Protocols aim to prevent trouble in the bubble
Safety in NHL hubs depends on testing, contact tracing and lots of common sense
Dr. Brian Conway would rather debate line combinations than COVID-19 pandemic concerns when the Vancouver Canucks open training camp next Monday at Rogers Arena.
Conway is president and medical director of the Vancouver Infectious Diseases Centre and he’s also a season-ticket holder. Like most fans, he wants to know if Micheal Ferland is healthy and a post-season wild card as a third-line left winger. But his greatest concern is coronavirus testing and tracing, physical distancing, and adherence to safety protocols among National Hockey League players.
Last week, eight of 144 players tested positive in Phase 2 of the return-to-play protocol. On Friday, the St. Louis Blues closed their facility prior to workouts because four players and one coach had tested positive. The 5.5 per cent of positive results are consistent with previous data detailing 45 confirmed cases since the season was paused on March 12.
“It’s a little bit high,” Conway said Monday of the positive test average last week. “What it means is that there is still transmission occurring and has occurred recently. We need to know where they (positive tests) came from.
The two places are from within the bubble and outside the bubble.
“Either the bubble isn’t completely closed, or people are stretching the limits of what they’re allowed to do and need to be coached.”
It’s also depends on the bubble. In Phase 2, groups of 12 players can train and skate voluntarily, but must remain in their individual quarantine bubbles — if applicable — and not have contact with other teammates. It’s a hotel-to-rink existence, depending on how players returned to Vancouver and under which quarantine edict.
For those back from Europe and the U.S., it’s a 14-day protocol. Players returning from another province via a commercial flight are subject to eight days in isolation, while those who remained in B.C., or drove here from another province aren’t under quarantine. Once camp commences and quarantine edicts are met, players are expected to train and stay at home.
The NHL and its players association have tentatively agreed on a collective bargaining agreement extension and protocols to operate hub cities in Edmonton and Toronto for Western Conference and Eastern Conference playdowns respectfully starting Aug. 1.
The inevitability of a positive test and resulting methods to avoid further spread of the virus will be under close scrutiny.
As presented, anyone within the 52-member team bubble who tests positive will immediately be isolated. A second test will confirm the first reading, and if that test is also positive, that person must isolate until medically cleared. And even if the second test is negative, the person remains isolated and tested again every day until they come up negative.
An asymptomatic confirmed case will allow the person to rejoin after two consecutive negative tests over a 48-hour period, or after 10 days in isolation. A symptomatic positive case can return after symptoms have subsided for a minimum of three days, provided the person was in self-isolation for a minimum of 10 days since the positive reading.
“The idea of differentiating a symptomatic from an asymptomatic case is a little bit problematic,” said Conway. “A case is a case. Thirty per cent are probably asymptomatic and these are probably individuals who account for a lot of the transmission of the virus.
“If someone is infected, the ideal situation is to isolate them for a period of 10 days, according to current public health recommendations. Trace all of their contacts and anyone who tests positive has to go through the same process. And then they can resume contact. That’s one thing.
“The issue of relating to a negative test to permit someone to resume their normal activities — as if they weren’t infected — is problematic. We know, in people who are asymptomatic, that the tests can be falsely negative in 30 per cent of the cases. If someone is positive and if they (test) negative and somehow ignore the initial positive and consider that a mistake, the proper health thinking would be the other way around.”
Contact tracing is just as crucial in preventing the virus from spreading further.
“It’s someone who has been in contact for 15 minutes or more at six feet (two metres) or less,” said Conway. “If someone tests positive and we identify all of the contacts, and they’re all testing negative and keeping the bubble sealed and no transmission outside of that bubble, I’m not sure what being ‘closely monitored’ is above being tested every day.”
Infrastructure for private testing and common sense among players will both be crucial in the hubs. The 24 teams comprise 1,248 players and staff, and the daily demands of testing along with quick and accurate results aren’t guaranteed.
Players also have the option of opting out of post-season play for any reason without recourse.
Canucks defenceman Alex Edler has two young daughters and he’s vigilant about COVID-19 safety protocols, but he’s also eager to play.
“There’s uncertainty for the whole world, but it’s obvious we have to create a safe environment for everyone,” said Edler. “And if we can’t, we can’t play, because that’s priority No.1. Everyone is in a different situation. Some may have health things going on, something in the family, or what kind person you are.
“The virus has been hard to predict, and it’s the right thing to think about health and family first.”
There’s also pressure to perform, whether it comes from the team, players, or from within. But this isn’t about playing through an injury or trying to cut corners to make sure you’re on the ice and not in isolation.
“This is a generational pandemic,” said Conway. “You can’t say I have a low-grade fever and a slight cough, so I’m going to take cough syrup and Tylenol Cold and just play through that. To say I’m going to take couple of Tylenol to get my temperature down is the dumbest thing you could do in our current environment.
“You could infect other people and someone could die.”
The bottom line is that it’s up to the players to be prudent now.
Canucks winger Jake Virtanen was at a Vancouver night club last Tuesday, and in a social media video post, he wasn’t wearing a mask and wasn’t practising safe social distancing. Although he was yet to enter Phase 2 and not under quarantine, the optics weren’t good.
“It’s the education of it all,” said Canucks general manager Jim Benning. “He drove in from Kelowna and some friends wanted to go out. The next day I got the video at 7:30 a.m. and talked to him. It’s about the optics. He wasn’t coming into Phase 2 yet and still had to test, but it’s about being out and what it looks like, and how it affects your teammates.
“When he makes a decision to go out — and it’s just not him — a player can affect his teammates, and there’s a responsibility that goes into that.”
Teams violating protocols could be subject to fines or loss of draft picks, and any player refusing to follow testing and monitoring edicts may be subject to removal from post-season play.