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Extensive protocols led to Big Ten decision

Extensive protocols led to Big Ten decision


The return of Big Ten football is accompanied by a detailed playbook of medical protocols and procedures designed to provide a uniform approach to dealing with COVID-19.

Daily antigen testing, enhanced cardiac screening and an enhanced data-driven approach to decide when teams can practice and play are all part of protocols adopted by the Big Ten Council of Presidents and Chancellors in their decision to allow a season to begin on the weekend of Oct. 23-24.

The Big Ten is requiring testing for all Big Ten football teams to begin by Sept. 30 and earlier if possible.

The conference is also requiring any student-athlete who tests positive for the coronavirus to sit out for a minimum of 21 days, seven days more than current Center for Disease Control guidelines recommend an infected individual stay home before returning to work or activity.

Dr. Jim Borchers, the head team physician at Ohio State and co-chair of the Big Ten’s return to competition task force, said a collaborative effort put the conference in a position where university presidents and chancellors believed a safe path forward had been determined.

“The last 40 days have been an incredible example of cooperation,’’ Borchers said. “We collaborated with each other, talking through things and seeking to find a way forward if at all possible.’’

Borchers said as has been the case since the coronavirus began to impact day-to-day life earlier this year, the success of the Big Ten plan will come down to cooperation of the student-athletes, coaches and staff members who are involved in making a season happen.

“We can’t emphasize enough that what we’re putting forward requires prevention,’’ Borchers said during a press conference Wednesday. “It requires accountability from everyone involved.’’

The increased availability of accurate rapid testing options for the coronavirus and the ability of Big Ten schools to access to cardiac MRI testing that was unavailable previously was a game changer in the minds of conference decision makers.

Options that weren’t available or practical in August that are now out there changed the views of a group which went from voting 11-3 in August to postpone the season to unanimously deciding this week to kick things off next month.

“There is a very strong view among the medical experts, a unanimous view, that we can do it safely,’’ said Morton Schapiro, president of Northwestern University and the chair of the Big Ten Council of Presidents and Chancellors.

“The feeling was if we could play football safely in the Big Ten and meet the cost of daily testing that there wasn’t any reason not to move forward on it. That is why I did, in fact, vote to go forward. I did grapple with it, thinking about that if the campus is closed that maybe you shouldn’t play football. At the end of the day, I felt that if we can do it safely, we can play football.’’

Each school will have a designated Chief Inspection Officer will make decisions about whether a team can practice or play a game and positivity rates will factor into those daily decisions.

If a team has a positivity rate greater than five percent, it must shut down regular practices and not participate in any games for a minimum of seven days.

If the team population, which includes players, coaches and support staff, has a positivity rate of 7.5 percent or more, teams will be required to halt practices and competition for a minimum of seven days or until the metrics have improved.

The Big Ten plans to use a standardized color-coded meter to determine just what can take place.

If a team has a team positivity rate of 0-to-2 percent, it will have a green code and will be allowed to continue with normal practice and competition.

If that rate is between 2-and-5 percent, the team will be assigned an orange code and must proceed with caution and enhance COVID-19 prevention.

A red code will be placed on teams with a positivity rate of 5 percent or higher, resulting in practices and competition being halted for seven days.

The code system also applies to the team population group, with a positivity rate of 0-3.5 percent assigned a green code, 3.5-7.5 percent an orange code and 7.5 percent or higher a red code.

The testing will occur on a daily basis and the Big Ten is requiring all student-athletes, coaches, trainers and other personnel who are on the field for all practices and games to undergo daily antigen testing.

The test results must be completed and recorded prior to each practice or game.

Student-athletes who test positive for the coronavirus through point of contact daily testing would require a polymerase chain reaction test to confirm the result of the point of contact test.

“For everyone involved from student-athletes to coaches to staff, progress will be measured by their efforts,’’ Borchers said.

All student-athletes who record a positive COVID-19 test will be required to undergo comprehensive cardiac testing to include labs, biomarkers, echocardiograms and a cardiac MRI.

Following the cardiac evaluation, student-athletes will need clearance from a cardiologist designated by the university before returning to practice.

Data collected from daily and cardiac testing will be become part of a cardiac registry will be used to allow researchers at all 14 Big Ten institutions to study COVID-19 and attempt to mitigate the spread of the disease among wider communities.

The hope is that registry and associated data will help researchers answer many unknowns regarding the cardiac manifestations in COVID-19 positive elite athletes.

“The registry is one of the most important aspects of this,’’ Big Ten commissioner Kevin Warren said. “I’m looking forward to seeing how the results from this can benefit others.’’

Testing for football programs will be operational by Sept. 30 and Warren said eventually all Big Ten sports programs will require testing protocols before they can resume competition.

Shane Lantz covers sports for the Globe Gazette. You can reach him at, or by phone at 641-421-0526. Follow Shane on Twitter @ShaneMLantz. 


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