Three members of the NCAA's COVID-19 advisory panel expressed skepticism Thursday, Aug. 13, that sports can be played safely on college campuses this fall.

That group included Dr. Brian Hainline, the organization's chief medical officer. Hainline, in a virtual media briefing hosted by the Infectious Diseases Society of America, described the path to competition in the next few months as "exceptionally narrow" for those conferences that are moving forward through the COVID-19 pandemic.

"When we started talking about a return to sport in April, we were envisioning that there would be a continued downward trajectory of COVID-19 new infections and deaths, that there would be a national surveillance system, national testing and national contact tracing that would allow us to really navigate this pandemic into re-socializing both in sport and in the rest of society," said Hainline, an NCAA senior vice president. "And that hasn't happened and has made it very challenging to make decisions as we approach fall sport."

The Big Ten and Pac-12 conferences earlier this week announced that they won't be playing football and other fall sports while expressing hope for holding some version of a season in early 2021. Meanwhile, the other three Power 5 conferences — the ACC, Big 12 and SEC — are pressing onward with plans to have a fall season.

Carlos del Rio, one of the IDSA doctors on the call, said he believes more focus should be placed on getting the pandemic under control before sports unable to play under a bubble, such as college football, can resume.

"I feel like the Titanic: We have hit the iceberg and we're trying to make decisions of what time should we have the band play," said del Rio, an executive associate dean at Emory University. "We need to focus on what's important. What's important right now is we need to control this virus. Not having fall sports this year, in controlling this virus, would be to me, the No. 1 priority."

The Big Ten's announcement on Tuesday that it wasn't playing this fall was met with resistance from players, coaches, parents, fans and media alike. Still, Colleen Kraft, the other IDSA doctor included in the briefing, said she approved of the conference's decision and the one made by the Pac-12 later in the day because "that keeps the safety of the athletes as the No. 1 priority."

Kraft, an infectious disease associate professor at Emory, made it clear she doesn't believe the other conferences will complete their seasons.

"Physicians can look at this pandemic and try to mitigate risk just like they're trying to do in the conferences that are playing," she said. "But I do predict because we've already been seeing it in those that have been very diligent that there will be transmission and they will have to stop their games."

'Dip your toe in'

What's confusing while trying to evaluate the decisions made by conference chancellors and presidents earlier this week is how the same data can lead to different conclusions.

Three major conferences are deciding to move ahead. Or, as Kraft put it, "dip your toe in and see what happens."

The Big Ten, meanwhile, announced it was shutting down the fall season less than a week after unveiling an updated conference-only schedule.

"It's exactly the same data," del Rio said, "just being looked at in different ways."

The NCAA has issued multiple documents with guidance and criteria to follow regarding testing and how to handle positive tests. Those recommendations are now mandatory, according to Hainline.

"You're seeing different conferences look at that document and say, 'We can't really envision this happening through January so let's make the stop now,' " Hainline said. "And other conferences are saying, 'If things continue to get better along this exceptionally narrow path, we can perhaps pull this off.' ...

"All of us are just learning about this disease in the last seven months and so there is no black-and-white answer. But we think that the guidance, which is a mandate, provides the pathway for which decisions will be made."

The chairman of the ACC's medical advisory team, Dr. Cameron Wolfe, said earlier this week he believes football can be played safely this fall.

"We believe we can mitigate it down to a level that makes everyone safe," Wolfe, an infectious disease specialist at Duke, told the Sports Business Daily. "Can we safely have two teams meet on the field? I would say yes.

"Will it be tough? Yes. Will it be expensive and hard and lots of work? For sure. But I do believe you can sufficiently mitigate the risk of bringing COVID onto the football field or into the training room at a level that's no different than living as a student on campus."

Although he didn't have precise data in front of him, Hainline said between 1-2% of college athletes are testing positive for COVID-19. He said there have been a dozen cases of myocarditis, a rare heart condition typically caused by a viral infection, found among those athletes who have tested positive.

While much is still unknown about the connection between COVID-19 and myocarditis, it's clearly enough to cause concern among medical personnel and college administrators.

"I'm very concerned about myocarditis," Kraft said. "I think one of the things about being a frontline physician is I don't see the statistics as numbers, I see them as individual patients. ...

"I think we're playing with fire. I think one case of myocarditis is too many."

Looking ahead

While the potential of a spring season at least provides hope for those in Big Ten and Pac-12 circles, there are serious questions about how realistic of an option that is.

Playing two seasons in one calendar year — even if one or both are reduced schedules — would be a heavy workload on the bodies of players who are considered amateurs. Draft-eligible players may opt out altogether, as some prominent players did even before the Big 12 and Pac-12 hit the brakes on their respective seasons.

Plus, there's no guarantee the COVID-19 landscape will even look better in the spring.

The doctors on the ISDA call expressed optimism on that front. They are they hopeful vaccines, already in advanced trial stages, will be ready by March or April. Other advancements could include tests that can generate results within minutes and drugs that, according to del Rio, will be able to "decrease the amount of virus in your secretions and therefore decrease infections."

"This (pandemic) is not forever," del Rio added. "We're going to find our way out, and we're finding our way out through research and through innovation.

"Just think of it as we're taking a pause, but we're not stopping everything. Things will get back to some sort of normal because of the things that are happening. So, support research and, in the meantime, wear your mask, watch your distance and wash your hands."

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