How these NFL players who had COVID-19 returned to play

Jarrett Bell

It’s the jolt from an early-morning phone call that as much as anything defined playing through an NFL season in the midst of a pandemic.

You’ve tested positive for COVID-19.

“Think about what it was like for these guys when they were given the news that they had tested positive,” Dr. Thom Mayer, chief medical adviser for the NFL Players Association (NFLPA), told USA TODAY Sports. “When it was confirmed, they suddenly worried about their families and they worried about their livelihood, wondering if they could get back to their normal level of ability.”

Mayer hates equating players' value to their physical skills as though they were slabs of meat. Yet he realizes the coronavirus has spared no one – not even finely tuned professional athletes – of the realities of risk and uncertainty.

Heading into Super Bowl LV on Feb. 7, 262 players had tested positive for COVID-19 since the NFL and NFLPA began its daily testing program on Aug. 1 with the opening of training camps.

Ravens quarterback Lamar Jackson had to leave a game against the Browns with cramping suspected to be a result of his bout with COVID-19.

“They are dependent on their bodies to do their work,” Mayer said. “It’s as if someone said to me as a doctor, ‘You’re going to lose your mental faculties and can no longer see patients. You may or may not recover.’ ” 

In other words, COVID-19 added another type of reality check – with mental challenges on top of the physical demands – for players who already grapple with a high-stress existence in playing a violent sport when the next play could be their last.

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While the majority of COVID-19-related casualties in the U.S. have struck the elderly and people with preexisting conditions, that has hardly allowed NFL players to minimize the threat. Mayer and other medical experts caution that so much is to be learned about the long-term effects of the novel coronavirus. 

The short-term implications have certainly been felt across the NFL, which included significant outbreaks with the Titans, Ravens and Browns and setbacks that involved some of the league’s highest-profiled players.

Remember the night when Lamar Jackson left the game at Cleveland due to cramps, returning later to spark a last-minute comeback victory? Jackson and the Ravens suspect the cramps were a residual from the COVID-19 that knocked the quarterback out of action for two weeks.

“Probably because of the body heat,” Jackson, 24, told reporters when asked if there was a link between the cramps and the coronavirus. “We were running in the cold.”

Jackson spent 10 days in quarantine after testing positive, experiencing flu-like symptoms including extreme fatigue. He also lost his sense of taste and smell. The contest at Cleveland was his second game back; he reported that his hand, forearm and entire throwing arm cramped with his fingers stuck together. The case puzzled the Ravens as Jackson was apparently well-hydrated.

“Who knows? Is that (COVID-19)? Is it the nutrition, the diet?” Ravens coach John Harbaugh said at the time. “It’s quite a mystery.”

Players who contracted COVID-19 reported a range of effects, although given that it is largely considered a respiratory disease much focus is directed to cardiovascular functions. Mayer said he was particularly tuned to the response during the return of larger players, linemen and linebackers, knowing that their body mass index (BMI) puts them at higher risk of complications.

“On long drives, you could see them winded, struggling,” Mayer said. “It was heartbreaking to me to have to watch that.”

Myles Garrett knows. The Browns’ defensive centerpiece missed two games after contracting COVID-19, and it took at least as many games for him to feel normal again. His breathing was labored. He battled through severe coughing fits and repeatedly felt choked. The All-Pro defensive end also felt less effective during the flow of the games after returning.

“It’s bound to affect your lungs, and I feel like I need those to be out there and give my full effort,” Garrett told reporters. “It’s hard to make a move or do something that you know is going to expend a lot of energy, knowing that you have to do it again the next play and the next play.”

Like many players, Garrett, 25,  had cardio training that included breathing exercises four times  a day as he prepared to return. The conditions for returning from COVID-19 were not as defined as, say, the multistepped protocols established for returning from a concussion. The coronavirus protocols include isolating players who test positive, in addition to others deemed to be in close contact, until they test negative for multiple days. Those measures, consistent with CDC guidelines, likely went far in allowing the NFL to contain the spread. The infected players  had EKG and echocardiogram tests that measured respiratory and heart conditions before returning.

Still, Mayer realizes that more will be learned of the long-term effects on lung and heart functions as data is analyzed.

“So far, the incidences of pericarditis or myocarditis has been extraordinarily low, but it hasn’t been zero,” Mayer said, referring to heart-related inflammation that can be fatal if not diagnosed. “Are those guys going to recover from that? Is there a differential effect in the African American population among our players (72%) versus the non-African American population?”

Mayer not only consulted more than half of the players leaguewide who contracted COVID-19, he also shared thoughts, answered questions and advised many wives, parents, significant others and children of infected players. That underscores the scope of impact far beyond the field.

“There’s this lingering sense in some people’s minds, ‘What does this mean for me and my family moving forward?’ ” Mayer said.

One of the most severe cases in the league involved Raiders tackle Trent Brown, who wound up on the COVID-19 reserve list twice. After returning from an initial placement on the list, Brown, 27, experienced such residual effects that he was administered fluids intravenously before a Week 8 game at Cleveland – which led to a medical emergency that forced him to be rushed to the hospital, where he was kept overnight.

Reportedly, Brown became ill after air entered his bloodstream as he received the IV. Mayer would not comment on individual cases, but clearly the episode involving Brown underscored risk.

In many, if not most of the cases involving NFL players, the infected players were asymptomatic. That, too, reflects a pattern that has existed in the population at large, particularly for younger people who tested positive for COVID-19.

Consider the case of Buccaneers linebacker Devin White, 22, who missed two games after testing positive. White never felt any of the known symptoms. Good for him.

 When he received the phone call – typically, players were given the news early in the morning after test results from the previous day were analyzed and relayed to league, union and team officials – White was stunned because he felt he had been diligent in his routine to stay safe. His first thought was that the test result was a “false positive” that would be corrected with further analysis.

“We weren’t really worried,” White recalled for reporters. “Everybody in the building knows me. They know I’m not going to the bar and outside.”

Yet the initial result was confirmed.

“It was just something I had to go through,” he said. “I never had no symptoms. That was the great thing. I was just thankful. They said you lose your taste, smell and stuff. I was just at home, eating good, being my normal self, watching TV. I watched a lot of SportsCenter and stuff, which I got sick of.”

With no symptoms, White tried to keep in shape by working out in his home gym.

“I was enjoying my vacation," he said. “My stupid vacation, because I didn’t need a vacation."

White missed the regular-season finale at Atlanta and the playoff opener at Washington but remained fully engaged – thanks to some prodding from Bucs coaches. Before the first game that he missed, he received an “assignment” from coaches to relay his thoughts via text message at halftime as he watched from home. He repeated the assignment the following week. He challenged himself to figure out the specific defensive calls as he watched. As other players around the league stated, he watched the video from practices he missed, which were uploaded on his iPad. 

“I was locked in,” he said. “I still felt a part of the team.”

When he returned, he caught up with teammates by talking through the situations he watched on TV.

“I was becoming more of a student of the game,” he said. “That’s about it.”

Mayer said part of the ongoing analysis by players moving forward will involve data gleaned from wearable technology that tracks performance and various biophysical measurements. It will be revealing to ascertain any differences over time for players who contracted COVID-19.

Said Mayer, “The players themselves are thinking about the whole performance repair cycle."

In other words, as in society at large, the impact of COVID-19 figures to be felt for quite some time in the NFL.