High-Risk Players and the Pressures of the Pandemic Season

Teammates with similar health risks arrived at different decisions when it came to playing a season while COVID continues to rage. The pressures beyond the pandemic, why some opted out, why some opted in, and what happens now that the league and its teams have to keep them safe.

Kyle Peko is 27 years old, listed at 6' 1" and 305 pounds. He is the father of two young kids and his wife, Giuliana, is a survivor of stage 3 Hodgkin’s lymphoma who finished chemotherapy and entered remission in late 2019. He is moderately to severely asthmatic, dutifully puffing on his inhaler once a day to keep his breathing under control, as he has done for the majority of his life.

Shelby Harris is 29 years old, listed at 6' 2" and 290 pounds. He is a father of three young kids and his wife, Stephanie, is pregnant, due in January. He is moderately to severely asthmatic, using a daily inhaler and occasionally needing to fortify his lungs before games with medicine from a nebulizer machine. He also suffers from sleep apnea, wearing a CPAP mask to bed every night, and carries the sickle cell trait.

Last month, as the NFL and NFLPA headed toward an agreement allowing players to opt out of the 2020 season due to health concerns amid the coronavirus pandemic, these two Broncos defensive linemen were forced to tackle the same Hamletian dilemma regarding their football futures: To play, or not to play, that is the question.

Neither option was without risk. On the one hand, medical experts say that no other sports league is more likely to host an outbreak than the NFL, between its squadrons of sideline personnel, full-contact collisions on every snap, and decision to eschew a “bubble” approach. And if a breakout does happen, the number of individuals at risk of severe illness due to COVID-19—from 65-and-older coaches on the sidelines to in-their-prime athletes with underlying health conditions—will no doubt be high.

On the other, no league offers its players a smaller window of time to secure life-changing money. The average NFL career lasts roughly three years and is mined with plenty of non-viral hazards, from broken bones to torn ligaments to battered brains; it only seems natural that players would make similar calculations about playing through a pandemic. After all, there’s no guarantee that a roster spot will be waiting for them when they return in 2021. And while the stipend for players opting out is nothing to scoff at—high-risk players will receive $350,000, while voluntary opt-outs only get $150,000 as a salary advance toward next season—it’s hardly a nest egg.

Harris (left) and Peko / USA Today Sports (2)

Harris spent days wrestling with his choice. Chief among his concerns was the toll that contracting COVID-19 could take on his body given his asthma, one of 15 conditions on the NFL/NFLPA’s high-risk list. “It affects the respiratory system,” he says. “That worried the hell out of me.” But when he weighed the professional benefits against the personal risks, like so many other workers in so many other fields today, he opted against opting out.

“I’m getting older, so every year I can get in the league, I’ve got to take,” says Harris, who became a full-time starter for the first time last season, his sixth in the league, and now will make a little more than $3 million in 2020. “It’s a scary thought: If you don’t play this year, there’s going to be another draft, another free agency [class] regardless, and there’s a good chance you could get replaced. The league waits for no one.”

Peko struggled too. After toggling between the practice squads and active rosters of the Bills and Colts last season, and then latching on with the Broncos in mid December, he was set to make $675,000, more than half of what he earned over his first four years combined, in 2020. “Pretty tough decision,” he says. “Football is what I’ve been doing for so long.” But when he weighed the personal benefits against the professional risks, like so many other football players, his asthma and Giuliana’s recent cancer bout “overruled all of the pros and cons,” he says. “With these trying times, I had to make the best decision for me, my health, and the health of my family.

“I sent an email to Mr. Elway and the team, and told them that I’m a high-risk opt-out, wished them best of luck, and said that I look forward to having an opportunity to be back in 2021.”

Similar ages, similar body types, similar family situations, same job responsibilities, same chronic respiratory disease … and divergent paths. Their choices were deeply personal, but as this seemingly unstoppable football season inches closer to reality, they were far from the only players who had to make them.

* * *

Until Cole Wick learned about the opt-out agreement after it was finalized on July 26, he was fully prepared to attend training camp. The 26-year-old tight end was comfortable enough with the health-and-safety protocol put in place by the Saints, whose practice squad he had joined last December. In fact, he was already halfway through an eight-hour road trip to New Orleans when he received the union memo, driving a car packed with clothes, recovery gear and, of course, his daily inhaler, nebulizer, and vials of liquid medication.

Upon arriving, Wick checked into a hotel and stayed up “pretty much all night” making phone calls—to his wife, to his agent, to his parents—as he weighed his options. The next morning, he reported to the Saints practice facility and received a nasal swab COVID-19 test, still somewhat on the fence. “I was so torn,” says Wick, whose first four NFL seasons were spent across five franchises and primarily on practice squads, with only 11 regular-season games under his belt. “I wasn’t sure how I wanted to proceed. There’s safety, and then there’s making a living, like we do on the field.”

