NBA's ‘bubble' idea has major holes


Just over three weeks into the suspension of the NBA season, there’s still no official word from the league office on when it expects to reopen its doors and play basketball again. 

The coronavirus continues to keep the league in a holding pattern as the calendar flips to the month of April. Teams have anywhere from 15 to 19 games remaining on their regular season schedule and several teams like the Portland Trail Blazers, Sacramento Kings and New Orleans Pelicans hope to make a late-season push into the playoffs. 

Whenever the NBA does come back, it might look drastically different. One possible scenario, according to ESPN’s Brian Windhorst, being considered inside and outside the league is a quarantined bubble. Under this idea, according to Windhorst, the league would reassemble in one or a pair of cities and resume the season in a locked-down hotel and venue without fans in attendance. 

Plans are being drawn up to do just that in the Chinese Basketball Association (CBA), which has been shut down since January, and NBA executives have suggested the league consider the same in possibly Las Vegas or the Bahamas, according to ESPN. The CBA hopes to restart in a bubble scenario in mid-May after several delays due to COVID-19. On a smaller scale, the BIG3 basketball league partnered with the production company of the hit TV show “Big Brother” to quarantine 16 basketball players in the same Los-Angeles-area home for three weeks with plans to play a 3-on-3 tournament and broadcast the reality show in early May. 

The bubble is an outside-the-box idea that actually does have some roots in the NBA ecosystem. 

Every December, the NBA hosts the MGM Resorts G League Winter Showcase, which convenes inside the Mandalay Bay Convention Center in Las Vegas. Over the course of four days, all 28 G League teams play several games in front of NBA general managers and player personnel executives -- and, most importantly for this time, no fans. 

Of course, that’s just a four-day affair. Restarting the season would likely require several weeks of play and the league has to find a way to protect players and staff from a virus that’s been detected in over 200,000 individuals in the United States and nearly a million across the world, according to Johns Hopkins University tracking

To properly shield its teams and league personnel, the NBA would have to establish extensive precautions to ensure the health and safety of those inside the bubble. It’s not enough to think about the 450-or-so NBA players and the surrounding staffs of all 30 teams. According to Dr. Caroline Buckee, an associate professor of Epidemiology at Harvard’s T.H. Chan School of Public Health, the NBA is just one piece of a very complicated puzzle.

“It sounds like potentially a bad idea,” Dr. Buckee said in a Zoom interview. “I don’t think it’s realistic to completely isolate and quarantine the players. For a start, there are people who will need to clean their rooms, feed them, wash their clothes, janitorial staff and so forth. And those people will not be protected and they will be interacting with their communities. 

“It is very difficult to truly self-isolate. Purposefully putting people at risk seems foolish.”

It’s not clear if the NBA is also considering hiring the necessary hospitality and support staff and housing them in the proposed quarantine facility. From an operations standpoint, the bubble could theoretically be staffed and run like a cruise ship on land where workers are prepared to feed, clean and operate for weeks at a time. The owner of the Miami Heat, Micky Arison, is also the chairman of Carnival Corporation, the world’s largest cruise operator. 

However, the cruise ship industry has been hit hard during the pandemic, a warning sign for the NBA as it tries to workshop plans for a closed-off community.

“I’m not sure the bubble scenario is wise,” said Dr. Charles Branas, professor and department chair of epidemiology at Columbia University’s Mailman School of Public Health. “The chances of pulling that off for the entire NBA seems highly unlikely. All you need is one unintended case of COVID-19 and the whole thing goes bad, like a cruise ship.”

Safely staffing the entire facility is one obstacle that must be addressed if the NBA wants to seriously pursue a restart in a closed community. Another is convincing players to go for it. Los Angeles Lakers star LeBron James isn’t fond of the idea, saying on the Road Trippin’ podcast last week: “I ain’t going for that s***. I’m not going for that.”

James, who lives in Los Angeles with his wife and three children and is observing California’s shelter-in-place order, is far from alone in his thinking. Dr. Neel Gandhi doesn’t call himself a die-hard sports fan, but as an infectious disease expert and associate professor of Epidemiology at the Emory University Rollins School of Public Health, he has found himself monitoring the coronavirus response of the sports world and worries about the practicality of a quarantined restart.

“It’s an interesting idea,” Dr. Gandhi says. “In theory, it can be done. But the question ends up being the details of what it means to quarantine these individuals. The key for me would be to truly create a closed community that they’re in.”

For Dr. Gandhi, who has been assisting at a drive-through COVID-19 testing site in Fulton County, Ga., several protocols would need to be in place for an NBA bubble to work. 

First, anyone who planned to be inside the bubble would need to be self-isolated offsite for 14 days to ensure they are free of the virus. Dr. Gandhi also recommends testing five to seven days into the self-isolation period and a second test at 14 days for all isolated individuals. This way, doctors could ensure, as much as possible, that an individual is not infected, and that there isn’t a false negative test before they enter the bubble and potentially transmit the virus throughout the community.

