...The NFL also developed an intensive protocol that imposed stricter infection prevention precautions when a case was identified at an NFL club. The intensive protocol effectively prevented the occurrence of high-risk interactions, with no high-risk contacts identified for 71% of traced cases at clubs under the intensive protocol...
...Interviews revealed that, among the brief interactions that did occur, some were during unmasked meetings in small rooms or while eating. Persons who contracted COVID-19 within this single-club transmission group received negative test results for several days after exposure (i.e., after club activities ceased) before receiving a positive result...
...These were, in addition to consideration of duration of exposure and specific distance between persons, assessment of face mask use (e.g., medical mask versus cloth face covering, proper mask use for both infected person and contact, and any mask removal to eat or drink) and setting and ventilation (e.g., outdoor, indoor large volume, indoor small volume, and during transportation)...
...Among those exposed outside of the home, all reported partial or no mask use, and the majority of exposures were external to the NFL environment (e.g., sharing a vehicle and eating at a restaurant). Among 107 traced cases among clubs already in the intensive protocol at the time of positive test result, 76 persons (71%) had no high-risk contacts identified...
...COVID-19 mitigation measures must be continually optimized based on available data. In the NFL, COVID-19 transmission was identified in persons with <15 minutes of consecutive or cumulative interaction and was reduced through implementation of an intensive protocol focused on environmental change, increased personal protection, avoidance of high-risk interactions such as vehicle sharing, eating in the same room or common areas, and expansion of the components of contact tracing to incorporate high-risk contact designations. Although the protocols implemented by the NFL were resource-intensive, strategies such as accounting for specific characteristics of the close contact, in addition to time and duration, and creation of an intensive protocol are applicable to other settings, including essential workplaces, long-term care facilities, and schools.
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