The NFL has its first COVID-19 team outbreak. At least nine members of the Tennessee Titans have produced confirmed positive test results in the past four days, a rash of coronavirus infections that could potentially have spread during Sunday's game against the Minnesota Vikings at U.S. Bank Stadium.
The Titans have closed their practice facility until at least Saturday, while the Vikings have closed theirs until they have further test results. Decisions on both teams' Week 4 games are pending.
Here's what we know at the moment, with appropriate context. We will continue to update as news develops.
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Timeline for return to facilities
Could games get postponed?
So this started with the Titans?
Yes. On Saturday, Titans linebackers coach Shane Bowen returned a confirmed positive test. The Titans received the results before they departed Nashville for Minneapolis, and Bowen was held back from making the trip.
Were the other eight Titans employees infected by Bowen?
We don't know. What we do know is that the entire Titans traveling party was tested Saturday, as they would ordinarily be. The Titans had those results by Sunday morning. All were negative, meaning every coach, player and staff member was eligible for Sunday's game.
The Titans stayed Saturday night at the JW Marriott, adjacent to the Mall of America in Bloomington, Minnesota, according to ESPN's Courtney Cronin. League protocol requires all members of the traveling party to have their own rooms and also prohibits them from "congregating, visiting or mingling with individuals outside of the Traveling Party once they have arrived in the game city."
On Sunday, they defeated the Vikings won, 31-30. The team flew back home after the game ended.
So no one was tested on Sunday?
Correct. The protocols call for daily testing on every day except game day. Neither the league or the NFL Players Association (NFLPA) has explained explicitly why, but timing is likely a substantial part of the answer. Results for polymerase chain reaction (PCR) tests, performed on the morning of a game by nasal swab, probably wouldn't be returned in time for kickoff.
Point of care (POC) tests have quicker results -- PCR tests are usually returned overnight, whereas POC tests can be returned on the same day, and even before kickoff after a morning test -- but are not as accurate. At this time, POC tests are only used to help confirm initial positive tests, and the NFL doesn't yet trust them on their own. And the NFL likely didn't want to sideline a player or coach based only off a POC test.
When were they next tested?
All Tier 1 and Tier 2 employees from the Titans and Vikings, which includes players and coaches, were tested Monday morning. Of the eight Titans who returned confirmed positive tests, three were players and five were employees. They have not been identified. None were displaying symptoms, according to ESPN's Dan Graziano. No members of the Vikings returned positive tests.
What about the officials who worked the Titans-Vikings game on Sunday?
Most officials travel home on the night of the game or the next morning. Per their protocol, they are tested twice per week -- once in their hometowns and once on the day before games. Referee Clete Blakeman's crew worked this game, and it is not immediately known if any of them were affected.
Does that mean the outbreak is contained?
No. General guidance from public health officials suggest it can take up to 5-7 days for an infection to register in a test. That's why the Titans facility is closed through at least Saturday. The NFL/NFLPA protocol calls for increased monitoring for eight days for anyone who had close contact with someone who returned a confirmed positive test.
How do they determine close contact?
The protocols follow CDC guidelines: within 6 feet apart for at least 15 minutes of an infected individual. The league identified 48 close contacts to monitor, based on contact tracing of the eight confirmed positive individuals, according to Graziano. It's unclear if those are all members of the Titans, or if some are members of the Vikings.
That includes contact during a game as well as data recorded by mandatory proximity devices worn by all team employees before and after the game. Per the protocol, "Tier 1, Tier 2, Tier 2M and Tier 3 Individuals will also be required to wear Kinexon Proximity Recording tracking devices at all times while engaged in team activities (including in the Club facility, during practices, and during team travel)."
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Dianna Russini explains the possible origin of the Titans' coronavirus outbreak and why she doesn't anticipate Tennessee playing its Week 4 game against Pittsburgh.
So did the virus find the one hole in the protocol?
If the Titans passed the infection to the Vikings, then yes. Games are the one point in the NFL week where social distancing is impossible, and the period when it's most likely that an infected person will breathe on others. That's part of the reason the NFL has insisted on coaches and other non-players wearing masks on the sideline.
The absence of gameday testing also heightens the risk. A POC test Sunday morning might have caught at least some of the positive results the Titans eventually recorded Monday.
Right. But it seemed as though the NFL protocols were working.
They were. As of Tuesday morning, there were only four players on the NFL's COVID-19 list. Only seven players, and another 29 non-players, had returned positive results during the four testing periods from Aug. 12 through Sept. 19.
But as Zachary Binney, an epidemiologist at Oxford College of Emory University, said earlier this month: "An outbreak really can happen at any time." It's fair to wonder if this will prompt a shift into game-day testing.
When can the Vikings and Titans get back to their practice facilities?
We know the Titans won't return before Saturday at the earliest. The Vikings' return depends on whether they receive any confirmed positive results.
How long will the infected players and staff members be kept away from the team?
It's complicated. Here is a flow chart for symptomatic and asymptomatic positive tests.
This graphic from the NFL protocols explains much of what the Titans and Vikings are doing now. pic.twitter.com/Z3JLQy43GZ
— Kevin Seifert (@SeifertESPN) September 29, 2020
What about their Week 4 games?
At the moment, both are still scheduled to play Sunday. That could change in the coming hours and days, however. The Titans' game Sunday in Nashville against the Pittsburgh Steelers could easily be moved to Week 7, if the NFL moves the Steelers' Week 7 game against the Baltimore Ravens into Week 8, when both have byes. A potential rescheduling of the Vikings' game at the Houston Texans is less obvious.
The NFL formed an independent committee made up of unaffiliated former league officials to advise commissioner Roger Goodell on equity and fairness in these situations. One immediate question is whether it's fair for the Titans to play the Steelers on Sunday if they have been away from their team facility, and thus unable to practice, all week.
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