NFL's COVID plan could fuel spread, experts say, but it's 'where society is going'

With the omicron variant baring its teeth, the NFL's revamped coronavirus testing policy will lead to an increase in infections among its ranks, experts said Monday, and could risk spreading the virus as hospital systems struggle to bear the weight of another wave of covid-19 infections.

But some epidemiologists said the league's plan also could provide a hint of what the general public can expect as the coronavirus becomes further entrenched in everyday life.

After dozens of players tested positive last week, throwing the league's schedule into chaos, the NFL overhauled its testing strategy, saying it will no longer conduct regular testing of vaccinated players who show no signs of illness. The new policy could keep teams from losing key players during the season's final weeks. But it also means more players and staff will probably walk into — and out of — team facilities unknowingly infected.

"From an epidemiologist perspective, it's not ideal," said Zach Binney, a sports epidemiologist at Oxford College of Emory University. "But it's nuanced."

"Even if no one person is likely to have a bad outcome," he said, "if omicron rips through the population very quickly, we'll have a sharp upward curve in cases. Even if only a small percentage are severe, that could overwhelm at least locally already overtaxed health systems."

The debate over the NFL's new testing plan comes as the sports world, battered by the pandemic in 2020 before largely returning to normal this year, again grapples with coronavirus outbreaks that threaten to upend seasons. Across the NBA, NHL and college and youth sports, games are being postponed as officials scramble to understand the new variant.

On Monday, the NFL had 47 new positive tests, a single-day record, according to a person familiar with the results. The NBA has allowed teams to expand rosters to account for players lost to covid-19 protocols. And the NHL will halt its schedule beginning Wednesday and running through at least Sunday. Both the NBA and the NHL have resumed daily testing of players in recent days.

Epidemiologists said that compared with many workplaces, the NFL has been progressive: requiring vaccines, meeting virtually, moving work activities outdoors when possible. The net result: The NFL completed its 2020 season with minimal disruption and was cruising through 2021. But the omicron variant forced the league to start rewriting its covid playbook.

As the schedule got scrambled, Commissioner Roger Goodell wrote to teams over the weekend saying that "omicron appears to be a very different illness from the one that we first confronted in the spring of 2020." While the virus was tearing through NFL rosters, the league felt fewer tests were necessary because "medical information strongly indicates that this variant is significantly more contagious but possibly less severe than prior variants," Goodell wrote.

Two-thirds of players who recently tested positive were asymptomatic, the NFL said, and the rest largely had mild symptoms.

Under the new protocols, vaccinated players are only subject to "strategic and targeted" tests. League officials have stressed they're not giving up testing and that unvaccinated players and anyone showing symptoms will still regularly be subjected to it. But the NFL is "trying to test smarter and in a more strategic fashion," said Allen Sills, the NFL's chief medical officer.

The league's new plan places "a big bet on a number of assumptions," said Asaf Bitton, executive director of Ariadne Labs and associate professor of health-care policy at Harvard T.H. Chan School of Public Health. Among them: that the early data is right and omicron causes less severe disease and that NFL players will reliably report their symptoms. "Whether it's head injuries or some other illness, the culture of football doesn't revolve around reporting every cough, ache or sniffle," Bitton said.

"If omicron is borne out to be much more transmissible but less severe, that's a win-win for everyone. In the short term, that's a lot of ifs," Bitton said, "and this strategy carries a risk of unintended consequences in the short term, even if it's in the right direction long term."

Michael Mina, an epidemiologist advocate for widespread testing, said the league is not only going in the wrong direction, it's sending the wrong message. He advocated for daily testing as omicron spreads.

"At this point in the pandemic, why reduce testing?" said Mina, the chief science officer of eMed and a former public health professor at Harvard. "It's finally becoming less expensive. The NFL can afford it. I wonder if they're taking the approach of, 'The more we test, the more we find people are positive, and we don't want that.' "

He added: "It's not exactly setting the right public health tone."

As the world responds to a crushing wave of omicron cases, businesses, schools and governments are trying to stave off another shutdown while sorting out how regular life can coexist with a highly infectious disease. Experts said that could mean eventually moving away from routinely testing vaccinated people who aren't feeling sick.

"There's never been strong value in testing asymptomatic vaccinated people outside of exposures," said Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security. "Leagues did that reflexively, and it led to a lot of diagnosed cases. I think we got to move away from that type of paradigm."

Adalja added that as breakthrough infections become more common, it's increasingly important for sports leagues — and other parts of society — to move away from "one-size-fits-all measures." An omicron infection doesn't necessarily act the same as a delta case or a 2020 infection, he said, so it shouldn't necessarily be treated the same way.

Sports leagues, he pointed out, have been able to serve as a lab of sorts for covid strategies later used by other sectors. And though the NFL, with its new protocols, breaks from other pro sports leagues, which continue to regularly test all players, it could provide some guidance on how to respond to a highly infectious disease that can be deadly in some but might present mild or no symptoms in most fully vaccinated people.

"I think the NFL is a leading indicator of where society is going," he said. "We saw the sports leagues in the past be kind of the pilot projects for bubbles, testing, and maybe we're seeing that with the NFL giving us a picture of how life is with an endemic respiratory virus."

He said it's important that the NFL is urging its population to get vaccinated and is trying to be more "precision-guided" as it considers safe, effective isolation times.

"Ten years from now, we can't have people taking 10 days off from everything because they test positive for an endemic respiratory virus," he said.

Mina agreed that the NFL could one day offer the public a road map for living with the coronavirus.

"There's going to be a time where we want the NFL to demonstrate there's a future ahead of us," he said. "That we can start taking a different road.

"But I don't think, in the face of omicron, that now is the time to do that. … Right now is not the time to project a message that, 'Hey, we're all good.' "

Mark Maske contributed to this report.