In preparation for an unprecedented season, the NFL and NFLPA have implemented comprehensive COVID-19 protocols to keep the team environment as safe as possible.

A crucial aspect of those safety measures is rigorous testing for the virus.

"One of the key risk management strategies clubs are utilizing is a testing program to help identify, isolate and treat COVID-19 cases," said NFL Chief Medical Officer Dr. Allen Sills.

"We expect to have positive cases," said Dr. Sills. "No matter how careful we try to be and how many protocols we have in place, we know that this disease remains endemic in our societies and our communities and it's highly contagious."

The robust testing program includes frequent screening for players, coaches and club personnel throughout the 2020 season to ensure that positive cases are quickly identified to help prevent the spread of the virus.

A Leading Lab

The NFL and NFLPA are working with BioReference Laboratories (BRL), a reputable national vendor, to perform the testing.

"The tests they perform are the most sensitive, reliable and accurate tests available with the shortest turnaround time for results," said Dr. Sills.

Equally important, said Dr. Sills, BioReference is a private laboratory. By using a private, national laboratory, the NFL is never taking away local testing resources from those who need them most.

"We wanted to make sure that whatever testing we set up did not in any way hinder the test supply, capacity or performance for the health care system," said Dr. Sills.

"We said from day one that that was an incredibly important goal to us. We didn't want our clubs having to go to health care facilities in their own markets and in any way compete for or take away testing resources."

Intake Testing

Before any player or personnel was allowed access to club facilities for training camp, they underwent a multi-day intake process.

"We did that very deliberately based on experience from other sports to try to reduce the risk of anyone coming in and infecting a team environment," said Dr. Sills.

"We tested 9,983 people – players, coaches, other staff – upon their intake. New positives, meaning people without a known history of COVID infection leading up to that intake, were 170 people, so that's 1.7 percent," said Dr. Sills.

Only individuals who tested negative after each intake test were allowed to enter the club facility.

Ongoing Monitoring and Screening

Players, coaches and essential staff have undergone daily COVID-19 testing throughout training camp and into the start of the 2020 season.

"Since the beginning of training camp, we have had a number of isolated, new positive cases of COVID among players and other personnel across nearly two-thirds of NFL clubs and one outbreak," said Dr. Sills.

"We have said all along that we expect positive cases. As long as the virus is endemic in our communities, we will see new cases among our teams. Risk mitigation, not elimination, is the key. Our protocols are designed to quickly identify new cases, get individuals the care they need, and prevent further spread of the virus."

In addition to ongoing testing, players and club staff are thoroughly screened every time they enter a club facility. This includes a temperature check and a COVID-19 questionnaire as additional precautions to protect the team environment.

Treatment Protocols

NFL players receive their test results within 24 hours. Given the prevalence of COVID-19 in communities across the country, the NFL has prepared specific treatment protocols in anticipation of positive test results.

If a player has a positive result without symptoms of COVID-19, he needs to wait until ten days have passed to return to football activities or test negative twice at least 24 hours apart.

"We are always going to err on the side of keeping people out of the team activities until we can go through confirmatory steps," said Dr. Sills.

If a player has a positive test accompanied by symptoms, he needs to wait at least ten days from the time symptoms first appeared, and at least 24 hours since he last experienced symptoms, consistent with CDC guidelines.

Clubs are also using innovative wearable technology to perform efficient and accurate contact tracing. This allows clubs to quickly review the interactions of any person who tests positive for COVID-19 in a fraction of the time it would typically take to identify and isolate points of contact to help prevent further spread.

As medical and scientific knowledge of the virus continues to grow, the NFL and NFLPA are prepared to update the testing protocols to reflect the most up-to-date best practices.

"We expect our protocols to continue to change and adapt based on what we're learning, and I think you'll see us continue to make changes as we gather more data throughout the course of the season," said Dr. Sills.

Sharing Data

Over the last few years, the NFL has openly shared data related to player health and safety to help spur progress across all levels of football, across other sports, and beyond. Now, the NFL plans to do the same with its COVID-19 data.

"Given that large-scale testing of a geographically diverse asymptomatic population has not yet been done, we expect that our testing program could provide broad insights about the spread of the virus and how public health interventions help mitigate risk," said Dr. Sills.

"While we will not release individual test results to protect the privacy of our players and personnel, we will regularly share aggregated, anonymized data regarding positive cases to help public health officials and the scientific community at-large gain insights from our testing program," he said.

Layers of Protection

Though critically important, testing is just one component of the NFL and NFLPA's COVID-19 mitigation strategy.

"We cannot test our way to safety," said Dr. Sills. "No matter how often we test or who we test, testing is always going to have some limitations. That's why it's important to add in other layers of protection."

New protocols have been implemented across club facilities to accommodate physical distancing and around-the-clock cleaning and disinfection, and access to the team environment – at home and on the road – is now restricted to only essential personnel.

"Risk mitigation is not one intervention, but a number of interventions you stack together in the hopes that the combination will be more effective than any of them individually," said Dr. Sills.

"Our number-one goal is to keep everyone safe and make sure that as best we can no one steps onto the field on gameday that is infected – whether that be player, coach, or other personnel."