NFLPA President unhappy NFL doesn't have daily testing

[Saint Doug]

Daily testing is likely going to cause more disruption than not doing it. This virus is now endemic, so we are going to have to learn to live with it. By this, I mean optimizing our body’s ability to fight and clear it. Said another way, get vaccinated. 
 

What happens when a team gets a handful of asymptomatic positive tests? For example, take the Bucs, 100% vaccinated. If Brady gets a positive test without any symptoms, should he be forced to sit? What about Allen? Is there any other industry/profession where asymptomatic people have to get tested daily?

[Jobot]

Very obvious reason at play here.. Daily testing costs a boatload of money. Not doing daily testing places the paycheck risk and all the pressure back on the unvaccinated players.

[Hapless Bills Fan]

25 minutes ago, Jobot said:

Very obvious reason at play here.. Daily testing costs a boatload of money. Not doing daily testing places the paycheck risk and all the pressure back on the unvaccinated players.

 

It's possible that cost of testing is a driving factor.  I'm sure it's a consideration - money always is - but there are ways to mitigate the cost.  So I think it's a reasonable guess it's not the main factor.

 

I think it's a good assumption that the NFL wants to keep the product on the field and maximize its quality, meaning they honestly do want to minimize the number of players on the Covid-19 list and minimize for how long they're out.  It's very much not in the NFL's interest to have unchecked spread within the facility, therefore it's not in the NFL's interest to have infected people wandering about the facility potentially causing spread.

 

Tests will have false positives.  Players and staff who are only testing 1x/week and who are asymptomatic or pre-symptomatic may go undetected and expose someone else.

 

My best guess would be that the NFL hired a consulting group of modelers, and their model at this time indicates that the risk of losing players (and their contacts) to a false positive is higher than the risk of losing players to an infection from or as close contacts to, an asymptomatic or presymptomatic infected player or employee, who goes a week without testing.

 

Models are only as good as the data and the assumptions that feed into them, so as data change, expect the model to change and the protocols to change.

 

 

[Rochesterfan]

2 hours ago, Hapless Bills Fan said:

 

These are good points - "follow the Money" - and I think that only counts the actual testing costs, not the costs of courier services to deliver the samples.

 

Except - I can't find the regular season protocols yet but here are the preseason protocols

https://static.www.nfl.com/image/upload/v1627485241/league/z62pmhkip5is8ohxmqza.pdf

There are two interesting points with regard to testing cost:

1) One is agreement to transition to saliva-based testing as soon as it meets sensitivity and selectivity standards.  If it's the Salivadirect test used by the NBA, it is said to be less expensive (p 60)

2) The other is use of the so called "MESA test" or Mesa Accula Rapid PCR Test,  which is actually called out as acceptable daily screening test for unvaccinated players and weekly screening for vaccinated players and personnel.  This probably has higher reagent cost, but may be cheaper overall due to lower personnel and transportation costs. (I'm personally surprised it meets the sensitivity standards).   It would also likely not have the throughput to support daily testing for all

 

Perhaps you know how these factors enter into the costing equation?

 

And last....the cost to the NFL of additional daily testing of vaccinated players and staff could easily be countered by a pooled testing strategy, an approach that has been thoroughly vetted (see what I did there?) for application in low positivity situations by a large surveillance testing program nearby.  (Follow the cows.)

 

 

 

 

Excellent questions Hap.  I started with costs based on a tweet before last season from Pellisaro I believe that stated $125 a test, but because most testing has gone cheaper - It could be cheaper, but again that did not necessarily include everything in the pricing.

 

I would imagine they have switched to saliva for general screening as that is how most large places have gone - schools, colleges, etc.  it can be less expensive, but we found it did not pool as well with the assays we had - we lost significant sensitivity.  Therefore for our hospital system we returned to nasal swabbing because we could pool the expected negative population into groups of 5 and/or 10 depending upon the assay.  Much beyond 10 patients pooled you again started to see sensitivity decrease and the increased risk of missing a positive.

