As sports teams return to the playing fields, new precautions have been put in place to protect fans, athletes and staff from the spread of COVID-19.
Some leagues, like the National Basketball Association (NBA) have had success with preventing the virus, primarily by keeping players in a 'bubble' that isolates them from other parties. Others, like Major League Baseball (MLB), have had interruptions in their already-shortened seasons as players test positive and games are delayed due to team outbreaks.
TODAY spoke to medical experts about what particular vulnerabilities sports teams have, what methods work best to control the virus, and whether schools and local teams can have a season while containing the virus.
Can isolating players slow the spread of COVID-19?
According to some experts, the success of the NBA in preventing infections is proof that the 'bubble' method works. As described in a 113-page manual, players are quarantined on a Disney World campus, where they can't leave without permission. Masks are required except when playing basketball, eating food or going outside. Players can only interact with those inside the bubble, and those who leave are penalized.
Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security and an infectious disease physician, told TODAY that the bubble system can help since it removes players from the community.
"We’re trying to play these sports during a pandemic when many parts of the country are not under control, not because of the sport, but because of community spread. Unless you can isolate your players, you’re going to see outbreaks (on teams)," he said. "Players aren’t robots, they live in the community as well. Whatever’s going on in the community will have an impact on your sports team."
While the bubbles may be an effective method, they're certainly not an option for all athletes.
"You can’t put Little League or college students in a bubble in the way that professional leagues can," Adalja said. Recently, students returning to campus for sports have tested positive after going to parties or other social events.
Justin Lessler, Ph.D., an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health in Baltimore, said that the spread was helped by the fact that teams spend a lot of time together. While the nature of most sports requires close contact, he said keeping teams isolated can help slow the spread of the virus.
Whatever’s going on in the community will have an impact on your sports team.
Dr. Amesh Adalja
"We know that most transmission happens in situations with very close extended contact, like households," he explained. "There are other places where transmission happens, but those situations are the places really driving the underlying epidemic. Things like locker rooms are places of closeness, and I suspect that’s the big driver of the disease."
How important is community spread?
Experts warn that the greatest hurdle most teams face is community spread. Unless teams bubble, like the NBA, the players will be going in and out of their local community, and that may lead to viral spread.
"Team sports seem like a place where it's particularly hard to control the spread," said Lessler. "I'm thinking less about the risk to the players, though that is there ... I think if kids are coming home from their team sports to a household where there's an older grandparent or someone with a health condition, they could be putting that person at a lot of risk even if they themselves don't have symptoms."
Lessler cautioned that sports should really only happen if community transmission is low.
"This is a high-risk activity, and we should be very careful in how we proceed, and really only do it if community caseloads are very low," he said.
Can testing help get teams playing again?
Testing is an essential part of returning to daily life, according to experts, but flaws in the system — like long wait times, faulty tests, and accessibility issues — means that many small sports teams aren't able to rely on them.
"Access to testing is critical, but I don't think it solves the problem," said Lessler, citing concerns like slow results and false negatives. "Testing is one of the most critical parts of our controlled strategy, I think depending on it alone, given the current tests available, to prevent outbreaks and spread among sports teams is not viable."
Some leagues, like the MLB, have relied on testing, but Dr. Yvonne Maldonado, a professor of pediatrics (infectious diseases) and health research and policy at Stanford Health Care, questioned that approach.
"Testing doesn't keep you from being infected, it just tells you who's infected," she said.
How can teams limit viral spread on the field?
Even with testing and other preventative measures, it's possible that athletes could spread the virus to each other while engaging in play. Some sports, like tennis or baseball, might not have much to worry about here, but contact sports like football or hockey could be higher-risk.
"Players will have a lot of contact," said Maldonado. "Sports are going to have to adapt ... (Teams) have to test ahead of time, only let players go out if they are negative, and keep hands away from their faces while playing."
As much as on the field behavior matters, Maldonado said the real risk is "off the field" where players are engaging with the community.
For teams that don't have the funds to test or quarantine players, she advises they stick towards more distanced or low-contact sports like baseball or tennis.
"There are going to be a lot of kids who are disappointed this year, (but) playing is very dependent on the amount of resources," she said. "I don't think schools have figured out how to be back in school, let alone have sports in the mix."