The Big Ten’s new football coronavirus protocols, explained


Daily testing, heart monitoring and a color code

INDIANAPOLIS, INDIANA – DECEMBER 07: Nicholas Petit-Frere #78 of the Ohio State Buckeyes celebrates after winning the Big Ten Championship game against the Wisconsin Badgers at Lucas Oil Stadium on December 07, 2019 in Indianapolis, Indiana. (Photo by Justin Casterline/Getty Images)

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COLUMBUS, Ohio (WCMH) – Big Ten football is back (with significant health precautions).

America’s oldest Division I athletic conference announced Wednesday that football will return five weeks from this Friday, but a season during the worst pandemic in 100 years will require serious health protocols.


By Sept. 30, the Big Ten will require players, coaches, trainers and “other individuals that are on the field for all practices and games” to get daily antigen tests for the coronavirus, which will be completed and recorded before every practice and game.

A COVID-19 rapid antigen test is quicker but less reliable than the more common PCR nasal swab test. While PCR swabs can take days to get results because they have to be tested by a lab, antigen tests can provide results in less than an hour.

Antigen tests, although more practical for continuous testing of large numbers of people, produce a greater number of false positives. The Big Ten’s testing plan, therefore, requires people who test positive to get a PCR test to confirm a positive antigen test result.

However, the bigger worry with antigen tests is not false positives, but false negatives – when a person is told they don’t have COVID-19 when they are actually infected.

“The reported rate of false negative results is as high as 50%, which is why antigen tests are not favored by the FDA as a single test for active infection,” Harvard University’s Dr. Robert H. Shmerling wrote last month.

He added, though, “because antigen testing is quicker, less expensive, and requires less complex technology to perform than molecular testing, some experts recommend repeated antigen testing as a reasonable strategy.”

The earliest an athlete can play in a game after testing positive is 21 days after diagnosis.

Color code

Similar to Ohio’s health advisory levels and your school district’s reopening model, the conference will operate on a color code of two metrics:

  1. Team positivity rate: The number of positive tests divided by the number of tests administered.
  2. Population positivity rate: The number of positive individuals divided by total population at risk.

Here is how the color code breaks down:

Green <2% <3.5%
Orange 2-5% 3.5-7.5%
Red >5% >7.5%
  • A university is in normal standing if its metrics are at Green/Green or Green/Orange.
  • At Orange/Orange or Orange/Red, the team “must proceed with caution” and consider things like altering practice and meeting schedules.
  • At Red/Red, the team has to stop regular practice and competition for at least seven days and reassess metrics until they improve.

Each university will appoint a “Chief Infection Officer” to oversee data collection and reporting. Data will be submitted every day and the color code will be based on a 7-day rolling average.

Heart health

Athletes who test positive for COVID-19 will undergo heart testing that includes a cardiac MRI, an electrocardiogram (ECG) and an echocardiogram. To return to play, an athlete must also get clearance from a cardiologist.

Ohio State University researchers in the spring studied 26 student-athletes with COVID-19 and found that four showed signs of myocarditis, a dangerous heart inflammation.

A co-author of that study, however, told The Columbus Dispatch this week that its findings don’t mean football shouldn’t return, it should just return responsibly.

And OSU Head Team Physician Dr. Jim Borchers, another co-author of that study, is co-chair of the Big Ten’s return to play task force.

“Everyone associated with the Big Ten should be very proud of the groundbreaking steps that are now being taken to better protect the health and safety of the student-athletes and surrounding communities,” Borchers said in the conference’s Wednesday news release announcing a return to football.

Other protocols

The conference says it has also developed minimum standards for away game travel, including air and bus transportation and hotels. The Big Ten also says it has recommendations about gameday and stadium operations to minimize the risk of spreading COVID-19.

When the Big Ten returns to play Oct. 23-24, it will join six other FBS conferences that greenlighted football this year. The Pac-12, Mountain West and the Mid-American Conference, which includes half a dozen Ohio universities, will not play football this fall. The MAC, however, is the only one of those three to leave no room for a fall return.

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