 

I know our sister lab has been trying several assays to find a saliva assay that pools in acceptable ways as not to lose the sensitivity - so I would assume some places have it available. 

 

I am sure they have a volume discount applied to their work, but for us the assay cost went down with pooling, but the manual labor piece to actually pool the sample and move them into proper tubes and then result them because that process could not be automated was significantly higher - so the cost to private clients didn’t really change - it just allowed us to hit throughput margins we needed.

 

I know that on the morning drive on NFL Radio last week - the team was discussing it and cost seemed to be what they pointed at as the biggest reason the NFL was maintaining the less frequent testing (and based upon available data at the time seemed and adequate and safe mix).  It was speculation, but the owners ate the cost and with the already decreased revenue last year and the agreed to limits - there was a significant shortfall for some owners.  
 

I think many owners were hoping that with the way things looked in the spring that they could claw back a little money and have full stadiums again and all would be right in the world, but we have all seen that change - we will see how long before the owners acknowledge that point and move back to follow all of last year’s protocols - I expect it will happen at some point due to a break-out, but I think they are being a little short sighted right now.

 

 

 

 

Edited September 7, 2021 by Rochesterfan

[Hapless Bills Fan]

4 minutes ago, Rochesterfan said:

 

Excellent questions Hap.  I started with costs based on a tweet before last season from Pellisaro I believe that stated $125 a test, but because most testing has gone cheaper - It could be cheaper, but again that did not necessarily include everything in the pricing.

 

I would imagine they have switched to saliva for general screening as that is how most large places have gone - schools, colleges, etc.  it can be less expensive, but we found it did not pool as well with the assays we had - we lost significant sensitivity.  Therefore for our hospital system we returned to nasal swabbing because we could pool the expected negative population into groups of 5 and/or 10 depending upon the assay.  Much beyond 10 patients pooled you again started to see sensitivity decrease and the increased risk of missing a positive.

 

I know our sister lab has been trying several assays to find a saliva assay that pools in acceptable ways as not to lose the sensitivity. 

 

I am sure they have a volume discount applied to their work, but for us the assay cost went down with pooling, but the manual labor piece to actually pool the sample and move them into proper tubes and then result them because that process could not be automated was significantly higher - so the cost to private clients didn’t really change - it just allowed us to hit throughput margins we needed.

 

I know that on the morning drive on NFL Radio last week - the team was discussing it and cost seemed to be what they pointed at as the biggest reason the NFL was maintaining the less frequent testing.  It was speculation, but the owners ate the cost and with the already decreased revenue last year and the agreed to limits - there was a significant shortfall for some owners.  
 

I think many owners were hoping that with the way things looked in the spring that they could claw back a little money and have full stadiums again and all would be right in the world, but we have all seen that change - we will see how long before the owners acknowledge that point and move back to follow all of last year’s protocols - I expect it will happen at some point due to a break-out, but I think they are being a little short sighted right now.

 

Again, I haven't found the full NFL regular season protocols, but the pre-season NFL protocols I linked clearly state that swab-based RT-PCR through Bioreliance or POC Mesa tests at the facility will be used, and that they will switch to saliva when the sensitivity and selectivity are shown to meet <5% thresholds.

 

 

[cba fan]

why did NFLPA agree to the protocols if they did not like them?

 

Edited September 7, 2021 by cba fan

[Hapless Bills Fan]

5 hours ago, cba fan said:

why did NFLPA agree to the protocols if they did not like them?

 

Good question!

 

Perhaps the NFLPA members involved in the negotiation were good with it, but then got a lot of pushback from other players

[Thurman#1]

13 hours ago, Rochesterfan said:

 

The NFL is against it because the cost.  They are alone absorbing the cost and last year the daily testing cost them close to 100 million dollars.

 

By setting it 2 weeks originally for vaxxed players/staff (let’s say 80% of players and all staff) during the season that equates to over 37,500 less tests performed every 2 weeks - at $125 a test - over 4.5 million in savings every 2 weeks or about 43 million in savings for the season.

