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Who is at risk if college football is played this fall?

Who is at risk if college football is played this fall?
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We are now just a few weeks away from when college football is scheduled to begin. After an initial surge of infections to returning athletes in June, the number of new infections has been eerily low, with some schools even reporting none. Is this good news, a lack of testing, or a lack of transparency?   

The worst-case scenario for college football is that a student athlete becomes infected, ends up in an ICU on a ventilator, and dies. However, college football player deaths have been more common than most realize. Between 2010 and 2019, there have been 98 fatalities among college football players, 42 of which were players on teams in the Football Bowl Series (FBS). The three primary causes of death have been health or illness, accidents and homicides or shootings. With football’s returns this fall, the past 10 years of experience suggest that between one and eight deaths will occur among these 13,000 college football players, with an average of just over four per year.  

The concern on everyone’s mind is whether COVID-19 will take a player’s life.   

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With 130 FBS teams, and 100 players on average on each team’s roster, there are 13,000 FBS team student athletes. If we consider a randomly selected group of 13,000, 18 to 24-year-old males, the COVID-19 per capita death rate indicates that to reach an expected number of deaths of one, the infection rate must reach 28 percent. In general, the lower the infection rate, the smaller the number of expected deaths.   

Comparing this to the four deaths per year on average observed for college football players over the past 10 seasons, we see that COVID-19 deaths would result in a fraction of additional deaths compared to the numbers that would be expected. Therefore, if the only concern is protecting college football players from COVID-19 death, then college football can be played with minimal fatality risk to the players. 

The key is to keep the infection rate as low as possible, ideally zero, which every school is actively working towards, with all players and coaches highly motivated to achieve.   

However, the players represent one part of the risk. The bigger risk is to the coaches. Suppose that each FBS team has on average four coaches on their staff between 45 and 64 years of age. Then one would expect one coach to die during the season due to COVID-19, if coaches have a 12 percent infection rate. If the coaches are in better health than the average person in the population for their age cohort, then the expected number of deaths would be lower. On the other hand, coaches over 65 and those with underlying health conditions have not been included in this analysis and have the greatest risk of poor outcomes. Therefore, the most significant risk to playing college football this fall are such members of the coaching staff.  

This risk analysis should begin, not end, the dialogue on college football’s return in the fall. Many questions remain with no clear answers. How many spectators watching games will get infected? Who is liable for hospitalizations amongst players and coaches? With one-quarter of college football players clinically obese, typically those playing on the offensive and defensive lines, how will this skew the analysis?    

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If students come back to campus for in-person education this fall, whether they are playing football, women’s volleyball, women’s soccer, or just being a student, they all have a comparable risk of infection. This means that with respect to student safety, the decision to field any intercollegiate sports should be driven by the decision to have in-person education. If LSU, Clemson, Ohio State or USC commit to in-person education, then let them play football this fall. If they opt for online education, football should be off the table. 

The more critical issue of concern are the coaches, particular those over 45 years of age, and especially those over 65 years of age, and those with any underlying health conditions. Every effort must be taken to protect these most vulnerable coaches. If we need a reason to not play college football this year, it begins and ends with the coaches.   

Sheldon H. Jacobson, PhD, is a founder professor of Computer Science at the University of Illinois at Urbana-Champaign. He applies his expertise in data driven risk assessment to evaluate and inform public policy and public health. He is an active member of INFORMS.