In an ideal scenario, Dr. Ghandi says, pre-bubble isolation would require extremely strict measures that go beyond the typical shelter-at-home protocol. If a player was self-isolating with family at their home, for example, no one could leave the property or enter during that two-week period. No grocery runs, no accepting deliveries from restaurants or the postal service, no trips to the pharmacy or doctor’s office. No interactions with the outside world. It’s a different world from most shelter-in-place protocols. 

Columbia’s Dr. Branas agrees with that self-isolation timeline, suggesting a strict quarantine for two to three weeks before anyone entered the bubble. 

And that’s just the beginning of the precautions. According to ESPN, the Chinese Basketball Association is considering doing daily temperature checks for its athletes. To Dr. Gandhi, that’s not enough. 

While it’s good news that players on the Los Angeles Lakers and Brooklyn Nets are no longer showing symptoms after several tested positive last month, more needs to be done before they could re-enter society or participate in a quarantined bubble.

“Part of why it’s become so difficult to get a handle on the novel coronavirus in cities and communities is this idea that people can transmit it before you’re symptomatic,” Dr. Gandhi says. “Simply checking temperatures on a daily basis would not be enough. There’s a possibility that a person can become infectious before they have manifested a fever. You have to be very meticulous and strict about it.”

Dr. Zachary Binney, adjunct instructor in Epidemiology at Emory University Rollins School of Public Healthy and sports injury epidemiology consultant, is fascinated by the proposed solution, dubbing it the “the National Bio-dome Association,” a reference to the 1996 comedy film featuring Pauly Shore about a biological experiment inside a closed ecological system.

But Dr. Binney wonders whether it’s worth the trouble and risk of infection.

“The National Bio-dome Association is an intriguing idea in theory but there are a lot of details to be worked out,” Dr. Binney said, reiterating the concern for the non-basketball staffers. “Are they staying there or do they go home to their families? Because now you’ve opened the closed loop. And you risk opening someone with COVID-19 going back into the system. It’s a really difficult question.”

Dr. Binney also worries about the finite resources it would take to protect hundreds of people under one metaphorical roof. He agrees with Dr. Gandhi’s estimate that thousands of tests would need to be set aside for an NBA bubble restart. And while new coronavirus test systems, like the Abbott Labs’ test that produces results within minutes, could be promising, epidemiologists that spoke to NBC Sports were skeptical that quick and accurate tests could be  to be available at the volume the NBA would need.

“We need to think about the fact that we can’t even staff our hospitals properly right now,” Dr. Binney says. “We don’t have enough tests and personal protective equipment for the folks who are on the frontlines of the epidemic and the people who are showing symptoms, they can’t even all get tested.

“To divert the resources to the NBA to allow them to do something like this right now, that strikes me as a question worth asking whether that’s actually something we want to be doing right now.”

To be fair, the NBA isn’t considering any sort of bubble plan to go into place in the short term. Timetables are fluid. Last week, Dallas Mavericks owner Mark Cuban expressed optimism that the NBA could return to the court as early as mid-May, but on Wednesday, he backed off those estimates.

“I have no idea,” Cuban told ESPN. “I mean, the only thing I know is that we’re going to put safety first and we’re not going to take any chances. We’re not going to do anything that risks the health of our players, our fans, our staff, the whole organization.”

Those words are powerful. For epidemiologists, the NBA has played a central role in sending the message to Americans about the seriousness of the COVID-19 pandemic. Not just by shutting the league down, but also in community outreach. Dr. Binney applauded Stephen Curry for his Instagram Live interview of prominent infectious disease expert Dr. Anthony Fauci.

“Sports leagues and athletes have a really big role in society. They can really get the public health message out there,” Dr. Binney said.

It’s something that troubles Harvard’s Dr. Buckee when she thinks about resuming the league even under a quarantined state.

“NBA players and the NBA are important role models for a lot of the country,” Dr. Buckee said. “And as people stop playing basketball themselves and parks and courts close around the country, I think it’s important that the NBA sets an example to show people that saving lives is more important than money right now.”

So if it’s untenable to restart the season in a bubble, what alternative options does the NBA have? 

From an epidemiological standpoint, the most prudent plan may be to wait this out and not risk a closed-community outbreak. In the short-term, the NBA has set up a 2K league that will be broadcast on national television. Those types of esports might be the closest we get to real competition for a while.

It’s still too early to think about organized basketball being played any time soon -- bubble or not. Dr. Gandhi points to China and South Korea as examples of countries that have taken months to return to any sort of normalcy even after their COVID-19 infection curve has flattened. 

“It’s going to be a few months before we can even really consider an athletic team taking the field or taking the court,” Dr. Gandhi says. “To think April, May or June, from my point of view, would be quite optimistic and to the point of potentially not being realistic, to think that the NBA could resume any type of normal game structure until this summer, at the earliest.”

In other words, there’s plenty of time to watch Bio-Dome before a possible NBA version of it reaches our screens.

Follow Tom Haberstroh on Twitter (@TomHaberstroh), and bookmark for my latest stories and videos and subscribe to the Habershow podcast.

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