College basketball’s biggest question: Will daily testing allow avoidance of contact-tracing quarantine rules?

In just over three weeks’ time, college football has helplessly watched as 22 of its 94 games were postponed or canceled due to COVID-19. That’s an eye-catching 23.4% of its schedule. Remember, four of the 10 FBS leagues (Big Ten, Pac-12, Mountain West, MAC) haven’t played a game. The SEC just started this past weekend. 

College basketball’s schedule, 57 days out from the planned Nov. 25 start, could be at even greater risk. If the sport were to have a cancellation/postponement rate that matched college football’s first month, hoops would easily see more than 100 games impacted with a high percentage of them being cancellations as there isn’t one game per week per team and there won’t be makeup dates in the nonconference portion of the schedule. 

College football has some built-in advantages to stave off coronavirus-related schedule suspensions. Mainly, teams are so large that they can practice in groups to maintain roster stability (reducing contact-tracing requirements). Another benefit: College football teams can practice outside where the coronavirus is believed to be much less likely to spread than in a contained environment. College basketball, on the other hand, practices indoors with small, hyper-interactive rosters. 

“Absolutely one of the biggest challenges we have in front of us: to figure out how to have a competitive season in any sport without major, major stoppages,” Oregon State director for sports medicine Doug Aukerman said Friday in an NCAA video

Aukerman was speaking hours after the NCAA released its “Core Principles of Resocialization of Collegiate Basketball”. That landed with a gloomy thud Friday afternoon. The NCAA’s COVID-19 Medical Advisory Group reminded everyone what should happen if even one player tests positive during the season. The protocols therein are being viewed across college basketball as existential threat to the integrity of the upcoming season. If you missed it — and many did — you can find this passage buried in the document:

“A typical basketball team has 15 players, all of whom typically train on a single basketball court at the same time in an enclosed space. Generally speaking, it is expected that the total number of Tier 1 individuals within a team would approximate 25-30. If any Tier 1 individual becomes infected, schools should consider quarantining the entire team, including coaching staff and other essential personnel who are part of Tier 1, for 14 days, provided determinations around who must be quarantined are ultimately the jurisdiction of applicable public health officials. At present, there is not a recommendation for consideration of testing out of quarantine.”

“Tier 1” applies to anyone in suspected or proven close contact. Anyone sharing a gym, around basketball practice day after day, is Tier 1. 

“It’s really the most important issue, especially in a sport like basketball,” chief NCAA medical officer Brian Hainline said in the aforementioned video.  

That final sentence is key, too. The Centers for Disease Control and Prevention (CDC) does not currently endorse the idea that someone put into quarantine due to contact tracing should be cleared to interact with the public before 14 days, even if negative COVID-19 tests are provided by that person day after day after day. 

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“I’m sitting with my trainer saying, ‘How are we going to have a season?'” one SEC coach told CBS Sports. 

His concern is shared by plenty. Many coaches are worried that, if the standards don’t change, college basketball will be ravaged by an endless parade of teams sitting out for weeks at a time. 

“If they say there’s a positive and everyone’s going to have to sit out 14 days, we’re not going to have a normal season,” Oklahoma coach Lon Kruger said.

An important distinction: the COVID-19 Medical Advisory Group has not mandated the 14-day quarantine.

“If everyone had to automatically follow the NCAA guidelines, then there’s no reason for us to have an advisory group or the Group of Five or the Autonomy Five to have one either,” Atlantic 10 commissioner Bernadette McGlade said. “I think that it’s going to continue to evolve and there’s going to be a lot of scrutiny on the rationale of that as well.”

Still, the way these guidelines go, expect them to be accepted as mandatory for many schools and/or conferences. America East commissioner Amy Huchthausen told CBS Sports she expects her league presidents to soon officially endorse them. Big West commissioner Dan Butterly said, “I’d anticipate that we’re going to take them very seriously.”

Guidelines have a gray area

There’s room for interpretation and potentially even a way out for some. Here’s what coaches want to know:

If we have a person or two in our program who have confirmed positives, OK, they need to go in a 14-day quarantine, no questions asked. But if the remainder of the players and coaches on our team can rapid-test daily and consecutively test negative for four or five days, especially if we have no proof that our positives came as a result of athletic competition or practice, shouldn’t we be able to continue to practice and play? Isn’t this the goal of daily testing to begin with? 

It won’t be so easy. There are three obstacles. 

  1. The potential for conferences to dictate these NCAA health guidelines as scripture to their schools. 
  2. Overcoming restrictions on a local level from health departments. Even if a school had the flexibility to test its way out of this, would their local health policymakers allow it? Some might, others might not. That could bring competitive inequity across college basketball. “The local public health officials, some are going to say 14 days no matter what,” Hainline said. “The CDC is at 14 days. And as long as you have that you then can’t move into an algorithm where you’re going to have some places where you can test out of quarantine and others you can’t.”
  3. Even if schools can test their way out of contact tracing protocols, what’s the likelihood that any team who had positive tests (and put those people into quarantine) would still have all of its upcoming opponents be OK with playing against the rest of the roster? 

