Ravens Team Doctor Discusses Strong Start, Remaining Concerns With COVID-19

Dr. Andrew Tucker

The Ravens are a month away from kicking off against the Cleveland Browns at M&T Bank Stadium. They're more than two weeks into the "start" of training camp when players began reporting to the Under Armour Performance Center.

There's still a long way to go and full-team practices, which begin Monday, will be another hurdle. But so far, the NFL and Ravens' response and COVID-19 mitigation protocols have been a success, giving encouragement that the season can start on time and hope that it can finish too.

According to Dr. Allen Sills, the NFL's chief medical officer, the league has just a 0.46% positivity rate among all players, coaches and staff members being tested, and there has been 109,075 COVID-19 tests administered. The player positivity rate has been 0.81%.

By comparison, the positivity rate across Maryland on Aug. 12 was 5.7%, and has hovered around that mark (below 6%) since June 18. Maryland is in the bottom half of states across the nation.

On Wednesday, Ravens Head Team Physician Dr. Andrew Tucker, with MedStar Health, participated in a video call with reporters to talk about the team's handling of the COVID-19 pandemic, and shared insight into how the process has gone and remaining concerns.

"I thought I'd seen it all, but I hadn't seen it all this year," said Tucker, who has been the Ravens' lead team physician since its inception in 1996.

Here are some of the biggest takeaways from Tucker's media session:

The Ravens are doing well.

While the team will not divulge specifics on positive tests, Tucker said, "Fortunately, our situation like most other situations in the league has been extremely encouraging and reassuring.

"It's hard to describe the efforts that have gone into [this] from the players' side, from the league's side, from the club's side, from the medical staff. All the different areas of this building have been touched by this whole process. It's an extraordinary, extraordinary effort to get us where we are today, which is on track for hopefully a game in about a month.

"I tell people, 'I think we're going to start, hope we're going to finish.'"

There has been a huge investment.

"We certainly accept the point that risk cannot be eliminated, but we can do a lot to reduce exposure," Tucker said.

Players, coaches and any personnel getting remotely close to them has been tested every day for the past two weeks. The Ravens mostly use tests that yield results in a day and can also administer tests with a "fair amount of accuracy" that produce a result within a half hour.

Before they are allowed into the Under Armour Performance Center, there is also a daily questionnaire and temperature check. Every place has been spaced out, with a massive expansion of the team's cafeteria among the most notable changes.

But one of the more interesting pieces of technology the Ravens have used is a proximity device from IQVIA which tracks everybody's movement and beeps if they are within six feet of other people.

If somebody comes down with symptoms while in the Under Armour Performance Center, has exposure to somebody that does, or tests positive for the disease, then the Ravens can call IQVIA to determine who has been within six feet of that person and for how long. It's a scientific way to contract trace and prevent outbreaks. Tucker said the whole process takes about 15-20 minutes to map out.

"It's incredibly amazing technology," Tucker said.

"It ends up being like a dog trainer collar, if you will, because I know when I'm not wearing it now and I get around people," Defensive Coordinator Wink Martindale said. "Like if I go home, even with my wife, I'll step back from her. You just know what six feet is now."

Tucker emphasized that testing does not prevent the spread of the virus. He called hand-washing, mask-wearing and social distancing the "blocking and tackling of infectious disease prevention" and said there has been a lot of time spent emphasizing that to players.

Daily testing will continue.

With a positivity rate under 5%, there was belief that the testing of Tier 1 and 2 individuals (players, coaches, and staff close to them), would move to every other day. However, the NFL and NFLPA reached an agreement Wednesday to extend daily testing to Sept. 5.

"While I wouldn't say it's fun, it's so little required of us to do that to just make extra sure that we have an environment that we can all feel comfortable in and feel good about the players being in," Tucker said. "I think that's absolutely fine and I'd rather err on that side than not."

People will get sick. Here's how it will be handled.

Each step of the season will come with new challenges. On Tuesday, the full team was on the practice field for the first time. Next Monday, padded practices begin. Once the season starts, players from around the country will share sweat.

In order for the season to continue, Tucker said he believes the league will have to maintain a low positivity rate week in and week out.

"We all assume there will be a positive here or there," Tucker said. "The critical thing we have to accomplish is when that happens is rapid identification of that person, appropriate isolation, and minimizing the risk of any spread so we have one or two people that might be affected and not eight or 10 or 12 that we saw in baseball recently."

If a player does test positive for COVID-19, Tucker said they will be out a minimum of 10-14 days, and that's if they show mild or no symptoms. They would be isolated and have to go through special heart testing before entering a ramp-up period with increased monitoring from the medical staff until they are allowed to return to full activity.

If they are sicker, they could miss three or four weeks, Tucker said. There's no telling how sick somebody would get. Tucker said it's "baffling" how different it affects different people. Regardless, a player would miss a minimum of one to two games.

"It's a significant diagnosis to make with respect to the players," Tucker said.

Heart condition (myocarditis) is still an unknown.

The reason why players would undergo heart testing if they test positive is because myocarditis, a rare condition of inflammation of the heart, has been linked to COVID-19 patients. As Tucker said, it's one heart condition that can also lead to sudden cardiac arrest.

Tucker said it is a "concern" because there just isn't enough information available to determine whether it's affecting patients with minimal or no symptoms or only those who get very sick. Tucker said they are learning every week and that protocols are "very conservative with respect to the heart."

"The risk is low," Tucker said. "But how low is a little bit premature to say because we just don't have the data. This hasn't been going on that long."

Isolating Lamar Jackson is not out of the question.

One popular discussion among fans is how teams will make sure integral players, such as star quarterbacks, are available to play. A team's season could be sunk by a key player testing positive.

The Ravens have the NFL's reigning MVP – as in most valuable player – so not having him on the field would be a huge loss. Jackson joked last week about being "Bubble Boy" this season to make sure he doesn't contract the virus.

Tucker was asked whether the Ravens have had any conversations about isolating their quarterback.

"No, not that I know of. I can't speculate as to if things changed in the community or changed in the team, there might be a different approach. I wouldn't rule it out," he said.

"You could extend that to player positions for which you don't have any immediate backups – a kicker or punter or something like that. There are particular positions that are more vulnerable to infection."

Harbaugh said last week that "all options are on the table" but that he generally does not like the idea of isolating players from their families, etc.

"We don't want to forfeit all these guys' lives, and they're not willing to do it – as I'm sure the players association (NFLPA) would say – and I wouldn't want them to do it," Harbaugh said.

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