Thread by @ADavidHaleJoint

Hi, Coronabro here. Let's talk a bit about how things are going with college football and the virus. A thread...

With the Saban news & another round of game postponements, it's getting tougher and tougher to suggest this is all going well. But is it going badly? Was playing a bad idea? It's hard to say because we have no established metric for success. That's by design.

But lets start with Saban. Could he coach on Saturday? It's funny that this was not a question when Mike Norvell had to sit out, but here's what @CFBHeather wrote yesterday.

@CFBHeather If this is even a consideration, then we've lost any foundation of legitimacy to how colleges are handling the virus. I've talked with numerous doctors, including three on the ACC's advisory group, who all said that testing out of protocols is risky.

@CFBHeather Now, I’ve also talked with some folks who agree that three straight negative PCR tests “likely” is as accurate as a 10-day isolation, but that hasn’t been the protocols in CFB before (see Mike Norvell) and this would create the notion that Saban is special. That’s a problem.

@CFBHeather From one doc: "Testing can’t predict the future. A test tells you your status now. You could still develop infection in the next couple of days so a negative test is not a 'get out of jail' card."

@CFBHeather Moreover, the bulk of postponements come from contact tracing -- guys put into quarantine for 14 days without ever testing positive. That's a big ask of players if you're going to entertain the notion of Saban -- who tested positive -- being allowed to test out.

@CFBHeather Contact tracing is another big issue to this story. How does it work? Depends who you ask. Some schools are very strict and very safe. Some are winging it. The standards are vague. CDC says 6 feet/15 mins, but obviously contact on a football field is diff than in a restaurant.

@CFBHeather From Dr. Cameron Wolfe: "Risk is proportional to many things: proximity, duration & frequency of contact, inside/outside, whether they are masked, etc. Each school is responsible for contact tracing w/the oversight of the local health departments associated with their campus."

@CFBHeather I've heard from multiple coaches who are frustrated that their program is taking contact tracing very seriously while others are not. Now, coaches tend to be a bit paranoid, but there's definitely some substance to this claim.

@CFBHeather But, you might ask, why do we do contact tracing at all if guys test negative? Especially in B1G with daily testing! Great question. Here's what I was told by a doc..

@CFBHeather “Testing is not sensitive enough to absolutely ensure you will catch everyone who is positive. As such, most do not test out but rather use the 14 day time frame. Because 30-40% of younger patients may be completely asymptomatic, truly knowing who has it is still challenging."

@CFBHeather Jeff Scott talked about this too. He actually approached USF Medical Center docs with this same question: Can't we just test daily and not worry about contact tracing? He was told the same answer: No. Tests are helpful but not foolproof.

@CFBHeather Again Dr. Wolfe: "Unfortunately, when we consider the incubation of CoVID, there is significant variability between people. During the incubation period, a test will be negative, yet that does not infer a person won't develop a future illness."

@CFBHeather What about false positives? We’ve had some issues raised by numerous schools already. I was told that tests are incredibly accurate when returning a + result. Of course *reading* those tests is still subject to error.

@CFBHeather So, some labs have a standard machine protocol that reads all tests and provides a result and that’s that. Others have back-up analysis. Others have a mix of human and machine. Some labs are better than others is the short answer here.

@CFBHeather Again from a doc, who says to err on the side of safety: "We have agreed to accept a positive test as a positive test and will not attempt to 'test out' of a positive result."

@CFBHeather What we should be doing is closely tracking the outcomes of contact tracing & testing. What % of contacts eventually turn positive? How quickly does that happen? What type of contact was associated w/ positives? Did it happen on the field? This data could help direct protocols.

@CFBHeather But I talked to two ADs who both essentially said "yeah, we should do that but no, we're not doing that." So for ex. the 14-day quarantine period is based on doubling the avg incubation time (7 days). What if data shows that no positives ever occur after 5 days though?

@CFBHeather Having that data could be a huge asset to schools, leagues & everyone really. But that gets to our next point, which is that less data is sort of the goal because if we don't have a clear demarcation between what's good and what's bad, we can't ever call the protocols a failure.

@CFBHeather So, is there a way to objectively measure if this is working? A few options...

1) Has anyone died? Gotten very sick? Been hospitalized?

As far as we know, no. That’s very good news but also not a predictor that it won’t happen. Just that it hasn’t happened *yet*

@CFBHeather This fits with the general consensus that younger/healthier people are better equipped to battle the virus and will face less serious SHORT TERM consequences. But this ignores potential longterm effects, for which we still know very little. There’s still risk.

@CFBHeather 2) Have we done a good job preventing spread? This is a better question because the goal should be fewer cases, not no deaths. But again, it's tough to measure. What % might we expect to be preventable? Or perhaps more accurately, are college athletes facing a greater risk?

@CFBHeather We're not getting robust data here because, frankly, schools and leagues don't want us to have it. But we can use what we’ve got to make some rough judgements…

@CFBHeather So, for instance, Clemson has done 6,382 tests with 124 positives -- a positivity rate of 1.9%. (Kudos to Clemson for sharing data). Nationally, the positivity rate has been between 4-6% since August. So, is Clemson proof that things are going well?

@CFBHeather That's tricky because the tested population is a little different. Ostensibly, the SAME people are being tested repeatedly - some daily - at Clemson, so 1 person staying negative for 2 weeks could = 10 clean tests.

@CFBHeather That's not true in the real world where, likely, a majority of folks tested have cause for getting a test and are not tested repeatedly. So with different population groups, it's really hard to compare directly.

@CFBHeather Perhaps the better comparison would be what's happening at Florida, where (that we know of) 19 players tested positive out of a group (players, coaches, staff) that's probably about 190 people -- i.e. 10% tested positive. That's definitely much worse than the national number.

@CFBHeather But again, is that number worse than the overall demographic group in the state of Florida? We could get very granular here -- which again, leads us back to why we needed better information and more clearly stated markers for what constitutes success.

@CFBHeather 3) Is CFB doing better than other sports? The clear answer here is no. Roughly 16% of scheduled games have already been postponed or canceled. We're not seeing that anywhere else. But, of course, CFB is unique -- it's on a campus, not a bubble. There are 120 players, not 15.

@CFBHeather Still, I think it'd be hard to look at what's happening in CFB at the moment and say the current protocols have proven effective in limiting spread of the virus or allowing teams to find some semblance of consistency. And that matters, too, for another reason...

@CFBHeather One argument for playing was the desire of the players & the impact on their mental health. That's laudable. But I've talked to one coach after another who's said that the mental toll of the on again/off again situation has been immense. We’re asking a ton of players right now.

@CFBHeather And that's not even taking into consideration the on-field impact. Have guys gotten hurt because teams are playing with thin depth charts? Are games being lost that impact the playoff hunt? And we certainly haven't asked about fans and potential exposure there.

@CFBHeather Where does this get us? For one, it means I'll get yelled at for rooting for the virus. But I promise, I'm not. I just think if we're asking these athletes to effectively be canaries in the coal mine, we should be paying closer attention to the real results.

@CFBHeather I’ve never once said I don’t think they should be playing. The entire point I’m making here is we don’t know. But if we don’t do a better job of analyzing what’s happening, we’ll never know and this whole experiment really will have just been for the TV revenue.