The Covid-19 Riddle: Can Sports Trust The Testing Results?

[UPDATE: Oct. 16 Indianapolis Colts had one player and three staff members with troubling initial positive tests, but all four came back as false positives after the rerun, per sources. Go about your regular lives/]

It was a near-run thing. For about 24 hours it looked as if a positive #SARSCoV2 PCR test for a player on the New Orleans Saints was going to scuttle Sunday’s game in Detroit with the Lions. (Hardly shocking since many Sundays the Lions never show up to play.) 

Then a re-test of Saints FB Michael Burton— drafted, ironically, by Detroit— came up negative, and the contest went ahead. ( New Orleans won easily 35-29.) Sunday’s game between the Patriots and Chiefs was also affected by a PCR test. In this case, however, Cam Newton’s positive test caused the New England QB and his teammates to face KC on Monday night, a day after their scheduled date.

The Tennessee Titans have had significant #SARSCoV2 positives (18 in all so far), and so their game against Pittsburgh last Thursday has been moved to later in the season. More games might be affected although, so far, none of the athletes has been hospitalized or needed ICU care.

So what’s happening? In every sport competitors are constantly tested to assure they are not carriers of #SARSCoV2 . The NHL managed to go through its entire bubble postseason without a player testing positively. MLB and NBA have had some positives but no serious outbreaks. In fact, no active player has been hospitalized for #SARSCoV2 .

With pro sports— and the presidency— now depending on PCR tests it raises a question of just how accurate are they? 

First a little sciencey stuff from the New York Times . “The PCR test amplifies genetic matter from the virus in cycles; the fewer cycles required, the greater the amount of virus, or viral load, in the sample. The greater the viral load, the more likely the patient is to be contagious. This number of amplification cycles needed to find the virus, called the cycle threshold, is never included in the results sent to doctors and coronavirus patients, although it could tell them how infectious the patients are.”

In July, the Times reports, New York’s state lab identified 872 positive tests, based on a threshold of 40 cycles. With a cutoff of 35 cycles, however, about 43 percent of those tests would no longer qualify as positive. About 63 percent would no longer be judged positive if the cycles were limited to 30. Conversely, a higher cycle could produce huge numbers of positives.

In other words, these tests produce a very broad picture of the #SARSCoV2 sample. As we wrote earlier many people’s positive samples are found to be asymptomatic with dead virus, strands of virus and the residue of previous infections producing huge numbers that have sports leaders and politicians petrified.

For this reason many epidemiologists are recommending application of less-sensitive tests that produce quicker results. 

With the fate of an entire season of NFL or NHL in the balance is it possible that the simple yes/no results of PCR tests are an acceptable way of deciding who plays? Dr. Michael Mina, an epidemiologist at the Harvard T.H. Chan School of Public Health told the Times, “Yes-no isn’t good enough. It’s the amount of virus that should dictate the infected patient’s next steps… It’s really irresponsible to forgo the recognition that this is a quantitative issue.”

So while there continues to be underlying illness behind the PCR tests— witness president Trump’s symptoms— much of the positive test explosion is simply Caseology, the public scaring itself unnecessarily. The vulnerable groups remain, as always, at high risk. Those under 60 represent fewer than three percent of the deaths from this COVID-19 outbreak. 

A glance at morbidity in Canada July 14 till Oct. 1 shows a few spikes in deaths, but seven-day moving averages of daily deaths in a nation of 35 million remained in single digits. Plus, there is much debate about how many #SARSCoV2 victims have died with the disease— not of the disease. 

The confusion about tests is not helped by the fact most people don’t know the history of pandemics in North America. Here’s the L.A. Times talking about H3N2, a nasty viral outbreak that killed about 100,000 in 1968 as Viet Nam vets brought Asian virus back to America. There was no quarantine, no lockdown of the economy and no panic. Of course there was no social media, either.

Today there is a persistent core of health authorities, politicians and social media figures heavily invested in their earlier narratives. Here, Irish researcher Ivor Cummins illustrates how European officials are keeping the scare going despite clear evidence that we’ve seen the worst of the virus.

So what is the future? Oxford Epidemiologist @SunetraGupta predicts “SARSCoV2 settles down to an endemic equilibrium such as… influenza— bugs that cause pneumonia & other pathogens. We live lives normally. That’s what society is about—optimizing complex landscape of risks”. 

Sports fans can only hope their stars can live with some SARSCoV2 risk, because hyper-cautious league officials show no appetite for leading the way back to normalcy by using less frightening PCR tests. 

Bruce Dowbiggin @dowbboy is the editor of Not The Public Broadcaster (http://www.notthepublicbroadcaster.com). The best-selling author of Cap In Hand is also a regular contributor to Sirius XM Canada Talks Ch. 167. A two-time winner of the Gemini Award as Canada's top television sports broadcaster, his next book Personal Account with Tony Comper will be available on BruceDowbigginBooks.ca this fall.