they’re going to be isolated, requiring two negative tests before group workouts can begin.

They’ll be using limited support staff, and no guests are allowed until the second round of the playoffs, and once they arrive, they’ll have to quarantine and test as well. Players and staff will be frequently tested within the bubble, and if they leave without permission, they’ll have to quarantine for 10-14 days. If someone does test positive, they will live in quarantine housing, and the league will use video technology to determine who they came in contact with.

In many ways, players in well-implemented bubbles will be safer than they’d be in their home communities. If every other business implemented even some of the NBA’s safeguards, we’d be in a much better place.

Of course, most businesses don’t have the oodles of cash that the NBA does, and it is downright unethical that the NBA can test its players and staff every other day right now while many people both locally and nationally can’t get one test. “Unethical” might not be strong enough — it’s a travesty.

How effective will those measures be at stopping the virus?

On paper, they should work relatively well. But in practice is a whole different can of worms, and we just don’t have much to work from at this point, other than the successful start to European soccer. Cases are down in Europe, and are rising in the U.S.

We do have some evidence from past sporting events, though, including one with a local tie. At the 2002 Winter Olympics in Salt Lake City, University of Utah researchers conducted the “Olympic upper respiratory infection study,” which tracked flu cases among people who visited the Olympic Village clinic. In all, doctors saw 729 athletes, coaches, security workers, employees and volunteers. Of those, 188 had upper respiratory symptoms like a cough; 36 of those 188 tested positive for the flu.

But the flu could have spread more if it wasn’t for the quick interventions of the medical staff, the Utah doctors argued. One athlete came in with symptoms two days after arriving, and tested positive for flu. He was given an anti-viral, and doctors then offered the anti-viral to his 11 close contacts. None got sick. The paper notes, proudly, that “the team competed successfully in the sport and won several medals.”

We don’t have a prophylaxis anti-viral for COVID-19 like we do for the flu, but quick quarantining can have the same result: spread stops. As difficult as it is for a team like the Denver Nuggets to close practice after three positive tests in their group, it’s a lot better than cases growing to the dozens.

There may well be positive tests for the NBA or MLS in Orlando, as the virus seeps in via hotel staff or undisciplined players. I would bet on high-profile players having to sit out games, and maybe even a team with a shortage of players. But I don’t think we’ll see the kind of high-frequency spread that would put the entire league at risk of shutting down, because they’ll react quickly to cut off the spread when it starts.

When can fans return to stadiums and arenas?

Allowing fans to attend these games, though, is a bridge too far in my opinion. That was a question I frequently received after my article looking at the lack of spread at protests: If protests were relatively safe, aren’t outdoor sports like college football good to go as well? After all, both are outdoor crowded events with lots of shouting, right? It’s a good point.

I think there are some important differences, though. First, the typical attendance at a college football game is much higher than the protests — Tribune reporters estimate that several thousand people gathered in one place for some of the biggest protests. Rice-Eccles Stadium seats about 45,000, while Lavell Edwards Stadium holds 63,000. Football game attendees are also an older demographic than those who protested, putting those who do get infected at higher risk. Protesters move and march around, while sports fans stay in place for hours on end. The stadium itself can provide some degree of wind protection, preventing the virus from dispersing, and games usually occur at night when sunlight can’t help.

The most notable example of coronavirus spread at a large outdoor sporting event is the Champions’ League soccer match in Milan between Atalanta and Valencia. About 40,000 people from Bergamo traveled to Milan to watch the match, and weeks later, hospitals were overrun. Traveling Valencia fans and players became sick as well.

“It was crowded in the stadium and then afterwards in the bars,” Giorgio Gori, the mayor of Bergamo, said then. “For sure, that night there was a strong escalation of contagion between people.” The head of pulmonology described the night as a “biological bomb.”

What about smaller sports? One bit of research done after the University of Vermont basketball game on March 10 paints a picture. Out of 3,200 fans, 20 people later tested positive, while 34 reported symptoms but couldn’t get a test in the early days of the pandemic. There seems to be a correlation between where people sat and their likelihood of getting the virus.

Spread of coronavirus at one University of Vermont basketball game. (https://vtdigger.org/2020/06/18/uvm-basketball-game-was-a-major-spreading-event-vtdigger-survey-finds/)

Three of the 20 positive attendees later died.

How would the return of sports impact a community’s viral spread?

As always, coronavirus research is limited, but there is research that shows sports can contribute to flu deaths. A study released this week conducted by researchers at West Virginia University showed that when a major professional sports team moves to a new city, that city then sees a rise in flu deaths.

The biggest rise came with a new NHL team, which resulted in a rise of 24% in flu deaths in the cities studied over the next year — or about 20 deaths per year. Next biggest was the NFL, which saw a 17% increase in deaths — 13 deaths per year. NBA and MLB teams meant increases of about 5%, or three deaths per year.

It’s a little strange that the difference between NHL and NBA is so stark, given the overlap in seasons and arenas. Researchers hypothesize the difference is because the NBA expansion and relocation studied happened earlier than the NHL’s. Weirdly, they did find a 25% reduction in flu deaths in NBA cities during the 2011 lockout, and no difference during the NHL’s 2004 lockout.

We should note that some of that spread isn’t just due to in-arena fans, but those who gather at home or in public, too. In a study cleverly titled “Success Is Something To Sneeze At,” researchers found that when an NFL team goes to the Super Bowl, their cities have experienced an 18% increase in flu deaths that year. Of course, the effect grows when the Super Bowl correlates with the peak of the flu season, and when the season is worse: The research team estimated that there were 146 extra flu deaths in 2014, when Seattle and Denver played in the game.

Coronavirus is spreading much more rapidly and is more dangerous than the flu, so you can understand the worry here: If sports lead to an increase in flu deaths, it could mean a much bigger increase in coronavirus deaths. Fans can cheer for their teams, but should do so safely, either in their own homes or with social distancing and masks in groupings.

Look, I believe the leagues that are opening over the next month without fans are doing so safely and responsibly — though I wish that we lived in a society that gave equal medical care to all of its members, not saving tests for the richest athletes. But at this point, putting butts in seats is a bad idea, and probably will be until we reach herd immunity, either through natural viral spread or with a vaccine.

Andy Larsen is a Tribune sports reporter who covers the Utah Jazz. During this crisis, he has been assigned to dig into the numbers surrounding the coronavirus. You can reach Andy at alarsen@sltrib.com or on Twitter at @andyblarsen.