NHL

As NHL deals with COVID-19 issues, is on-ice transmission among players to blame?

The signs that COVID-19 would wreak havoc on the 2021 NHL season were there before the first puck even dropped.

Five days prior to opening night on Jan. 13, the league announced the defending Western Conference champion Dallas Stars would not open the season as scheduled because 17 players had contracted COVID-19 during training camp.

Since then, seven more teams have been sidelined because of COVID-19. The toll so far has been 35 games postponed and at least 124 players landing on the NHL's COVID-19 list. Players are put on the list for several reasons, from testing positive for COVD-19 to high-risk close contact to quarantining following a trade. 

Meanwhile, the NBA — which started three weeks before the NHL — has postponed 29 games on account of the coronavirus. The NFL just completed 100% of its 16-game season and playoffs, albeit with 18 make-up games. MLB, the first North American pro sports league to not play in a bubble last year, postponed more than 40 games before completing its shortened season, though two teams did not play all 60 games scheduled. 

WINNERS AND LOSERS IN NHL: COVID-19 causing chaos

The Devils-Sabres series at the end of January seemed to contribute to 24 COVID-19 cases among players. (Photo: Timothy T. Ludwig, USA TODAY Sports)

What may make the NHL unique is the possibility that the coronavirus is being transmitted during play. In other leagues, including major college football, there has been no documented evidence that players or officials are contracting COVID-19 as a result of competing.  

But the NHL is now acknowledging that COVID-19 may be spreading around the league as a result of on-ice contact and because the more contagious strains have infiltrated the league. 

"We continue to evaluate the issue, and have introduced new technological and scientific interventions to assist us," NHL deputy commissioner Bill Daly said in a statement to USA TODAY Sports. "At this point, we don’t feel we have sufficient information to draw a definitive conclusion."

Players and coaches are sounding more and more certain that they are contracting COVID-19 from each other on the ice, but experts are not as sure.

Mark Poloncarz, the Erie County (New York) executive, said he believes the two-game series between the New Jersey Devils and Buffalo Sabres at the end of January was a super-spreader event. In total, 24 players from the games went on the COVID-19 list, two officials tested positive for COVID-19 and Sabres coach Ralph Krueger had "moderately severe" symptoms. 

Minnesota Wild forward Marcus Foligno is convinced his positive test from Jan. 30 was the result of playing the Los Angeles Kings on Jan. 26 and 28.

And Detroit Red Wings coach Jeff Bashill said he thinks the five cases on his team were the result of playing the Carolina Hurricanes on Jan. 14 and 16.

"I think we have a couple of anecdotal cases that might suggest that it was (on-ice transmission), and obviously that concerns us," Daly told ESPN on Tuesday. "That's why we're doing the genomic sequencing testing to see if we can get a better handle on that issue. Whether there was in-game transmission between teams, whether there were any unique circumstances associated with that, including the fact that it might be a different strain than we typically been dealing with and facing in the past; which, you know, there's some anecdotal evidence that that may be the case as well."

The NHL’s struggles to contain spread of the coronavirus prompted the league last week to issue heightened protocols for the second time this year. That included daily rapid-result testing and barring access to arenas earlier than 1 hour, 45 minutes before game time. 

Also, in a nod to potential on-ice transmission, the league mandated the removal of plexiglass around the team benches and the penalty box to improve airflow.

The Philadelphia Flyers are scheduled to play Thursday after having four games postponed due to COVID-19 issues. (Photo: Eric Hartline, USA TODAY Sports)

Jose-Luis Jimenez, a professor of chemistry at the University of Colorado who specializes in aerosol research, said the lack of air circulation can allow the coronavirus to remain in the air longer.

“I was wondering what was happening in these hockey matches because they tend to have those barriers (boards and plexiglass) and those barriers could basically be accumulating that air,” Jimenez said. “They either don’t have good ventilation or they’re not wearing good masks that are well-fit. Then, they could give it to each other within the team.”

However, Dr. Benjamin P. Linas, associate professor of medicine at the Boston University School of Medicine and an infectious disease physician at Boston Medical Center, argued that airborne transmission is not the major source of NHL outbreaks.

"It’s like the butterfly effect,” Linas said. “The virus lands in some place and sometimes it just takes off and sometimes it doesn’t and some of that is pure damn luck. If you happen to walk by at the wrong time, et cetera, and it could be happening in the NHL, but that’s a lot of teams to just be bad luck."

While Linas stressed that the coronavirus spread in the NHL may be attributed to several factors, he did acknowledge hockey could be at a disadvantage because it is played indoors on ice and in low humidity, conditions that allow viruses to thrive and live longer.

In football, linemen huff and puff in each other’s faces before players pile up at the end of nearly every play – but it’s outdoors. Basketball players are in proximity with the opposition for the duration of the game, like hockey, though they play on a warmer surface. 

Little research is available on team-to-team spread, Jimenez said, but he and his colleagues have been arguing that airborne transmission is nearly as prevalent as person-to-person.

The CDC published a case study in October detailing an outbreak from a recreational hockey game in Florida in June in which 13 of the 21 players tested positive. According to the study, “the high proportion of infections that occurred in this outbreak provides evidence for SARS-CoV-2 transmission during an indoor sporting activity where intense physical activity is occurring.”

“With leagues that big and many players, it’s just inevitable that somebody is going to come into the system infected,” Ryan Demmer, an associate professor at the University of Minnesota School of Public Health, told USA TODAY Sports. “So the only way to stop is to do a lot of testing and catch people in their pre-symptomatic phase, or really isolate very tightly – bubble the whole group so that the infection never gets in or it’s extremely rare, at least.”

The NHL completed last season playing in a bubble, but neither the players nor the league saw it as a viable option for the 2021 season. 

Of course, the NHL wouldn’t have to worry about possible team-to-team airborne transmission if every player skating was negative. Foligno took a PCR test Saturday, Jan. 30, didn't feel like himself while playing against the Colorado Avalanche that night, and received the news of his positive test the next morning. Vegas Golden Knights forward Tomas Nosek played two periods and 13 shifts against the Anaheim Ducks last week before the result of his positive test came in.

Demmer said the daily POC tests (rapid antigen) are meant to be another backstop for extended PCR test (more reliable) turnaround times, since spread among the general population usually derives from a person who is roughly two days away from developing his or her symptoms. Ventilation could also be a factor in spread, he added, based on evidence of airborne pollution leading to bad health outcomes.

“So if you extend that to hockey and viral transmission, it just suggests that if an infected person is out there breathing heavily for a whole game, the air could be stagnant and it’s just could be sitting there for a while, creating more opportunities for someone to skate into it and inhale it,” he said.

Theoretically, Linas said, this type of spread is possible. But he also questioned the players’ behavior during non-game situations, and whether they were taking proper precautions in their day-to-day lives.

“What portion of their lives are spent in a game condition?” Linas asked. “We focus on the games, but it’s probably only five percent of their life, if that. It’s probably more likely going on at practice, in the locker room."

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