DENVER, COLORADO - NOVEMBER 29: New Orleans Saints rushes against the Denver Broncos during the ... [+]
As our nation is recording an average of over 150,000 new Covid-19 cases per day, testing programs and test access remain widely varied. Some counties have resumed modified “safer-at-home” mandates, and many hospitals report triple the number of inpatients with Covid-19 infections compared to just a few weeks ago. But testing access continues to be a struggle for most, even to those who are treating those infected with coronavirus. Some sectors, notably professional football, have gone on with business as usual, albeit with multiple coronavirus hurdles muddling their huddles.
Take the Denver Broncos, who played against the New Orleans Saints this past weekend without a quarterback. If you are someone who doesn’t follow football, has never seen a football game, or lives on Mars, this is a big deal. The quarterback is the offensive (as in the sports term “offense,” not as in the “offensive” term in language, where an expletive would include a bleep sound or an asterisk) leader of the team, throws the passes, and calls the plan for the play when the players are in the huddle.
FOXBOROUGH, MA - OCTOBER 25: The 49ers huddle up around San Francisco 49ers quarterback Jimmy ... [+]
Those huddles can get pretty cozy, and are certainly not physically distanced, either prior to or deep into the days of the pandemic. But as we are continually reminded to “mask up,” keep a distance from those not in our household of six feet or more, minimize contact with those living outside of our homes, avoid crowds, avoid restaurants, bars and gyms, and stay home from school, one wonders how huddling football players are pulling this off. Well, they’re not. The QB-less Broncos were left with a rudderless huddle because one of their four quarterbacks tested positive for coronavirus, and the other three had been without masks while in close contact with said infectious quarterback, punting all four out of the game. Apparently quarterbacks are pretty important, because although the Bronco’s wide receiver stand-in gave it his all, they were pummeled 31-3 by the Saints, who had a Covid-negative quarterback in the game.
The Baltimore Ravens, despite being tested every day for coronavirus and wearing masks, reported that 13 of the players are now infected with coronavirus. While many NFL players, coaches, managers, and not to mention, spectators, are dismayed yet not surprised to hear about these mini-outbreaks in the league, healthcare workers have quite a different take. Even those who like the sport.
The Seattle Times, via washingtonpost.com, published a piece last week featuring a nurse’s love for football, even during the pandemic, but underscored her dismay in the disparity in who gets tested and why. Jane Sandoval, an emergency room nurse in the San Francisco Bay Area, stated that in eight months of working on the front lines, she has never been tested for coronavirus. Not once. Most of her friends assume that she is tested regularly, as should be the case for most front line healthcare professionals. She goes on to explain that her employer does not offer coronavirus tests to employees, even after exposure to an infected individual.
Hospital COVID Healthcare workers during an intubation procedure to a COVID patient
The piece, written by Kent Babb, delineates the discrepancy in testing access for professional athletes, most notably football players, compared to healthcare workers, most notably those on the front line:
“Among the haves are professional and college athletes, in particular those who play football. From Nov. 8 to 14, the NFL administered 43,148 tests to 7,856 players, coaches and employees. Major college football programs supply dozens of tests each day, an attempt — futile as it has been — to maintain health and prevent schedule interruptions. Major League Soccer administered nearly 5,000 tests last week, and Major League Baseball conducted some 170,000 tests during its truncated season.”
Seeing football players huddling, passing the shared ball, tackling, and later congregating, all maskless, juxtaposed with healthcare workers layered in PPE (personal protective equipment) while treating patients actively infected with Covid-19, juxtaposed with public messaging, imploring folks to stay home, wear a mask, and keep social distance, the inconsistencies in messaging, access, and the stark reality in disparities in access to healthcare are even more vivid.
Dr. Mark Morocco, Emergency Medicine physician at the Ronald Reagan UCLA Medical Center and Clinical Professor at UCLA, where he has been on the front lines treating Covid-19 patients since March, comments that the ready access to frequent testing of athletes is “really a slap in the face to front liners and shows that money drives these organizations rather than good citizenship.” In addition, he notes that “Pros and pro teams have enough money to pay top dollar for tests and monitoring that regular institutions like public health and hospitals cannot compete with. Profit driven companies gladly sell tests or PPE at higher profits, pulling them out of the reach of others with greater needs. So it's not just sports stars getting better food or a good seat at a restaurant — its means that nurses, doctors and patients may find that although they are at greater risk, they are less valued.”
Many healthcare workers do not have ready access to testing, but there are some institutions that are making tests available to their staff. Dr. Scott Krugman, Vice Chair of the Department of Pediatrics at the Herman and Walter Samuelson Children’s Hospital at Sinai in Baltimore, Maryland, states, “I am fortunate to be at a hospital that has easy access for employee testing through PCR send-out that takes 24-48 hours to return. It would be great for all healthcare workers in the country to have access to a rapid test they could self-administer or have done regularly when coming to work at the hospital in order to prevent asymptomatic carriers from spreading the disease.”
But in general, it hasn’t been that easy. Dr. Seth Trueger, an Emergency Physician at Northwestern University in Chicago, has had a mixed experience regarding test access. “We don’t do surveillance...If exposed or symptomatic, we finally have options at our drive up center across from the [emergency department] but it was a hassle for awhile...It's a sad state on our priorities that athletes are being tested routinely to play sports but health care workers aren’t. But the bigger frustration is that 8 months in we still have generally pretty bad tests, and not nearly enough of them, and we're starting to run short on PPE.”
Doctors helping patients who are in hospital beds during the COVID-19 pandemic
Dr. Mark Shapiro, a Hospitalist at St. Joseph Health Medical Group at Santa Rosa Memorial Hospital in California, notes that “As far as professional sports teams go, and as a physician who treats Covid-19, it’s frustrating. We shouldn’t have to be in a scarcity mindset regarding testing, but the reality is money is leading to access. The resource for sports isn’t being used in the way it should be. The NBA made the bubbles work, but it’s not happening with the NFL.”
With vaccines on the horizon, and no clearly defined protocol for which groups of individuals will have earliest access, more equitable and widespread access to testing will remain a priority for months, and perhaps years, ahead.
