Louise Radnofsky, Ben Cohen | The Wall Street Journal | Source URL
The darkest shadow hanging over the future of sports, concerts and other mass gatherings is another spike in coronavirus cases, hospitalizations and deaths
The September sports calendar is suddenly packed. In addition to the usual Saturdays and Sundays filled with college and professional football, the lineup now includes the Kentucky Derby, the Tour de France, two rescheduled marathons, golf tournaments and tennis Grand Slams. And that could deal another blow to an industry already reeling from the unprecedented disruptions of the coronavirus pandemic.
Those blockbuster sports events are scheduled right in time for a bigger problem: the second wave of the virus.
There has always been a second wave in the epidemics that have interrupted American life over the last century, from influenza to AIDS, and top infectious disease experts have been warning for weeks that history will likely repeat itself in the coronavirus pandemic.
The return of this new coronavirus is the darkest shadow hanging over the future of sports, concerts and every kind of mass gathering that was commonplace before. If there is no second wave, it would break a streak of centuries.
“Second waves are inevitable in pandemics when you don’t have a vaccine,” said Carlos Del Rio, head of the global-health department at Emory University, who chaired the panel that guided the National Collegiate Athletic Association to shutting down sports this spring. “Any disease when you have an epidemic, when you loosen up prevention, you’ll have a second wave.”
The question of when American life gets back to normal is not whether there will be another spike in cases, hospitalizations and deaths. Del Rio says it’s this question: “How much of a second wave are you willing to tolerate?”
That means that the conversation about getting the country back online—and sports as the most high-profile example of that—has come to revolve around the preconditions for containing a second wave through identifying and isolating new cases. They’re not there yet. If they’re not in place by the fall, mass gatherings are out of the question. Even if they are, mass gatherings may still be out of the question.
It has now been more than a month since the shutdown of American sports, and the return of games on television and fans to stadiums has become a litmus test for a return to normalcy. That sentiment is coming directly from the White House, where President Trump has said repeatedly that “we have to get our sports back.”
But the second wave is what’s in the way of that vision. The first outbreak put the NBA playoffs and MLB opening day on hold. A second wave hitting in September would collide with football season—and that’s exactly when it’s being projected.
“The great fear is that this will recur again this fall,” said Gary Simon, chief of infectious diseases at George Washington University, who warns that autumn is when social distancing would be relaxed just in time to collide with the beginning of flu season.
In a study published this week in Science, a team from Harvard University cautioned that the success of this first round of interventions may push the epidemic’s peak into the autumn, when the resources of hospitals and healthcare systems would be strained again. They said some periods of social distancing might be necessary until 2022.
Scott Gottlieb, the former Food and Drug Administration commissioner who is advising the Trump administration on its coronavirus policy, says he sees a high risk of a second wave in the fall. He’s been pushing for a staggered return of activities. His plan calls for gradually scaling back up again, based on the size of the gatherings and their significance, and monitoring the effects at each stage.
Mass gatherings for sports games are at the bottom of his list. The sight of fans in stadiums is contingent on a “quiescent” fall and robust system of testing and contact tracing to identify and isolate new cases— as well as measures that include fever guns, hand sanitizer handouts and masks inside stadiums.
“We could bring lawn maintenance crews back at the end of the month with very low risk, but we can’t fill up stadiums,” he said Wednesday. “I think the entertainment venues are going to be some of the last things we bring back… Sports are going to be played with no fans for a while.”
For some scientists, it’s a probability problem. The prevalence of cases is unlikely to sink low enough by this fall to host a football game without the high risk of someone infected being in the crowd. The more people in the crowd, the greater the chance that at least one is infected, and the more people the infected will be in contact with. All it takes is one game to trigger a local outbreak.
“I think the risk of a second wave is a huge risk, and you’re playing with fire holding a football game with people in the stands,” said Carl Bergstrom, a biology professor at the University of Washington.
There are roughly 20,000 fans at NBA games and 30,000 fans at MLB games. But the average NFL game draws about 65,000 people, and the University of Michigan has one of several college stadiums that can hold the sort of enormous crowds that might become a relic of the recent past. “You’re certainly not going to put 100,000 people in the Big House,” Bergstrom said.
Another part of the fear is historical. The first wave of the 1918 flu pandemic hit the U.S. and the world hard. It was mitigated in the summer only to come roaring back harder in the fall.
“The second wave killed far more people than when the Spanish flu first swept through the world,” said Lawrence Gostin, the director of the World Health Organization’s center on global health law. “We have no reason to believe that Covid-19 will take more lives this fall and winter, but it is likely to return and will continue to have similar impacts on health, deaths, and hospitalizations.”
There are big unknowns as well. Some of these factors might end up cutting against a big second wave. But experts also suggest that what we don’t know could add up to a cycle of waves until the existence of a vaccine, which almost nobody thinks will have been developed and mass distributed by the fall.
“Will enough people have been infected in this present round to bequeath some kind of herd-immunity and so protect those who were not exposed? No one knows,” said Jeremy Brown, an emergency medicine physician and author of “Influenza.” “Does the fact that you have been infected once give lifelong or prolonged immunity, or some lesser degree of immunity, or perhaps none at all? No one knows. Will Covid-19 just go away, like so many other winter viruses do, as the weather gets warmer, perhaps never to return? Possibly. But no one knows.”
Those unknowns are felt by none other than Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, and the most prominent scientist in the White House briefing room. He says the only guarantee is that there are no guarantees. Not even Fauci can say whether there will be 100,000 people in football stadiums in five months.
“I think that’s going to be determined by the virus, not by anybody’s proclamation,” he said Wednesday. “If there is a lot of virus around, I think it would not be prudent to be putting people in close quarters together the way we did prior to coronavirus. If we get back to some degree of normality, I think this is possible. But I cannot predict.”
“The answer is none of us know at this point what the situation is going to be like in the fall.”