Pac-12's top doctor talks basketball's schedules, risks and tests ahead of season

The availability of daily rapid-result COVID-19 testing might have saved Pac-12 football, but it could become even more vital to the 27-game basketball season that will start shortly afterward.

Consider just some of the differences between the two sports: Basketball has fewer players, meaning a quarantined cohort of just four or five players could shut down an entire program for two weeks or more.

It has more close contact, although it’s not as physically jarring. It is played in virus-friendly indoor environments. There are also many more games.

And, unlike in football, Pac-12 basketball teams will play teams from other conferences, potentially against some that don’t have access to the same daily testing they do.

“There are some very unique challenges in basketball, absolutely,” said Dr. Doug Aukerman, senior associate athletic director for sports medicine at Oregon State and chair of the Pac-12’s Student-Athlete Health and Well-Being Initiative. “It’s going to be something that we are going to have to have a good plan for because it is indoors, and there are a limited number of people on the team. The contact tracing and quarantining of somebody who tests positive will have significant impact on teams.”

Also a member of the NCAA’s Medical Advisory Group, which recommended a nationwide minimum of three tests per week for Division I basketball teams in season, Aukerman discussed the challenges and strategy ahead in an interview with the Star. The conversation was lightly edited for clarity and brevity:

If you test daily and somebody tests positive, do you consider that he might have been exposing his teammates in practice the day before and therefore the whole team has to sit out? Or would you not have to worry about that day before because he tested before that practice and was negative at that point?

A: “If we’re testing people daily and you have a negative test right before you step out on court, there’s a good assurance — it’s not 100%, but there’s a good assurance — that people are not in an infectious state at that point. Having said that, all of the contact tracing and quarantining recommendations are based off of public health experience as it relates to groups of people who don’t have regular testing. That is the standard that will need to be applied.

“Ultimately, all of our institutions are going to have to work closely with their local public health departments and state health authorities in terms of both how to determine who needs to quarantine and who doesn’t.

“I think one of the strengths with daily testing is that we will have a track record of negative testing results that we can use to help the contact tracing.”

So if teammates from the previous day’s practice would probably be OK, would it then be more about who the player testing positive was eating breakfast with that day, or who else he might have been into contract with? How far back do you go to determine if you have to put somebody else in quarantine?

A: “Each situation is going to have to be investigated individually with appropriate contact tracing, looking at their other potential contacts outside of the athletic practice environment.”

How did the NCAA committee come up with the three-tests-per-week recommendation? If some schools are only doing it that often, could you have to trace back 48 hours with somebody who tests positive and maybe then the whole team has to sit out? Or is it tough to demand that all 353 teams test every day?

A: “I think it would pose a significant challenge to have all Division I athletes testing five, six times a week. Certainly some conferences are going to have that ability, but not everyone. The NCAA group arrived at three times a week as an attempt to be understanding of a lot of different factors. When we look at the recommendation that we’ve made within the Pac-12, we’re also taking into account a more specific set of teams and communities.”

If somebody has had contact (in the previous 24 hours) with four or five others, how long will they be out?

A: “Somebody who tests positive has to isolate for 10 days and if they don’t develop symptoms, at the end of 10 days, within the Pac-12, they’ll need to go through a medical evaluation with specific screening for heart-related issues. And then there’ll be a return-to-play protocol that will take place.

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“For those that are considered high-risk contacts (of the player testing positive), the quarantine period is 14 days. That’s a standard number that is set by the CDC and public health guidances. During that quarantine they still can be doing activities to stay in shape, but they’re not going to be able to practice. At the end of that 14 days, as long as somebody doesn’t develop symptoms or turn positive, they can return back into regular activity.”

Can exams show clearly if there are any heart issues after 10 days?

A: “Each person will undergo an EKG, a blood test looking for damage to the heart, and then an echocardiogram looking at the structure and function of the heart. As long as those three tests all look fine, they should be able to return through the return-to-play protocol. But certainly if they do have any issues with any of those tests, then that would prompt an immediate cardiology consultation and a cardiac MRI.”

How can Pac-12 teams and their nonconference opponents get on the same page with testing?

A: “We in the Pac-12 Medical Advisory group, including the infectious disease doctors, are studying this and will come up with recommendations to ensure that their athletes don’t pose a significant risk to our conference athletes in terms of COVID exposure. What exactly will that be, we’re still discussing. But our intent is to create a standard that ensures continued safety of our student-athletes, yet also provides an opportunity for nonconference games.”

Since you’ve got the Quidel (daily antigen testing) machines on school campuses in the Pac-12, could agreements be made where nonconference opponents have to come in and use them to test on site the day of a game?

A: “We are talking about that as an option, yes.”

Are there any other challenges unique to basketball, or does the daily testing take care of them?

A: “Daily testing is certainly going to help us. But we also need to make sure that our student-athletes and coaches are trying to decrease their exposure and risk outside of that athletic facilities as well. Testing doesn’t remove the need to wear face masks when you’re not practicing and it does not remove the need to make sure you’re washing your hands and not sharing water bottles. All the other high-risk things that we’ve been educating our student athletes to not do they still need to follow.”

Do your guidelines cover what kind of contact teams can have in practices and at what point?

A: “There’s multiple layers to try to determine whether or not a team can be doing contact practice. You have the university oversight. Then you have your local county oversight and your state oversight. The (Pac-12 school) presidents and CEOs gave permission to move forward so it’s not the conference that would be stopping the activity.”

Have you had any input on whether fans should be allowed and at what point?

A: “That ends up being a decision that’s made at the conference level but also the individual state and local health departments. That’s not something that our Pac-12 Medical Advisory Group will likely weigh in on … we certainly know that large groups of people close together indoors is a situation where that virus has a higher likelihood of spreading, as opposed to that same number of people outdoors.”

In the big picture here, are you optimistic? Do you see everyone being able to play 27 games or do you expect teams might have to postpone or cancel a game or two, or maybe play only 22 or 23?

A: “I’m optimistic. Obviously, it’s going to depend on student-athletes and coaches doing their part with the steps to help decrease their exposure to COVID in the community. I feel more optimistic that schools that are going to test to daily will have less interruptions that schools that don’t. I think our recommendations within the Pac-12 conference put our institutions in a good spot to be successful and play the majority of their games.”