Op-Ed: Let’s pump brakes on MLS return to play

Dr. Nipun Chopra is a neuroscientist who studies neurodegeneration and has held a lifelong passion for the beautiful game.

He is currently an assistant professor of Biology at DePauw University.

Dr Chopra’s article initially appeared in Soc Takes and is reproduced in full here with the kind permission of both Nipun and their Managing Editor, Kevin Johnston.

Are we ready to return to play? I’m sorry, but we are not. Not even close

It feels as though it has been years since I watched Tyler Pasher terrorize Tim Howard in Indy Eleven’s away win against Memphis 901. Since then, U.S. Soccer has come to a complete standstill.

The impact of COVID-19 has been global, and the number of cases and deaths in the United States have been remarkable. Currently, over a quarter of the world’s cases and deaths have occurred in America. The impact on global and local economies has been catastrophic and a fifth of Americans currently find themselves unemployed.

One of many economies struck by the pandemic is professional sport, and particularly my favorite niche, professional soccer. Leagues all across the world have rightly canceled matches and training over the past two months, but are now exploring resuming sporting activities. In England, suggestions are that the Premier League may resume in early June, even though it must be noted that mother nature was so upset at the idea of a Liverpool Premier League win, that she imparted a global pandemic upon us.

Closer to home, Major League Soccer (MLS) and the United Soccer League (USL) are all beginning to explore a return to training, while the professional National Independent Soccer Association (NISA) and multiple amateur leagues have suspended play for the spring season.

But should we start playing soccer?

REASONS TO PLAY

While there has been no statistical analysis of this yet, the downturn in the economy is undoubtedly negatively affecting club finances. Based on the financial instability of American club soccer — even before the pandemic — it is likely that we stumble to the other side of this thing with more defunct clubs and more irresponsible behavior directed toward players and staff. The latest example of this will be possible cuts to player salaries.

So, in the unfortunate roller coaster that is American soccer, financial implications demand a return to play. And, likely, a return to play that includes incorporation of supporters. Unlike the financial behemoths of England, Spain, etc., which can account for sponsorships and TV revenue as a significant portion of club income, American soccer continues to rely heavily on ticket revenue to remain financially solvent.

In other words, the ecosystem of players, technical and non-technical staff, referees, administrators, vendors, etc. need the game to return at some point. Fans, too, need a distraction from the terrifying reality of the world around us.

But are we ready to return to play? I’m sorry, but we are not. Not even close.

TESTING

In order to return to play, we must be able to test players regularly. How regularly? Every day. Every day that they train and/or play a game. Can we achieve this?  We — and I cannot stress this enough — cannot.  Harvard Global Health Institute analyzed that the country should be conducting approximately 900,000 tests every day by May 15th. Our current rate of testing is far short of that at around 350,000 tests. So, even in a best case scenario, we are not close to our testing goal.

Beyond that, there are significant ethical considerations to prioritizing testing professional athletes over healthcare personnel, the elderly and other at-risk populations.

But, let’s assume that we do get to a panacea that allows for us testing everyone. There are two more things we should consider: a methodological and epidemiological concern about testing.

The first has to do with the test itself. You see, there are two ways we are testing for COVID-19. The first and most common test is a Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR)-based test. That’s a fancy way of saying: It is a test for presence/absence of viral particles in a patient’s blood. The other, the antibody test, looks for signs of a patient’s immune response to the virus, and is therefore an indirect measure of infection.

To put it simply, the former allows you to test for current infections more accurately. The latter — depending on the type of immunoglobulin (A flag your immune cells produce in response to infection) being tested — can affirm current or previous infections.

Here’s the kicker. Neither test is perfectly accurate. The current estimate for the RT-PCR (viral-particle)-based test suggests that it inaccurately diagnoses between 10-20% of tested individuals as COVID-19 free. Other tests can be less accurate.

Using those statistics in an overly simplistic way, that means that if we test our 10 outfield players — let’s ignore goalkeepers because they don’t really matter — it is possible we misdiagnose one of them as being COVID-19 free when they are not.

The assumption above is that all 10 players are COVID-19 positive, so it is far from a perfect illustration and forgive me the imperfect analogy. The key is to understand that with a big enough population, this false negative will eventually manifest. If we test every player, every day, this will manifest. Given the close quarters professional athletes find themselves in — locker rooms, hotel rooms, contact on the field, etc. — this could be the beginning of a focal breakout.