 

At 1 time a week testing you cut that saving in half down to about 20 million in savings.

 

Daily testing goes back to the owners paying an additional 100+ million out of their profits.  
 

Plus I think the idea was to have incentives to get vaccinated, but the money is the driver.

 

 

You may well be right that cost is the sticking point for the NFL, but $100 mill divided by 32 teams is worth it if it greatly cuts the possibility of having games cancelled. If they were smart, they would do it.

[Wayne Cubed]

10 hours ago, cba fan said:

why did NFLPA agree to the protocols if they did not like them?

 

 

It may be that the majority of players were ok with the protocols. The NFLPA does represent all players, not just the ones that scream the loudest. And as Haps pointed out it might be that this is roughly 160 players that are upset, which represents a small percentage of overall players.

[Bill from NYC]

7 hours ago, Hapless Bills Fan said:

 

Good question!

 

Perhaps the NFLPA members involved in the negotiation were good with it, but then got a lot of pushback from other players

Do we know the percentage of false results (both negative and positive)? At one point they seemed to be very high. If I owned a team, I would want to know these percentages before I sink more millions of dollars into daily testing.

[Rochesterfan]

1 hour ago, Thurman#1 said:

 

 

You may well be right that cost is the sticking point for the NFL, but $100 mill divided by 32 teams is worth it if it greatly cuts the possibility of having games cancelled. If they were smart, they would do it.

 

If you felt that the protocols in place are sound and you didn’t think the additional testing adds anything - why spend the additional 100 million?

 

Their doctors and infection prevention team put together a plan that got them through last season without cancellation - so I would image they are listening to them and going based on heir models and if based upon what you hear coming out is true - they NFL team felt the additional testing added little value.  
 

The NFL gave some limited reasons why they felt the testing added little value and why even adjusting to weekly testing was probably not needed.  Now whether that is fully true or not will be seen, but if I asked you to just throw in additional money for what is deemed limited value - I would assume you would have to think about it and may not want to provide the money.

What we don’t know is if and when and what data their planning was done.  The one thing I suspect is that the NFL will adjust this policy as needed - just as they did last year to ensure games were played.  
 

 

 

 

[Hapless Bills Fan]

12 hours ago, Bill from NYC said:

Do we know the percentage of false results (both negative and positive)? At one point they seemed to be very high. If I owned a team, I would want to know these percentages before I sink more millions of dollars into daily testing.

 

The NFL/NFLPA-agreed protocol for pre-season specifies a method that has a sensitivity  and selectivity >95% so false positives AND false negatives <5%.  Math says that the real rate of false positives must be considerably lower than that (see below).

 

There was an initial event where 77 false positives were identified after a contamination event at Bioreliance, but after that not much was heard.

 

The CDC co-authored a paper with the NFL about last year's testing program:

Quote

Over the course of the monitoring period (August 9–November 21), 623,000 RT-PCR tests were performed among approximately 11,400 players and staff members; 329 (approximately 2.9%) laboratory-confirmed cases of COVID-19 were identified.

Even a 1% rate of false positives would be over 6,230 false positives and we didn't hear anything like that after the initial 77-sample debacle.

I don't even think we heard about an equal number of false positives to confirmed cases (of course, we didn't hear about all the confirmed cases either unless they involved players or coaches).  So I think it was probably a fraction of 1%.

 

You bring up a good point though.  If the disease prevalence in a population is lower (say, 7x lower in vaccinated athletes as in NFL preseason per Allen Sills), one can easily get to a point where the false positives become a significant fraction of the positive tests.

 

It's an interesting paper.

 

Oh, BTW: if we ever wondered why the NFL was so unbending towards the Denver Broncos and made them play without a QB, here's why:

 

 

That explains why the QBs weren't immediately ID'd as contacts but classified as contacts later (after the surveillance video was reviewed).  And the NFL was like, "yeah, my Nose Bleeds for you, Elway; self-inflicted wound."