Five swabs a day keeps COVID away, and other tales from the league’s unprecedented epidemiological experimentDuring the pandemic, a video game offers more than simple fun.
August 28, 2021
from STANFORD Magazine
by Sam Kelly
The bubble was holding. Through the first two months of the NBA’s astonishingly complex and expensive restart to the 2019–20 season at Disney World in Orlando, Fla., the league’s unprecedented social, sports and epidemiological experiment seemed to be working.
The strict quarantines, the daily tests and health checks, the electronic checkpoints, the endless cleaning and sterilization, the mask wearing and hand washing—all the procedures that NBA vice president and events medical director Leroy Sims, ’01, MS ’02, MD ’07, and his colleagues had labored over for months and that hundreds of players, coaches, reporters, staff and resort workers complied with daily—had kept COVID-19 at bay. As the regular season ended and playoffs began, no player or other resident of the NBA campus had tested positive for the coronavirus, even as the pandemic raged across the state.
But as the end of August approached, a new and potentially troublesome variable loomed: little kids. The NBA had agreed to allow player guests—four per player, restricted largely to family—inside the bubble after the first round of playoffs. How well would the bio-fortress hold then? “It’s one thing to ask adults to get tested every day, wear masks and follow strict social distancing guidelines for the common good,” says Sims. “But a 5-year-old?”
The grade-school set’s tolerance for nasal swabs was just one of scores of questions keeping Sims up at night—that is, when he wasn’t already pulling an overnight shift as an emergency medicine doctor at Mills-Peninsula Medical Center in Burlingame, Calif. A Chicago native who loved the field of medicine as a kid and ran track at Stanford, Sims found himself juggling two high-adrenaline jobs, including the orchestration of a novel medical endeavor that his boss at the NBA, Jeannette Neyses, likens to “running a bunch of sprints, every day.”
Heading Level 2
“Work in this bubble is harder than working in the ER because I’m so prepared for the ER,” said Sims in early September. He spent six weeks in the bubble early in the summer, flew back to California to his wife and two young daughters for three weeks—and six ER shifts—and then returned to Orlando to finish out the season. “There is no playbook for the bubble.”
Heading Level 3
Before COVID, Sims oversaw the operations of all things medical at NBA events worldwide, from the annual All-Star Game to a Global Game in Paris to an NBA Africa Game in Johannesburg. The bubble was a hybrid beast—both an event and the end of a season that was put on pause for four months due to the pandemic. In effect, it was an event of such long duration—from the restart in early July to the crowning of the Lakers as champions in mid-October—that, in addition to sourcing MRI machines and sussing out which local hospitals could provide private entry, Sims had to think about all the off-court medical needs people would normally handle themselves. What if one of the 1,500 or so bubble residents suddenly needed an ophthalmologist? Or had chest pains?
Heading Level 4
Then there was the matter of a global pandemic to repel. Before players arrived for the restart, Sims and his NBA colleagues spent months consulting with specialists in everything from mathematics to infectious disease to industrial hygiene. They talked with the NFL, the NHL, Major League Soccer, Major League Baseball, various European soccer leagues, the Fédération Internationale de Basketball and the Australian Football League. They wrestled with questions such as: What type of test should we do and how often? How do we do that without taking resources from the local community? (The NBA, in conjunction with BioReference Labs, provided free testing in the Orlando area.) How do we most reasonably limit the biggest COVID risk factor—exposure to other people—while playing basketball? “I know a lot of people give us kudos: The NBA is showing people how to do it in the bubble,” says Sims. “But the NBA didn’t sit in the room and come up with this de novo. We really did our homework and consulted folks.”
Heading Level 5
The resulting 113-page medical protocol spells out what would have happened if someone had tested positive (isolation housing and further testing) and is rife with rules and restrictions: no visits to teammates’ rooms, no caddies in golf, no doubles in table tennis. No reusing a deck of cards. No interaction with the outside world. (In July, Richaun Holmes of the Sacramento Kings inadvertently crossed the bubble border to grab a delivery of chicken wings and paid for his indiscretion with 10 extra days in quarantine.) COVID tests—three shallow swabs of the throat and one swab of each nostril—were mandatory daily, as were temperature and oxygen saturation readings and symptom checks that were uploaded into wearable devices that tracked bubble denizens’ health and accordingly granted or denied them access to entrances around the campus.