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NBA Bubble

How the NBA conquered COVID-19

In the midst of a pandemic, a sports institution led with science and taught the world how to thrive in a time of great uncertainty

The fact that COVID-19 is a small part of the current NBA conversation is a testament to the success of the NBA bubble.

Nearing the end of the season, there have been no outbreaks of COVID-19 among NBA players, no interruptions since the bubble began. COVID-19 has been handled so thoroughly by the NBA that its largest COVID-related stories have involved individual behaviors that didn’t lead to any actual outbreaks, but potentially put others at risk. For instance, Houston Rockets forward Danuel House’s removal from the bubble for breaking bubble rules.

How, in the midst of a pandemic that continues to affect millions, did the NBA manage to make it about basketball?

On the list of items that a public health expert would suggest are essential for combating an emerging epidemic, the availability of accurate testing would be toward the top. Even without a treatment or a vaccine, knowledge of who is infected allows public health professionals to intervene, engage in contact tracing and identify those who should quarantine. During the COVID-19 pandemic, the availability of tests has, and remains, a contentious issue. While testing capacity has improved over the past several months, industries are still unable to produce tests at the level necessary to control COVID-19 more effectively.

The NBA bubble provided an ideal setting to explore important questions about testing: data on thousands of individuals, detailed information on who they are, who they were in contact with and other specifics.

On Sept. 28, Nathan Grubaugh, an assistant professor at the Yale School of Public Health, and a list of colleagues published an article titled SalivaDirect: A simplified and flexible platform to enhance SARS-CoV-2 testing capacity.

In it, Grubaugh and colleagues demonstrate evidence that a new test, called SalivaDirect, is effective and equipped to solve large challenges facing widespread COVID-19 testing: the large costs associated with producing tests, the complexity of tests and shortages in the supply chain required to manufacture existing tests. The study, based on a cohort of 3,779 healthy NBA players, staff and contractors, proposed a saliva-based test that is less invasive and simpler to execute than existing tests, which generally require a swab of the area between the nose and mouth. The study determined that SalivaDirect is 99.7% valid, with few false positive results (0.03 – 0.05%).

SalivaDirect may be relevant for school reopenings, where costs of routine testing using current methods are high, and the material burden too great. For example, estimates suggest that we will need 176 million tests per month to safely reopen schools, far above the current 21 million tests. And SalivaDirect could be the key to expanding the testing capacity such that schools can safely reopen, potentially saving many lives in the long run.

The data supporting SalivaDirect is the first of a series of studies that will soon be published by teams of researchers who were involved in the NBA bubble. The research was the product of a collaboration between a large team of researchers at Yale University and the league. The NBA’s direct involvement in the SalivaDirect project can be observed from the list of authors who contributed to the study: Along with scientists spanning departments at Yale is Robby Sikka, vice president of basketball performance and technology for the Minnesota Timberwolves and a member of the NBA’s sports science committee. That a co-author of a major COVID-19 study has a formal basketball affiliation is unprecedented and highlights the depth of the collaboration between scientific institutions and the NBA. Though the NBA was centrally involved, the goals of this research transcend basketball, as the reach of SalivaDirect is far greater than sports.

“We want to make sure that everyone can benefit from science,” Sikka said. “Not only the point guards playing the bubble, or the point guards in our league. But for point guards from Coney Island to Senegal, and their families, we believe that our work can have an impact.”

While the NBA’s wealth allows it to implement programs at a grand scale, its general embrace of the scientific method and belief in science for the common good have broader appeal. The NBA has created a sort of blueprint for how an institution can manage COVID-19, and other scientific challenges:

  1. Invest in, and listen to scientists. Sports have long funded research at academic institutions. For example, the NFL has been a big supporter of concussion-related research at universities for many years. But the NBA’s investments not only support research with direct application to sports performance, but also seek to expand knowledge in many areas. The NBA has pushed its academic collaborators to be more practical about their science: Actionable technologies and policies are the currency, not only data sets and publications. Most importantly, the NBA has encouraged the advice and insight from a large number of highly respected scientists from the outset.
  2. Participate in the scientific process. Like the study involving SalivaDirect, data from NBA-supported research is shared with the world, using the existing instruments through which scientists communicate results with each other. This includes the use of “preprints,” freely available pieces of scientific literature that allow researchers to communicate their results early so that the world can read and evaluate them. This allows the public and the scientific community to evaluate the quality and importance of a result instantly. This is relevant in medical and biomedical contexts where results may have implications for how we treat or manage a modern problem.
  3. Promote transparency and generosity. We must not forget that the NBA is a large, lucrative, multinational corporation. While the NBA benefits from cheap, effective testing, it has the financial resources to test its employees and staff using standard methods. It doesn’t stand to benefit from the discoveries nearly as much as society does. And that SalivaDirect has already been requested for use by hundreds of institutions outside of the NBA demonstrates this philosophy in action: It can help schools, small businesses, churches and community organizations that are unable to afford to test their constituents using current methods.

When reflecting on how the NBA’s commitments fomented success in preventing COVID-19 outbreaks, we realize that the “bubble” was a bit of a misnomer.

“The NBA is the most forward-thinking sports organization when it comes to data and sports performance,” Sikka said.

While the NBA players, coaches and select staff were confined to a single setting, there were hundreds of others who were not. Operating the NBA during the bubble involved the hard work of hundreds of individuals, ranging from hotel staff to media personnel to people involved with daily deliveries — many who moved in and out of the bubble daily.

The NBA’s ability to prevent outbreaks was not about keeping the league away from society, but in learning that the world and the NBA are one and the same. And so the NBA bubble was much more about a holistic science-first perspective than it was a single set of policies.

After the season is over, the league plans to expand its efforts and collaborations with other organizations (sports and others) toward long-term solutions for a range of problems.

“COVID is not going away just because the bubble was a success,” Sikka said. “There are challenges down the line, not only for sports, but for society.”

C. Brandon Ogbunu, a New York City native, is a computational biologist at Yale University. His popular writing takes place at the intersection between sports, data science, and culture.