But he thought more about his wife, Kristin—the couple had only just learned that she was pregnant with their first child. He thought more about his asthma, which had made practicing with the Niners amid the California wildfires in 2018 “a big struggle,” and which labored his breathing so badly when a wave of Saharan dust recently rolled through Texas that Wick was initially convinced that he’d caught the coronavirus. He also thought about the outbreak that was, at the time, hitting the Miami Marlins and MLB. And so Wick promptly turned around and drove back home to San Antonio, emailing Saints officials of his decision to sit out under the high-risk clause.

“I’m not entirely sure how the virus affects the lungs, but I know that it does affect the lungs,” Wick says. “And I know I’ve been living with asthma for a long time. It’s just the risk factor, know what I mean?”

For players with underlying medical issues such as Wick, Peko and Harris, there were mainly two layers of risk. Specific and most serious to them is the increased likelihood that, because of their conditions, they could develop a severe illness as a result of contracting COVID-19. Peko and Harris’s teammate Von Miller experienced a spate of symptoms—weight loss, no sense of taste or smell, breathing issues exacerbated by his asthma—for several weeks after his initial diagnosis in April but believes he has escaped lasting, long-term impact. Others aren’t so lucky; for instance, myocarditis (heart inflammation) has cropped up among coronavirus patients in college football and shelved Red Sox pitcher Eduardo Rodriguez for the season.

“We know there are some people who feel sick for a very long time,” says Dr. Gretchen Snoeyenbos Newman, assistant professor of infectious disease at Wayne State University. “We know some people have lung damage that continues on past when the virus has gone, though we haven’t been around COVID long enough to know how long that lasts. When we talk about young athletes, death is not the only bad outcome. Even if it doesn’t require them to be intubated, even if they don’t die from it, getting sick can have profound, career-altering effects.”

It’s hard to estimate exactly how many players could be in the virus’s invisible crosshairs. Early on in the pandemic, an internal NFLPA study determined that more than 70% of union membership were considered high-risk. But that was based on well-documented medical data showing that Black populations are disproportionately affected by COVID-19, as well as CDC guidelines that included obesity, which is defined as a body mass index over 30. (In other words: virtually every lineman and then some.) “When we talk about obesity, we don’t fully know what that means for elite athletes with high BMI,” Snoeyenbos Newman says. “People who are mostly muscle definitely have some risk with high BMI, but we don’t have data that breaks things down for COVID.”

Sixty-nine players opted out in the end, according to the NFLPA, a third of whom (23) were offensive and defensive linemen. Asked how many were high-risk opt-outs and what the most commonly cited high-risk conditions were, a union spokesman declined comment, citing medical confidentiality. In addition to asthma, the NFL/NFLPA list contained, among others, hypertension, Type 2 diabetes (but not Type 1), sickle cell disease (but not the trait) and cancer. But it is safe to assume that far more high-risk players will be taking the field than not come September. “I know a number of guys who are high-risk and playing,” Peko says. “Some don’t have obligations off the field. Some don’t have a wife or kids and they’re willing to risk their own health to play for their future. And I don’t blame them. I get it.”

The other layer of risk is all but baked into the sport. Rosters alone are big enough to make sideline social distancing virtually impossible, and that’s without considering the dozens of coaches, trainers, doctors, officiating crews, chain crews and camera crews needed to stage an NFL game. Most plays are preceded by huddles and end with pileups. Quarterbacks incessantly lick their fingers. Everyone spits and sweats, and hardly anyone drinks their own water. “When we think about coronavirus spread, we think about proximity, droplet generation, and duration,” Snoeyenbos Newman says. “All football players are professional droplet generators.”

It stands to reason, then, that those players charged with clashing in the trenches, snap after snap, are most vulnerable by simple virtue of their position. “The CDC talks about 10 to 15 minutes of exposure as being high-risk, and they don’t define whether that’s at one go or accumulated,” says Snoeyenbos Newman. “The several minutes that your linemen are in contact with each other, multiplied by however many downs of a game, does give you this cumulative exposure risk. It isn’t zero for anybody, but it’s the highest for linemen.”

As he was making his decision, Peko called a handful of teammates and other friends around the league to see what they were thinking. Many of the linemen he spoke to expressed a similar sort of concern about their basic job duties. “I believe that the NFL and the teams are doing the best they can to prevent any exposure, or containing the problem if there is an exposure,” Peko says. “But no matter what, every play, we’re getting gritty and hands-on, we’re transferring our breath, our sweat, our blood constantly. Baseball, they’re not full contact, and they’re getting these cases. Football’s going to get a number of them. It’s just inevitable.”

Even while they watch from home on Sundays, safely ensconced on their couches, Wick, Peko and other players who opted out won’t have a worry-free year. There is the dice roll that everyone casts in this country when they so much as go to the grocery store these days. There is the much more football-specific challenge of keeping themselves from falling out of shape in the fall and winter months, when they would otherwise have access to an NFL franchise’s gaudy resources. And, even though the contracts of every opt-out, medical or voluntary, will toll until 2021, for many there is the looming uncertainty of their employment status that awaits their return.

