Abstract
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 high-risk 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.
Highlights
What is already known about this topic
What is added by this report
COVID-19 mitigation measures must be continually optimized based on available data
Summary
Implementation and Evolution of Mitigation Measures, Testing, and Contact Tracing in the National Football League, August 9–November 21, 2020. RT-PCR tests, with results available in 24 hours, were initially conducted 6 days per week for players and most staff members.† Analyses were performed to actively evaluate the efficacy of the NFL-NFLPA protocols in limiting high-risk interactions and preventing COVID-19, including comprehensive review of RT-PCR results, device-recorded interactions, and contact tracing interviews. A third league-wide change was expansion of contact tracing and transmission risk assessment focusing on high-risk contact identification, which comprised four main components These were, in addition to consideration of duration of exposure and specific distance between persons, assessment of face mask use (e.g., medical mask versus cloth face covering, proper mask use for both infected person and contact, and any mask removal to eat or drink) and setting and ventilation (e.g., outdoor, indoor large volume, indoor small volume, and during transportation).** Expanded contact tracing covered all club-related contacts of persons with confirmed COVID-19 within the preceding 48 hours, including those outside the facility, with interviews regarding the full context of exposure and medical expert evaluation of the risk level for each interaction.
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