At the time of my last blog, we were 110 days out from the first mention by Chinese health care workers identifying an infectious novel coronavirus culture. At the time, there were 2,356,475 global cases accounting for 162,070 fatalities. The United States reported 735,366 cases accounting for 39,095 fatalities. These numbers indicated we were not nearly out of the woods yet but they did suggest the spread was slowing. We are now 136 days out with 4,508,435 global cases accounting for 305,395 fatalities. The United States reported 1,429,990 cases accounting for 86,744 indicating the quarantine/social distancing method is clearly flattening the curve.
The curve has flattened so much that states like Florida, Georgia and Wisconsin have begun to reopen albeit under great controversy. The decision on when to open or not open is further convoluted by the publication of a new study in a peer-reviewed journal, Health Affairs. This study implies that parts of the United States that don’t adhere to any physical distancing policies face 35 times more cases of the novel coronavirus.
The fact that we are moving in the right direction opens up the return to sports argument. Assuming the aforementioned study is valid we know that we still need some adherence to physical distancing. How do we return to NBA basketball when by nature of the sport it is a contact sport?
Yogi Berra said it best, “it’s hard to make predictions, especially about the future”.
Accurate predictions are data-driven and as of now, we don’t have all of the data. Going back to your multiple regression equation from statistics class. If I asked you to predict something but didn’t give you any information, you would just be guessing. But if I gave you one piece of information it would be a more accurate guess. If I gave you two pieces of information, it would be even more accurate and so on until no matter how much information I gave you, you couldn’t increase your accuracy. This is what’s known in statistics as the point of diminishing returns and we’re not there yet.
The reason you hear one expert saying one thing and another expert saying something else is because they just don’t know and with more data input daily the models change so the opinions change. The fact is, we are all in one big giant case study. The treatment for covid-19 which is the disease caused by the coronavirus is being treated differently from hospital to hospital which tells you no one knows for sure the best treatment for the virus.
We’re in an area in which science, morality, money and politics are at odds in figuring out what is socially acceptable. There is not going to be a cure for this virus. It is not going to go away like measles and HIV is never going to go away. So, if we are waiting for a zero infection or zero fatality rate, that’s not going to happen. The answer is a vaccine as in measles but that is still a long way off. So what is acceptable?
My confidence is in the NBA. As I said before they have and are in contact with the best and brightest in the world. I experienced the leadership of three commissioners in the 34 years I worked in the NBA and never once saw a decision from the league office that risked the health of the players. The reason the NBA has not resumed play is because they don’t have all of the answers to protect the players and staff. The reason they don’t have those answers is because no one does. In professional sports you sell winning or you sell hope. In my last years with the Lakers, we couldn’t sell winning and we couldn’t sell hope so we sold Kobe and fans came out for that experience. By keeping the possibility of a return to play alive you keep hope alive. Losing hope is a horrible feeling and no fan wants that. So, the NBA has yet to pull the plug on the season.
Things are changing almost daily and decisions will be made as more data is collected. Most recently we are seeing this inflammatory syndrome in children that is similar to Kawasaki disease. It may have more to do with a child’s own immune system causing an inflammatory response after they have successfully fought off the virus while being asymptomatic. I mention this because it came out nowhere, yet it is here. Case in point, there are things we just don’t know and when we don’t have the answers, it leads to more questions. We still don’t know where SARS came from. The current theory is, a bird had a virus and a bat had a virus but they couldn’t give it to each other nor could they give it to a human. But they both could give it to a pig which they did and the pig gave it to a human. Like SARS, this coronavirus will not be the last one we see. As geography is shrinking and the population is growing there will be more animal to human contact transmitting viruses to humans that would normally stay in the animal world. Hopefully, we will be better prepared when the next one comes.
The main question is how do we return to normal and how does the NBA bring players and staff back to a safe working environment. I don’t think anyone has the answer to that just yet, despite the talk of playing in an Orlando/Las Vegas like bubble.
Diseases spawn whole new industries to create anti-microbial environments. During my tenure, we dealt with HIV in which bloodborne pathogens were our main concern. Then we had SARS, another coronavirus which burned itself out before it became a real problem. We also had Methicillin-resistant Staphylococcus aureus (MERSA) which was a bacterium that is resistant to antibiotics. What may start with a boil ends up with an infection in the bloodstream. It had every athletic trainer in every league taking extraordinary precautions to create an anti-microbial environment to treat and compete. Once we knew what we were dealing with the NBA set up protocols to keep everyone safe. Coronavirus is a different animal. It’s an air-born virus that is highly contagious from being in close proximity to people.
I always asked myself as an athletic trainer: what am I trying to do? Why am I doing it? And, how am I going to do it? From my perspective, we don’t have enough data to answer those questions. What we do know for sure, is there is a higher fatality rate in the elderly with co-morbidity and with minorities. There are many senior citizens working in the NBA today and the league is predominately made up of minorities.
Most believe testing is the key. So far we have had many issues with the validity of some of the tests. The FDA has approved a test created by Rosche Corporation which I believe is a valid and reliable test. Much has been said about antibody tests but we really don’t know if having the antibody makes you immune and if it does, how long will your immunity last.
Bottom line is, they just don’t know. It’s going to take time and some people think we’re out of time. The worst thing that can happen is to come back too soon. It’s the old joke about the guy that was going to swim across the Atlantic Ocean and got halfway and thought he couldn’t make it so he swam back. It’s the same here, we’ve invested so much time and money in holding out. If we come back to soon, we start a second wave which will put us all back to square one.
There are two types of people in the world. The people that don’t know and the people that don’t know that they don’t know. The reason the NBA has not come back is that they know that they don’t know and I have all the confidence in the world they will bring back the sport when the benefit from safety outweighs the risks. As I’ve said in the past, the NBA is a microcosm of society and it would behoove us to follow their lead.