“I’ll still be with the Saints, unless they cut me, and that’s my fear,” Wick says. “The risk is there.”

* * *

By now, the unfamiliar has become routine. Each morning, as soon as he wakes up, Harris fills out a survey on his phone that, among other questions, asks whether he’s developed a fever or come into contact with anyone with COVID-19. Answering no to them all, he says, he is given a barcode that is later scanned upon arrival at the Broncos facility. Before he can enter, though, he must first receive a nasal swab test, a thermal temperature scan, and a tracking device that blinks red if he comes within six feet of another person. “Then when we’re walking in, our phones are sanitized,” he says.

Inside the building, where arrows on the floor have made each hallway a one-way street for Harris and his teammates, masks are mandatory. Tall dividers separate locker stalls. Meals are served in to-go packaging and eaten at socially distanced tables. “Constantly washing, sanitizing your hands,” Harris says. “Everyone gets their own water bottle, it’s not just a free-for-all.” The same is true for the workout area, where each player must lift on a weight rack by himself and wipe down the equipment when he’s done. D-line meetings were moved to a more spacious room so everyone can spread out. By the time Harris returns his tracker and heads home around 5:30, not a moment has passed without the presence of the virus.

“It’s very different,” Harris says, but it’s also a welcome sense of security given his health conditions. “I really didn’t know necessarily what it would take to feel comfortable to go back. It was just like, ‘O.K., wow me.’ So when I saw the measures the Broncos have been taking, it definitely made me feel comfortable.”

In a way, it was confirmation of a stone-cold, if not sobering, sort of logic that had helped persuade Harris to play when he was considering opting out. As he says, “It’d look really bad if someone died because of the NFL, so they’ve got to go through everything possible to make sure everyone’s safe.”

Since the NFL isn’t housing team employees in bubbles for the 2020 season, mitigation starts with individual accountability on common-sense protocols while away from the facility, such as social distancing, avoiding large indoor gatherings, and wearing masks. (And not, say, sneaking friends into hotels disguised as players.) “Everyone has to come together as an NFL family and be like, if we want to have a full season, guys are going to have to not be selfish and do what they’re asking us to do,” says Buccaneers center Ryan Jensen, who has obstructive sleep apnea, a respiratory condition that, while on neither the CDC nor NFL/NFLPA high-risk lists, is still associated with issues such as heart attacks and high blood pressure. “Guys got to keep themselves accountable, and not be going out and putting themselves at risk and in turn putting everyone else at risk.”

It’s why the NFLPA established a confidential whistleblower hotline for players to report potential violations of protocol. (A union spokesperson declined comment when asked if the hotline had been used yet.) And it’s why shedding the classic athlete-warrior, grind-through-the-pain mentality in favor of a culture of self-reporting symptoms might be the key to keeping the virus under raps. “We’ve trained these players to play through the pain, and to want to play,” says Snoeyenbos Newman, herself a former college rugby captain. “Now, in order to be a productive and helpful member of your team, we’re asking players to do the exact opposite,”

Of course, it’s unrealistic to expect zero slip-ups. (As of Aug. 12, according to the NFLPA, 64 players had tested positive since they began reporting to training camp.) “That’s why it’s such a big deal that everyone is tested,” Harris says. “Once you finally do start hitting each other, there’s going to be spit, there’s going to be all sorts of stuff all over the place. We need to have the comfort knowing everyone is COVID-negative.”

On this front, a recent NFL/NFLPA agreement extended daily testing through Sept. 5, five days before the Chiefs and Texans are to kick off the season. It’s not hard to speculate why owners might’ve balked at committing to the full season just yet (the answer rhymes with “honey”). Regardless, last week’s emergency FDA authorization of a cheap, rapid-response saliva test was a promising development for sports leagues and society in general.

Perhaps even more critical than catching cases at the door, though, is having strict protocol to limit the ripple effects if the virus gets inside. “It is very, very challenging to think about when someone tests positive,” Snoeyenbos Newman says. “Let’s say your center tests positive. Well, are you going to isolate your whole line for several days? What about your tight end? What about your quarterback? What the Marlins have shown us, you can have spread even with very aggressive testing. And most of those people [were] asymptomatic.”

For those who have returned to work, nothing is the same. “It’s crazy, every morning, showing up to the facility, having to get a Q-tip shoved up your nose,” Jensen says. But as training camps around the league have plodded on, progressing to a full-contact stage this week, some measure of normalcy has taken hold. “Besides the little things, the masks, the social distancing in the locker room,” Jensen says, “everyone’s back to that normal vibe of guys just hanging out and talking ball and excited for the season.”

Another step closer toward Week 1, in the league that waits for no one.