How the NBA is beating COVID-19

And why our schools could never pull this off

BY HENRY ABBOTT

It was bold, a few months ago, when the NBA—a basketball organization—resolved to give itself a Ph.D. in virology. In normal times, a sports organization would follow re-opening recommendations from the CDC. But it’s 2020, so Adam Silver tapped league executive David Weiss—a man with a law degree from Michigan—to work insane hours talking to people like Dr. David Ho and Dr. Lisa Maragakis, and to contract with BioReference Laboratories for a huge number of quick-turnaround PCR tests. Together, they essentially invented the Orlando situation that the league assiduously avoids calling “the bubble.” 

A month after the teams boarded planes to a pandemic hotspot, the NBA still has zero confirmed positive cases. That’s zero cases not only among 22 teams’ worth of players, but also among the entire assembled microclimate of 1,400ish staff, media, vendors, league officials, and others. The NBA might be, for now, the United States’ signature victory over COVID-19.

And, perhaps, a guide in reopening schools and businesses?

Probably not.

UNLIKE STUDENTS, NBA PLAYERS ARE SUPER MOTIVATED
“The buy in from everyone, especially players, is pretty amazing,” says a league executive. He’s talking by phone, from the NBA’s campus in Orlando where players like LeBron James and Kawhi Leonard are wearing masks and using hand sanitizer. “To watch a whole team, with superstars, walk by and swipe their Magic Bands and have them flash green, which means they filled out symptom surveys that morning, is awesome.”

Anyone who has been to Disney knows a Magic Band is a dystopian digital tracking device with a Mickey Mouse logo that you can’t throw away because it is also your room key. Today, it’s a lynch pin of the NBA’s coronavirus strategy, which involves the kind of invasive oversight teams have long sought, and the Players Association accepts in a pandemic.

It’s hardly worth asking why the players are OK with these hassles. One clear answer is because, duh, nobody wants to get sick. 

But … all kinds of Americans chafe at similar recommendations.

The NBA has a lot of tests (keep reading, we’ll get to that) but one expert involved in the process points out that testing doesn’t get you to zero cases. To get to zero means managing every possible instance of transmission. Zero cases is about masking, washing hands, distancing from each other while eating, and cleaning everything

That the NBA has no cases has been a surprise even to the NBA, which has a medical facility standing by, and exhaustively prepared procedures to deal with a handful of cases that seemed inevitable even before Florida developed into one of the hottest spots in a global pandemic. 

Maybe the whole NBA has another motivation: This bubble has to work to remain anything like the rich league it has long been. If the NBA can’t come together, some very fine salaries might disappear for the foreseeable future. Plugged in people suggest a 2020-2021 season depends on players’ agreeing to the biggest pay cuts in history—the other option is the force majeure clause, and quite possibly tearing up the collective bargaining agreement.

We all think of the NBA as a pot of gold, but the NBA had a terrible financial year. It was in the hole many hundreds of millions because of China’s hard line against Daryl Morey’s single tweet in response to Hong Kong protests. Then the pandemic brought revenues down, temporarily from some billions a year, to zero. The pain is real now. There are suggestions the NBA, itself, might seek federal support. Billionaire owners have already been circling the White House, hoping for bailouts of their restaurant chains and cruise lines. Longer-term the outlook is hardly any rosier. Fans won’t be in stadiums anytime soon, which the NBA says means about a 40 percent revenue reduction. Disney just reported that ESPN had a great quarter in part because the NBA was closed—meaning not airing the games didn’t hurt as much as paying the rights fees. Cable, the league’s primary source of income, is in a freefall. Young people don’t watch at the rate of their parents. China is supposed to be the league’s key market of the future, but is a tough and increasingly unpopular partner.

UNLIKE SCHOOLS, THE NBA HAS TONS OF QUICK TURNAROUND TESTS
Recently TrueHoop reported that while the NBA has no confirmed cases in the bubble, it has had some players receive positive COVID-19 tests. That led to a discussion about how testing works. 

There are several ways tests can give weird results. Sometimes only some of the expected DNA is present. Sometimes the machine detects an amount that’s outside that machine’s parameters (which are stated on the machine, not unlike how your bathroom scale can only weigh things accurately that are maybe one to 400 pounds, but not a gram or a ton). The most common—and here the NBA, CDC, and experts all agree—is that someone who has recovered from the virus will keep fragments of DNA around long after they are infectious or sick. This is a common cause of positive test results. The tests detect the virus at levels that are a tiny fraction of the amount believed necessary to transmit from one person to another. (The best research, according to an NBA source, is that infectiousness occurs when there are 10 to the third or maybe better 10 to the fifth virions. Sensitive PCR instruments can detect a level of 300.)

These oddball results would exist anywhere there is widespread PCR testing. Most schools and businesses can’t achieve that base level of testing. But here’s where the NBA is especially well resourced: When these outlier findings occur, they have the resources to a) get results in hours because of the deal they negotiated with BioReference Laboratories, b) use a second test on that same person and then c) also administer a second kind of test. In very rough numbers, the U.S. has about one PCR test per 450 people per day. The NBA has at least one PCR test per person in the bubble per day.

Without all those tests, the answer would often be to quarantine for two weeks to be on the safe side. In the NBA, players can be back on the court less than a day after an inconclusive test result.

Harvard’s Michael Mina and others suggest there could be plentiful, affordable, accurate-enough tests in our future. But until then, it’s hard to see how regular life could mimic the NBA when it comes to testing. 

IN ORLANDO, EVERYONE LIVES ON A CLOSED CAMPUS
The NBA made a plan to reopen in Florida, even as an epidemiologist advised Florida’s case count would likely get worse before it got better. Then, in a surprise, it got much worse. The state became a major global hotbed of coronavirus, and put a ton of pressure on everyone to get the science right. 

But it was conceivably possible, because they would be substantially isolated from the local community. 

A month in, signs are good, although no one is certain it will work forever. (As other sports, from baseball to college football, have had poor results, the NBA officials don’t take it as a sign their plan is so much better—they take it as a reminder how difficult COVID-19 is to control.)

No one knows how players will handle the personal and mental health challenges of many months stuck on a Disney campus. Cabin fever could wreck this. Something that seems increasingly to matter: Psychologist Derick Anderson is living in the bubble, and is available to everyone. He is working with Dr. Kensa Gunter who has been available to players remotely. 


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