UConn says coach likely didn’t spread virus to players, but experts are unsure
The UConn women’s basketball team will play in the NCAA Tournament this Sunday despite coach Geno Auriemma having COVID19, a decision that experts say raises complex questions about how to assess coronavirus risk.
Auriemma tested positive for COVID-19 on Sunday, then again Monday.
After reviewing tape from practices on Friday, Saturday and Sunday, UConn concluded that the coach had not been within six feet of any player or coach for 15 minutes or more — the definition of “close contact” according to the U.S. Centers for Disease Control and Protection.
Auriemma has not seen his team since Sunday, the school says, and did not travel with players and other coaches to San Antonio for the tournament.
The university, after consulting with the NCAA, decided to send the team, which is being coached by UConn assistant Chris Dailey.
Dr. Deena Casiero, UConn’s director of sports medicine, said through a spokesperson that Auriemma’s initial positive test showed a “high cycle threshold,” which is believed to correlate to a lower viral load. Auriemma said Monday he was told his viral loads were “so minimal that the chances that I would transmit [the virus] to anyone is highly unlikely.”
But Dr. Tom Balcezak, chief clinical officer at Yale New Haven Health, says that’s not necessarily the case.
“I think that’s speculation,” Balcezak said Wednesday. “The fact is, he has the virus, he is contagious and he has the potential to spread it to people. I wouldn’t pin too much on what the cycle threshold was.”
Zachary Binney, an epidemiologist at Emory University who has spent much of the pandemic analyzing sports leagues’ coronavirus prevention protocols, said “it’s not crazy” to reason that Auriemma might have had a relatively low viral load, reducing his odds of spreading COVID19 during practice. Still, Binney said, “that does not mean the risk is zero.”
“Coach Auriemma was indoors, which raises the risk of transmission,” Binney said in an email. “If he was yelling, that would raise it further. If he wasn’t wearing a mask, that would raise it a lot more. His likely low viral load is a mitigating factor, but does it fully mitigate those other things that may have raised the risk of transmission? I don’t know. Obviously UConn would like to focus on the things that work in favor of them playing and ignore anything that doesn’t, but the truth is always more complicated.”
A UConn spokesperson said Auriemma wears a face-covering during practice, typically a neck gaiter.
While Auriemma is self-isolating and can’t rejoin his team until March 24, the rest of UConn players and coaches were allowed to travel to San Antonio. Aside f rom Auriemma, all tested negative for COVID-19 every day since Tuesday, March 9. Another UConn coach, assistant Shea Ralph, left the team after a family member tested positive for COVID-19 but has not shown symptoms or tested positive.
The Huskies quarantined for two days upon arriving in San Antonio and were set to begin practice Thursday.
Binney said he is comfortable with UConn playing its scheduled game Sunday, assuming no one else in the program tests positive before then.
“If players’ and other personnel’s tests are negative through [Saturday], that’s six days after any possible transmission,” he said. “We would see some evidence of transmission by then. So if there is none, then my comfort level goes way up. If there are any more positives in the program, UConn probably shouldn’t play on [Sunday].”
Balcezak isn’t as sure about the timeline.
Due to an incubation period between when someone is exposed to COVID-19 and when that person has a large enough viral load to test positive, the CDC recommends anyone with potential exposure to quarantine for 10 days without testing or seven days with a negative test.
UConn will return to practice well before seven days have passed and will play its first-round game on the seventh day.
“If you’re exposed, you’re going to come down sick most likely within the first three or four days, but the risk doesn’t drop to near-zero until 10,” Balcezak said. “This is not a binary thing.”
He said this situation resists a simple yes-or-no-answer.
“The fact that he had a high cycle threshold, the fact that he was in a place where there was lots of air exchange, the fact that he was not in proximity for more than 15 minutes, the fact that he was more than six feet away, all of these things stacking up make it less likely that he infected anyone,” he said. “That very well may be true, but at the end of the day he still was infected. The potential still existed that he could spread it to someone else, so the risk isn’t zero.”