Stamford Advocate (Sunday)
Sports medicine director cautious as fall approaches
The emergence of the COVID-19 Delta variant has reintroduced familiar and disconcerting late-summer conversations to the world of college sports with the start of fall competition weeks away.
“Our approach is one of caution,” said Dr. Deena Casiero, UConn’s director of sports medicine and head team physician. “When I talk to athletes about this upcoming semester, I tell them we’re in a better place than we were last year, but this is not behind us. This pandemic is not over. … Until we get that [national] vaccination rate up, we are going to see continued mutations, which are going to bring different challenges.”
It is August 2021, not August 2020, but the Delta variant has thwarted that return-to-normal feel that prevailed in June and July. UConn athletics is not quite facing the complications of
last summer, when sports far and wide were disrupted or canceled, but the approaching season does coincide with rising infection rates and a strain that is more contagious and harmful — particularly to the unvaccinated.
“Looking back to what we battled through last year, when we were facing a virus we knew nothing about and we had very few resources in place, we’ve come a long way,” Casiero said. “We now have phenomenal access to testing. We have a really good track record of what mitigation strategies work. And we’ve identified where we see transmission in this population, which is less on the football field and more in dorm rooms and social situations.”
Casiero, previously the medical director and team physician at Hofstra and team physician for the New York Islanders, was hired at UConn in 2015. She occupies one of the state’s most important seats at the intersection of athletics and medicine, responsible primarily for the health of about 650 student-athletes.
With counsel from the CDC and the state Department of Public Health — in conjunction with university leadership overseeing COVID mitigation strategies, with cooperation of athletic department leadership and with help of university scientists — Casiero has been a guiding voice toward what is feasible for college athletics during a pandemic.
“The delta variant brings a lot of mystery with it,” she said. “We’re starting off in a place that is certainly better than we started off last fall. The beauty is we have the ability to scale things back or advance things forward depending on what we see. And if we see that things are going well, we can dial those mitigation strategies back. We also have a fabulous vaccination rate [in UConn athletics]. The higher we get that vaccination percentage, the closer it gets to 100, overall the more optimistic I will feel about the season progressing with less interruption.”
The student-athlete rate of vaccination at UConn is over 90%. UConn reported Thursday that 94% of students who will live on campus for the fall semester have been vaccinated.
Per university policy, all students living on campus must be vaccinated. Waivers have been granted, however, accounting for the holdouts. Casiero said in February, when no athletes were vaccinated, she would have had a different approach to events if athletes who came down with COVID experienced severe symptoms.
“Younger, healthy people tend to do better with this virus in general,” Casiero said. “The delta variant changes that because, for an unvaccinated person, in certain cases it has exhibited more significant disease. It has made young people sicker than other variants. As we speak about the unvaccinated, I may be a little more concerned than I was last year.
“As it pertains to the vaccinated individuals, I am even more optimistic. I feel that much more confident that, if they test positive, they will likely have very mild symptoms. Nothing is absolute. Young people die from this virus every day. It is very, very rare. But it happens.”
According to the CDC, 50.3% of the total population and 61.3% of those over age 18 have been fully vaccinated.
UConn conducted about 300 tests a day on studentathletes in February. Testing is down to just 20 per week. The on campus testing lab, developed and run by numerous campus scientists, has shifted focus from volume management to sequencing. The lab can now identify which variant is present in positive samples.
“I felt that we were headed in the right direction [this summer],” Casiero said. “But in true COVID fashion, you can’t underestimate this virus. This is why we have to think about our vaccination rate not just as our rate within athletics, but on this campus. Our athletes are going to have the most exposure to people on this campus. We are sending the message that vaccination is what ends this pandemic.”
UConn athletes reluctant to get vaccinated consult their sport’s athletic trainer and, if so desired, meet with Casiero.
“We sit in a completely judgement-free zone,” she said. “I provide them with medical facts, scientific papers and resources. Some of them walk away from those encounters deciding to get vaccinated, and some do not. … If an athlete chooses not to get vaccinated, that is their right, as it stands now at the university. But there are additional mitigation strategies that athlete has to undergo in order to play sports at the University of Connecticut.”
Vaccinated UConn athletes are not tested for COVID unless they exhibit symptoms. If deemed a close contact, they are not required to quarantine, instead made to wear a mask for 14 days (or produce a negative test in days 3-5). Unvaccinated athletes are tested weekly, monitored regularly and must quarantine for 10-14 days following close contact.
UConn in the fall season will follow guidelines from the CDC, state, university and the Big East. Casiero is less concerned with travel than with making sure student-athletes remain vigilant in their behavior.
Last year’s student-athlete experience was one of online learning and isolation. Athletes will be in classrooms for the fall semester, as the current plan goes. Additionally, there is COVID fatigue to fight. Many restrictions nationwide were lifted early in the summer.
“What ended up happening is a lot of people stopped wearing masks indoors — likely both vaccinated and unvaccinated individuals,” Casiero said. “And the virus was able to mutate and here we have this variant taking over. Human nature is such that we’re tired of this. And you saw it with a spike in air travel. … I think that’s just evidence that people were ready to get back to normal life. I do think that we jumped the gun, which is why we find ourselves in this position.”