This amounts to the biggest dangling dilemma in college basketball right now — and there’s probably no way to avoid it once the season starts.

The issue is complex and the science is not in yet. Hainline said sports across the country could, in fact, eventually wind up informing the science on the coronavirus in the long run, leading to changes in quarantine recommendations. We’re not there yet, though. It could be six weeks, could be a year, could be never. The current CDC guidelines — remember: local county and state ordinances take precedent over anything the NCAA puts out — are based on the general population. They aren’t written for groups of young athletes who have the ability to test daily. There’s a difference between community spread and those living on a team who are mostly cloistered together. 

“It’s not a mandate; it’s suggested. It leaves open for interpretation whoever’s going to claim authority over it,” Oklahoma State coach Mike Boynton said. “For instance, on the daily testing, I think that eliminates the need for significant contact tracing, not that you don’t need to make sure no one else is sick, but if no one else is showing symptoms and you’re testing every day, I don’t see the need for pulling guys if they’re not showing illness. What’s the point of testing every day if you’re not going to trust the test?”

In other words: Why would you shut down 20-plus people — who aren’t showing symptoms and don’t have positives — for as long as 14 days when you have access to daily testing? 

So for Boynton and all coaches who are trying to make the most of a unique season, this issue here in September feels as urgent as any big game ever could. More than a dozen coaches who spoke with CBS Sports since Friday expressed worry that more than half the sport could struggle to even play the NCAA minimum of 13 games to qualify for NCAA Tournament consideration. 

“With as much as it’s going to cost to do [daily testing], are we still going to then make kids sit out who aren’t showing any signs?” Boynton said. “That doesn’t make any sense, but I’m not a doctor.”

Leaning on medical advice

Doctors have been informing conference commissioners and university presidents for months now. College basketball is banking on daily antigen testing that removes contact tracing from the equation altogether. That plan, with authorization from health officials, is the workaround. And it’s what the Pac-12 believes it can do. When the league announced last week it would return to play, the Pac-12’s medical advisors noted they were alleviating the burden of contact tracing within athletic activities by implementing daily testing, citing pro-sports’ established model for doing the same. 

Excerpt from Pac-12 medical advisory board, which could save college basketball from losing dozens of games.

Pac-12 commissioner Larry Scott told CBS Sports his league will go forward with the understanding that daily antigen testing model, via Quidel’s testing kits, will remove the need for contact-tracing conventions. There are a few big caveats, though.

“It assumes the tests are being given close to the start of practice,” Scott said. “Secondly, we feel confident in that testing, but you still need to look at outside the practice environment. Contact student-athletes may have had, either through who they’re living with or who they’re getting together with otherwise, that could have happened later that night or the next day before practice. Our guys feel comfortable, if you’re testing right before you go into a practice, it’s reasonable to have a high degree of confidence that no one’s infectious during that practice. But later that night, the next day before that before you test for the next practice, it might be different story.”

Scott also stressed the final word comes down to local health officials. Who those officials are will vary by school and county. For some, it will be a team doctor. For others, it will be someone or a board outside of the jurisdiction of the university. 

“I don’t think this is a decision a coach can take or an athletics department could take,” Scott said. “Most importantly, local public health officials will weigh in on some cases there may be guidelines, in some cases they may want to enforce them. It’s different in every place.”

Bottom line: Scott said every Pac-12 school is expecting to not fall under the contact-tracing restrictions because it’s advanced beyond that due to daily antigen testing, which is downright crucial when it comes to identifying pre-symptomatic or asymptomatic people.

“Yes, absolutely, every school has had or will have those conversations,” Scott said of programs working with local health officials for clearance. “And so it may be different, across the country across our footprint in terms of how it’s applied. What we’re doing is groundbreaking. It has not been done before, not at this at the scale, certainly not in a collegiate environment. One of the benefits of what we are doing, we think it will inform public health officials.”

The Pac-12 isn’t the only league in a good spot. Some Big Ten programs are heading into the season with the understanding that if you have daily antigen testing, contact tracing rules need not apply. If contact tracing isn’t in the equation, no one sits out until they have a positive and practices and games can continue — provided opponents are comfortable with the situation. 

How many negative tests are needed?

So, how many days worth negative tests should suffice? Four straight? Five? A week? And shouldn’t players be able to test themselves out of a quarantine situation? 

“The most intense discussion was all about quarantine and can we test out of quarantine,” Hainline said. 

