HIV and ID Observations

Mickey Mantle and fan, 1956 (with permission)

A few weeks ago, I got a text from a long-time ID colleague here in Boston:

Hey Paul want ur opinion … this is for an interview with MLB radio, and no one knows less about baseball than I do, but as an avid fan and wise ID doc, do you think the season should continue?

Confession — it took me around 3 milliseconds to respond, if that.

And my answer was yes.

But, some no doubt are thinking, we’re in the middle of a pandemic. It’s hardly under control. A bunch of players had already tested positive, proving it’s not safe.

And — let’s remember — it’s just sports. Sports don’t matter.

But here, in all its tarnished, selfish, complicated, and ultimately messy way, is why I still think it’s worth trying to play professional sports in 2020.

These professional leagues have extraordinary resources — and the motivation — to control outbreaks. The NFL alone boasts annual revenues of $25 billion. You think this might motivate the owners to play the games safely?

The players’ careers don’t last forever. The average professional football player’s career length is only 3-4 years, Major League Baseball 5-6 years. That’s the brief time most of these supremely talented individuals make the bulk of their life’s earnings.

The slowed reflexes, loss of muscle strength, decreased vision, accumulating injuries, and other changes brought on by aging loom as opponents that no athlete has ever beaten. A fast, hungry young rookie is always coming up to take their place — especially if they’re not superstars.

The clock ticks down on these brief careers even during a pandemic.

Sports have already taught us something about disease control — and can teach us more. With coordination well beyond what our government appears willing, motivated, or capable of doing, they have deployed extraordinary strategies that, so far, have been remarkably effective.

Can anything be more of a success story than the NBA? Who could have predicted that they would have zero COVID-19 cases when they placed hundreds of young men into Florida during a surge of cases?

Their strategy of frequent testing, creating a limited “bubble” of exposures, and importantly getting buy-in from both the ownership and the players now is being emulated by other industries.

Not only that, they helped validate a new technique for using saliva for COVID-19 testing.

I’ve made no secret that I don’t like football, and confess I prepared myself to reject whatever plan the NFL came up with to play the games safely. The decades of denials the NFL tossed out about the hazards of the sport gave me no confidence they could possibly go forward with a legitimate plan.

But no! After listening to this Freakonomics podcast, I was frankly blown away at their thoughtful and highly detailed approach. This includes frequent (daily!) testing, active participation of the players’ union and the league in civilized negotiations about policies, reliance on science rather than emotion or politics to do the right thing, wow — this is how to bring an epidemic under control!

Professional sports give many of us something we need right now — a distraction. Pandemic. Fires. Violence. Racial tension. The death of an inspirational public figure. Raging political discord.

Yep, 2020 has it all. Why not enjoy a few moments away from these nightmares to watch Naomi Osaka storm back and win the US Tennis Open, or LeBron James fight Father Time in the NBA playoffs, or Mike Trout continue a career that looks like he could become one of the greatest baseball players of all time?

With echoes of FDR’s advice to proceed with the baseball season despite World War II, again sports can give us a well-needed reprieve from the grind of daily existence, both as fans and as participants.

One of my patients, mostly very isolated since early March due to COVID-19, kindly shared the above picture with me since he knows we share a fondness for baseball. (Ok, “fondness” = obsession.)

It’s a promotional photo taken with Mickey Mantle in 1956, the year he (Mantle) won baseball’s Triple Crown. (I’m sharing it with my patient’s permission.) Take a look at that kid’s face! And thinking about sports still gives him pleasure today.

Some might argue that these professional leagues’ safety measures divert resources (especially testing) away from schools, nursing homes, and other settings that need them more. Fair enough.

But is there any indication that if pro sports didn’t start up again, that the tests would have flowed to the schools? As noted by Will Leitch, “All of us should be able to get tested easily and quickly! But that fact does not inherently mean that what leagues are doing is wrong.”

So let’s play ball — and hope we learn something from these professional leagues about how to control the pandemic by getting buy-in from all involved.

And, most importantly, by following the science.