July Brings Major Changes For Coronavirus Testing And Tracing Of College Athletes

Before more should athletes return to campus this month, the Centers for Disease Control have added more layers of complexity to the testing and tracing protocols already in use. I’ve noted the highlights below:

CDC no longer recommends “entry testing” for all returning students, faculty, and staff

Here is their reasoning: “Testing of all students, faculty and staff for COVID-19 before allowing campus entry (entry testing) has not been systematically studied. It is unknown if entry testing in colleges provides any additional reduction in person-to-person transmission of the virus beyond what would be expected with implementation of other infection preventive measures (e.g., social distancing, cloth face covering, hand washing, enhanced cleaning and disinfection)”.

This video shows symptom tracking, not testing:

Before you bring athletes back, the CDC says that the “testing protocols must be clearly explained and agreed to by students and their families before implementing them”. I’m not sure how many athletic departments are discussing protocols with the athlete’s families. In fact, in recent discussions I had with a parent of a Division I football player, he said he had not been made aware of what the protocols were, by anyone in the program. Learn more about what questions parents should be asking.

More contact tracing will be essential

Here’s the tough part of contact tracing—if you test positive, could you identify everyone you came in contact with in the last 24-48 hours? Sure, you might remember your friends, your family, and the places you went to. But, could you identify the person who stood to close to you in the grocery store? Or the person in the hair salon who was sitting near you? Think back to your workplace (back in the olden days when you went to work)—did you know everyone you shared an elevator or a bathroom with? 

This is what we will be asking of our athletes, and anyone else they come into contact with. It’s hard—we are all human and rarely pay full attention to who is in our immediate orbit. The new guidelines provide more detail as to what to take note of: “Residence halls, laboratory facilities, and lecture rooms may be settings with the potential for rapid and pervasive spread of SARS-CoV-2.” Can your athletes identify every person who they came into “contact” with in those settings? And consider this—an athlete who does not know the other people in the building or classroom could be sharing a communal space. How do you contact trace that person the athlete doesn’t know?

Who should take on this “case investigator” responsibility when someone is exposed? The default answer may be it should fall on the athletic trainer. Remember, these are the folks who are at the facility two hours before every practice and stay until the athletes finishes their last treatment of the day. Consider the fairness of asking them to take on this important task, particularly if there are multiple positive tests. If not them, be sure that anyone taking on this responsibility has enough PPE (personal protective equipment) if you are going to ask them to interview others who may be infected.   

Testing problems will continue to confound us

It is becoming more and more clear that there are problems with Covid-19 testing. Whether its how often you want to test or how realistic the turnaround time is for results, there are a lot of holes in the process. Now, the CDC has stated there is a “limited usefulness of a single administration of testing; single administration could miss cases in the early stages of infection or subsequent exposures resulting in transmission, and would only provide COVID-19 status for individuals at that specific point in time”. 

As a result, Athletic Departments must create detailed plans for specifying:

• The kinds of testing they are doing;
• How often the tests will be done;
• How they will account for the number of false positives (some testing procedures have a 20-30% fail rate);
• What they will do while waiting for the test results.

Also, the new guidance strongly recommends that colleges and athletic departments should have a plan for when there is limited availability of dedicated resources and the logistics needed to conduct broad testing among students, faculty, and staff. 

An emerging alternative testing strategy

Instead of testing everyone, the CDC is now recommending testing some or all of asymptomatic athletes, staff and coaches who “have no known exposure”.  This tactic is recommended because it may help to “identify outbreaks and inform control measures” in communities that are experiencing moderate to substantial community transmission. So, testing small groups of asymptomatic athletes who live in a common apartment complex periodically might help with averting a larger outbreak. This is a particularly notable departure from what schools have been doing.

Five things athletic departments should already be doing

• NCAA rules now require the decisions about when an athlete can return to practice be made outside the athletic department reporting structure. A team physician cannot clear an athlete after recovery from, or quarantining for, coronavirus;
• “As part of symptom screenings, athletic departments should be prepared to refer symptomatic individuals to an appropriate health care provider (not the team doctor) who will determine when viral testing for SARS-CoV-2 is appropriate”;
• Additionally, in accordance with state and local laws and regulations, athletic departments” should work with local health officials to inform those who have had close contact with a person diagnosed with COVID-19 to wear cloth face coverings if they are able, quarantine in their living quarters or a designated housing location, and self-monitor for symptoms for 14 days”;
• Regularly reminding their athletes: Anyone can be a carrier of the virus and not show symptoms; and
• Someone can be positive for several days before they show symptoms.

The rules of the game are shifting fast. As schools allow more fall sports athletes like soccer, field hockey and volleyball players to return for voluntary workouts in July, the protocols and strategies to protect them have to change as well.

Ready?