Implementation and Evolution of Mitigation Measures, Testing, and Contact Tracing in the National Football League, August 9-November 21, 2020

Abstract

The National Football League (NFL) and the NFL Players Association (NFLPA) began the 2020 football season in July, implementing extensive mitigation and surveillance measures in facilities and during travel and gameplay. Mitigation protocols* were evaluated and modified based on data from routine reverse transcription-polymerase chain reaction (RT-PCR) tests for SARS-CoV-2, the virus that causes coronavirus 2019 (COVID-19); proximity tracking devices; and detailed interviews. Midseason, transmission was observed in persons who had cumulative interactions of <15 minutes' duration, leading to a revised definition of high-risk contacts that required consideration of mask use, setting and room ventilation in addition to proximity and duration of interaction. The NFL also developed an intensive protocol that imposed stricter infection prevention precautions when a case was identified at an NFL club. The intensive protocol effectively prevented the occurrence of high-risk interactions, with no high-risk contacts identified for 71% of traced cases at clubs under the intensive protocol. The incorporation of the nature and location of the interaction, including mask use, indoor versus outdoor setting, and ventilation, in addition to proximity and duration, likely improved identification of exposed persons at higher risk for SARS-CoV-2 infection. Quarantine of these persons, along with testing and intensive protocols, can reduce spread of infection.

FIGURE

Laboratory-confirmed COVID-19 cases (N = 329) and mitigation strategies implemented — National Football League, United States, August 9–November 21, 2020 Abbreviations: COVID-19 = coronavirus disease 2019; PCR = polymerase chain reaction. * Reverse-transcription PCR tests were processed on two platforms (Roche Cobas and ThermoFisher QuantStudio) and transcription-mediated amplification on one platform (Hologic Panther Aptima). ^† Twenty-nine clubs spent 431 days under the intensive protocol beginning October 1; 189 high-risk contacts of 215 cases were identified and subsequently quarantined beginning October 15.