A focal breakout, where a potentially asymptomatic individual infects multiple other people during a training session or a game.

Does either league have a plan for this scenario? Or are we in – “let’s figure it out later” mode?

As a proof of concept, the CDC reported a scenario where one individual infected multiple other individuals during a 2.5-hour choir rehearsal. While I don’t anticipate watching Bastian Schweinsteiger and Mark-Anthony Kaye singing harmony on “Bridge over Troubled Waters,” anytime soon, the same issue of close contact during a soccer game presents potential superspreader risk.

The second problem with the testing is the latency period of the virus. Let’s return to our current scenario of testing, where people are being tested when they start to show symptoms. To put it simply, if you are exposed to the virus on May 12, it is likely that you will show symptoms by May 15. But, it may be between 1-24 days until you show symptoms.

And, as many of you know by now, it is possible that that player can spread the virus during that time.

So, please, I implore you, we are not ready.

SEQUESTRATION

One commonly cited method of returning to professional support envisions a scenario where players are sequestered from the outside world. They live in hotels, do not physically interact with their families, and simply train and play football.

In premise, this seems reasonable. But, how realistic is it in practice? Sure, we can sequester players in a hotel. But, what about coaches? Sure, let’s throw them in there, too. What about referees? Alright, get Howard Webb the presidential suite at the Ritz Carlton. Sorted. Ummm… what about non-technical staff who interact with players? What about hotel workers? What about the mental toll of separating players from their families during a global pandemic?

Sure, if the question is: Would a player accept being separated from his family over not getting paid? The answer is likely “yes.” But, I implore you to recognize that the problem is THAT question.

The question should be – “How dare a millionaire or billionaire ask a player to decide between his health (and that of his loved ones) or a paycheck?”

And how dare Major League Soccer and United Soccer League – who will continue to generate revenue – allow owners to do so?

So, please, I implore you, we are not ready.

RECOVERY

Let’s take a hypothetical scenario. We restart MLS/USL seasons. All goes well for the first couple of game days. Indy Eleven is top of the table, per usual. Players are enjoying their hotels, spending their time playing video games, eating delicious lasagna at the hotel and FaceTiming with their loved ones. But then, it happens. (And it undoubtedly will at some point.)

One of the players tests positive for COVID-19.

What’s the plan? If you are an MLS player, you’re covered by medical insurance. If you’re a player in the USL, are you paying out of pocket in absence of medical insurance?

OK, let’s look past the uncomfortable reality of player insurance that we all like to avoid. Let’s look at logistics. In terms of logistics, quarantining the player is the easy part. Who else gets quarantined? His roommate? Easy. Check. Every person he has interacted with? Yeah, probably. Since everyone is coexisting in a hotel, that means the entire team. Players, technical staff, everyone.

So, please, I implore you, we are not ready.

SOLUTION?

I know, I know. I’m a complainer not a doer. It’s easy for me to point out the problems and not give you a solution.

And, you know what, I’m fine with that characterization. Because, the only solution right now is — we need more time. We all do. We are in the middle of an unprecedented pandemic that is evolving before our eyes. We are still understanding the scientific mechanisms, spread (have we considered the possibility of a soccer ball as a disease vector?), evolution and the likelihood of a second wave. In the absence of achieving an estimated 70% recovery-contingent herd immunity, we must wait. We must wait for access to a reliable and safe treatment modality. Ideally, we must wait on a vaccine.

So yes, there are significant financial implications at stake. But, the burden of those questions SHOULD be on MLS and USL owners. Those owners should not be placing the health of their employees over their own short-term financial stability.

While I don’t have clear-cut solutions other than “more time,” I know what isn’t a responsible decision — players should not face salary cuts. Whether owners have to take short-term hits, this is what they signed up for. In an environment where lower-division soccer players are paid low wages and occasionally don’t have medical insurance, truncating their salaries is unacceptable.

Across the country, states are reopening businesses as the scientific consensus has taken a backseat to right-leaning politicking. As a soccer community, let’s not make the same mistake.

I implore you, we are not ready.

Follow Nipun on Twitter: @NipunChopra7