If the rest of the team has the capability to test in the next five or six days, and they are still seeing negative results, is that an acceptable threshold? The answer to this question will determine whether or not college basketball can have a season with occasional cancellations or whether it will have a season with an endless outbreak of abandoned games. 

“I would tend to agree: Five days is a lot if you’ve got tests for five days when you have student-athletes that don’t have the virus,” Butterly said.

Scott calls the league’s daily antigen testing a “groundbreaking” step.
USATSI

McGlade said the A-10’s medical advisory group includes people who worked closely with the NBA and MLB. That background has informed a lot of their understanding for how to deal with this come November. 

“MLB put that in contact tracing, too: testing five days in a row and their players could get back on the field,” McGlade said. “I think that’s something that all of the medical committees are going to take a deep dive on. We’ve seen what’s happened with football, look what’s changed with the medical advisory groups. We’ve got Big Ten, Pac-12, Mountain West and their advisory recommendations are changing three or four weeks later. I think we have to be patient right now and we can’t set the house on fire with this. Everything is fluid with these recommendations, and guidelines are going to continue to evolve over the next several weeks.”  

The NFL, with its daily testing and the millions put into that effort, has received exemptions for this. Its teams don’t have to quarantine for 14 days upon returning from travel to a hot-spot state. It’s avoided outbreaks, but if it were to have one, daily testing and the high-level tech associated with curbing the spread is giving pro teams flexibility thanks to working with health officials. On Tuesday, the NFL’s Minnesota Vikings and Tennessee Titans announced halts to all in-person activity after the Titans reported three positive cases. What happens next with these teams will be watched closely throughout collegiate sports.

What steps can be taken to minimize risk?

Coaches could get creative, too. Each team has 13 scholarship players and a few walk-ons. Coaches without rapid daily testing capabilities could opt to separate players into two groups of eight and have them practice in different gyms or at different times to avoid wiping out their team for 14 or more days. 

“That may be something that you have to do,” Kruger said. “That’d be crazy, though. That’d be really crazy. The integrity of the season is not going to be what we’re used to.”

Conference schedules will need to be as flexible as imaginable. Butterly said he will be planning for contingencies that include a 10-game Big West schedule with one game every Saturday to build in a buffer if 14-day quarantines are wiping out teams with regularity. For small conferences and small schools that won’t be able to have near-daily antigen testing, this is probably the scenario college basketball will find itself in. The Big West working with Quidel to get its antigen testing up to above-average standards for a conference of its size.

This reality is why most power-conference schools are either going to play one mid/low-major or none at all this season. Hundreds of schools won’t be able to afford testing on an every-other-day basis, let alone an everyday basis. The process is expensive and the commitment is huge — and 14 days doesn’t really tell the story.  

“It’s 14 days, but when you think about it, it’s really 21 because you’ll need at least five more days based on cardio and the heart then maybe by the 21st day you’re ready,” Georgia Tech coach Josh Pastner said. 

From here, the issues in the sport extend out even further, which is what’s happening behind the scenes with scheduling. If schools are not being provided cover in MTE events with extensive testing, then big programs playing smaller programs will be much less likely this season. 

“We are not going to play a team from the Southland or SWAC that we normally would play because we can’t be guaranteed they are going to test the way we are going to test,” Boynton said.

It’s why the Pac-12’s teams are largely planning on only playing nonconference opponents from big conferences or playing games in a pod-like scenario. There are coaches who, because of all of these potential setbacks, believe that playing games almost exclusively in controlled environments is the only way to have a season with minimal setbacks. Even Butterly said his conference will consider the so-called bubble option as a last result for league play in January and February. 

“There is no college basketball based on contact tracing as it is today,” Pastner said. “There’s theory and reality. The theory is that — based on CDC guidelines as of today, based on contact tracing how it is clearly defined in CDC guidelines — it’s going to be very hard to play basketball games without some sort of isolation. I have been saying for the longest time, unless this contact tracing gets resolved, I don’t know how any other way you can play without having isolation, bubble-type of scenarios in order to have normalcy to play games, otherwise I think it’s going to be hard for teams to get to 13 games.”

The double-edged sword of college basketball’s nonconference slate in this environment is teams schedule three or four games in seven days’ time. You can get them all in — or maybe lose them all at once. At the top of this story I mentioned the existential crisis on college basketball’s schedule. Keep in mind that all of this is under consideration and we might see the country’s COVID-19 situation considerably worsen in the winter. 

“If a second wave hits we’ve go to be prepared for whatever that outcome may be,” Butterly said. “And if it’s shutting down college basketball, that may be what everyone has to consider.”  

Postponing the end of the college basketball season could be an inevitability. We won’t have answers to that until late 2020 at the earliest. But in advance of that, what appears crucial for college basketball is to have as many teams find a way to afford near-daily antigen testing so that we don’t look up in early December and see the sport getting dozens of games vaporized with no end in sight. 

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