David Fisman, an epidemiologist from the University of Toronto’s Dalla Lana School of Public Health, was asked over email about hope the NBA and NHL have for welcoming fans back into their arenas for their next regular season.
His response was three words long.
“Need a vaccine,” he wrote.
The Montreal Impact, of Major League Soccer, became the first professional Canadian team to allow fans inside for a game when 250 spectators walked into Saputo Stadium — which can normally seat more than 20,000 — for a weeknight win last month. Teams across North America are wrestling with their own numbers.
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In Texas, where the state government allows stadium capacity of up to 50 percent, the Dallas Cowboys will open their season in front of fans. In New York, the Buffalo Bills will play in front of empty seats, at least for their first two home games.
Both the NBA and NHL have targeted restart dates in December, and both are exploring plans to get at least a percentage of fans back into the stands. While it seems unlikely a vaccine for COVID-19 would be widely available by then, not all experts agree that necessarily disqualifies the conversation.
Could fans return by January, even without a vaccine?
“I’m hesitant to say it’s impossible,” said Dr. Lynora Saxinger, an infectious diseases specialist who is an associate professor at the University of Alberta. “But I do think there’s some fundamental questions that would need to be answered to see if you could make it reasonably safe.
“And I say reasonably safe because I don’t think we can make anything completely safe. So reasonably safe is really what we’re aiming for.”
Unlike the soccer stadium in Montreal, which is open air, NBA and NHL games are all played indoors, and Saxinger had questions about the airflow inside those arenas. She did not know, for example, what kind of evidence there might be of respiratory virus transmission in the stands — if someone sitting in front could end up exposing everyone seated behind them because of the air conditioning system.
“So what are the big risks? The risks really have to do with the people that you’re close to, the direction of the airflow and whether there’s a lot of pinch points where people are going to end up clustering,” she said. “Because it’s hard to imagine filling an arena without having a whole bunch of people clustered all over the place.”
She said she would also need answers to questions about movement inside the arena. How would masked fans avoid bottlenecks getting into, and out of, the venue? How would they avoid lineups at the bathrooms or concession stands?
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“The big question is: Would this be a setup for a super-spreader event?” she asked. “That’s the worst-case scenario. Someone is unwittingly infected and happens to be one of those highly infectious people — who appear to be rare, but are very efficient at spreading infection — and you have them all in one place.”
Earlier this year, Italian officials blamed a soccer game for helping spark COVID-19 across an entire region. A Champions League match between Atalanta and Valencia, held in Milan in mid-February, reportedly drew more than 40,000 fans from the Italian province of Bergamo.
Within a month, Bergamo was swamped with cases of infection. An official with a local hospital was quoted as calling the game “a biological bomb.”
“If this disease were to ever go away — if — then maybe we’d be able to reasonably get fans back into the seats,” said Dr. Andrew Morris, an infectious diseases expert at the University of Toronto. “But I don’t see that happening any time soon. I think there’s a lot of work that the NBA and/or NHL and/or NFL would have to do to safely get fans back into the seats.”
Morris, who is also medical director of the Antimicrobial Stewardship Program with Sinai Health System/University Health Network, suggested sports organizations could take a more active role in determining who is able to venture inside their arena.
Teams could use rapid COVID-19 tests away from the arena gates. These kits could turn a swab or a bit of spit into a result within minutes, and Morris has advocated for their availability in the face of resistance from Health Canada. (Though Health Canada’s stance on the tests since appears to have softened.)
He suggested fans would also have to provide reliable contact information, which would help in contact tracing following the game, in the event someone seated nearby had tested positive.
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“All of these organizations have money where they can do things to make this work, and make this reasonably safer,” Morris said. “It all depends what’s going on in communities. I think that’s the real challenge with all of these: You may have to be nimble around allowing fans.”
Some of the challenges seem easy on paper, he said, but might not be as simple in practice. Fans might be able to enter the arena at staggered times — to avoid that bottleneck heading into the venue — but a staggered exit plan could be less popular, with some fans waiting in their seats long after the game.
“You’re going to probably have to say no concessions,” said Morris. “It’s not that it isn’t doable. But you’ve got to really figure out how to do it safely.”
As with Saxinger and Morris, Dr. Isaac Bogoch’s gut reaction is that January would be too soon to get fans back into the arenas. As with his peers, though, neither did he rule it out entirely.
“As far away as January seems right now, it actually isn’t that far away, especially when we’re thinking in pandemic timeframes,” said Bogoch, an infectious diseases specialist based at Toronto General Hospital. “The situation on the ground can certainly change rapidly. I think that it’s unlikely that something like that would happen in January.
“But on the other hand, it’s very hard to predict more than 3-4 weeks in the future, especially with something like this. There very well could be vaccine programs that are started, or that could be in various phases of implementation.”
Different regions could have different levels of control over infection rates, he said. There could also be changes to public health policy that would allow for more people to gather in one spot at the same time.
“Can this happen in January? Maybe, maybe not,” said Bogoch. “I have no idea at this point in time. Is it worth thinking about and constantly reevaluating as we progress through the pandemic and get closer and closer to that time? Absolutely.”
(Photo: Kevin Sousa / NHLI via Getty Images)
