MLS tournament testing: The health, safety and medical protocols for Orlando

The health, safety and medical protocols for the 2020 MLS is Back Tournament in Orlando were developed by MLS's medical department, in consultation with infectious disease specialists, government officials and public health entities with a focus on the safety of players, coaches, officials and staff. These build on the screening, monitoring and prevention efforts implemented since the start of individual training sessions on May 6.

Here’s a brief summary of the detailed protocol provided to all 26 MLS teams:

Testing and travel to Orlando

All 26 MLS clubs will travel to Orlando via charter plane and must arrive no later than seven days before their first match.

Prior to traveling to Orlando, all essential members of a club delegation must undergo two Polymerase Chain Reaction (“PCR”) tests 24 hours apart. Players will also undergo a baseline serology (antibody) test as part of a physical exam that also includes a temperature check and the completion of a screening questionnaire. PCR tests detect an active COVID-19 infection, typically via a nasal swab or saliva test. Serology (antibody) tests detect the presence of antibodies in response to a COVID-19 infection.

MLS is partnering with BioReference Lab to provide and process PCR tests and antibody (serology) tests for all clubs prior to travel, as well as on-site in Orlando during the competition.

Individuals who test PCR positive will not travel and will be isolated and overseen by club medical staff. Contact tracing will also be triggered to identify close contacts. Individuals who test PCR negative but serology positive may travel to Orlando if they are asymptomatic.

Arrival in Orlando

Upon arrival in Florida, all individuals will immediately receive an additional PCR test.

Players may begin training and staff may begin working only upon receipt of a negative result from the first PCR test in Orlando.

Testing in Orlando

During an individual’s first two weeks in Orlando, that person will be tested every other day. After those first 14 days, players, coaches and PRO staff will be tested regularly, including the day before each matchday.

In addition, self-temperature screenings and the completion of standardized screening questionnaires will be required for all individuals traveling to the ESPN Wide World of Sports Complex or providing services at the hotel and convention center where MLS league and club personnel will be staying.

A positive response to the daily questionnaire or a temperature check above 100.3 degrees must be reported and the individual in question will be isolated immediately and PCR testing will be performed.

Prevention

In addition to the screenings and testing described above, an MLS task force has worked with leading experts to create guidelines and best practices to help reduce risk and prevent spread of COVID-19. These include:

  • Wearing face coverings / face masks;
  • Social distancing;
  • General hygiene (Ex. avoid touching face, washing hands frequently, avoid sharing food, bottles, towels or equipment);
  • Cleaning and sanitization (disinfecting surfaces).

The Walt Disney World Resort and the Swan and Dolphin Hotel will be providing enhanced cleaning of all venues and enforcing appropriate capacity-management and other social distancing guidelines.

In-Match Prevention

General hygiene measures extend to the field for official matches:

  • Players, coaches and officials are asked to exercise care when spitting or clearing their nose;
  • Players, coaches and officials on the bench or technical area are required to wear masks and practice social distancing to the extent possible;
  • Players involved in the game are asked not to exchange jerseys or kiss the ball;
  • Masks or face shield protections should be used during press conferences or flash interviews.

Protocol for a positive COVID-19 test

If an individual develops COVID-19 symptoms, that person must first contact club medical staff via text, email or phone. An on-site telehealth physician will provide an evaluation, and next steps will be determined including potential isolation, testing or hospitalization.

If an individual tests positive as part of routine testing, that person will be relocated to an isolation area after evaluation by an on-site telehealth physician.

Isolation requires relocation to a room in a designated area of the hotel and that relocation would occur under a strict and detailed protocol to minimize the risk of transmission. The individual would remain in isolation and would be monitored daily and tested routinely.

A test-based plan or symptom-based plan will determine an individual's timeline for a return to play or work. Using the test-based plan, an individual can return to activity once the person is asymptomatic and tests PCR negative twice in a span of 24 hours. The symptom-based plan takes into account the days elapsed since the resolution of fever and the number of days since symptoms first appeared.

In either case, players who test positive will be required to undergo cardiac testing (high-sensitivity troponin, EKG and echocardiogram) before receiving final clearance from club medical staff to return to training.

Contact tracing is also mandatory in case of a positive COVID-19 test. This process identifies close contacts: individuals who spent at least 10 minutes within six feet of a person who has tested positive or is presumed positive. Those close contacts will also be tested and they can continue to train or work as long as they wear a face mask at all times when not competing, remain asymptomatic and continue to test negative.

Hospital visits unrelated to COVID-19

Any player who suffers an injury will be evaluated by his club’s medical staff. If hospitalization is required, MLS has identified hospitals and facilities in close proximity to team hotels and training fields.

After receiving hospital treatment unrelated to COVID-19, the player will not be required to isolate unless he becomes symptomatic or tests positive for COVID-19. If the player is identified as a close contact of someone who tested positive for COVID-19, that player will quarantine until the results of the first PCR test are obtained.

If the player can no longer play or train due to injury, a decision on potential travel home will be made jointly by MLS and the club.

High-Risk Individuals

Players considered to be in a high-risk category for severe illness related to COVID-19 will not be permitted to travel and participate in the tournament unless cleared by their club’s chief medical officer. Club staff members who are considered in a high-risk category will similarly need clearance from their primary care provider.

High-risk categories currently include:

  • Persons with chronic lung disease or moderate to severe asthma;
  • Persons who have serious heart conditions;
  • Persons who are immunocompromised;
  • Persons with diabetes;
  • Persons with chronic kidney disease undergoing dialysis;
  • Persons with liver disease;
  • Persons with severe obesity (body mass index of 40 or higher);
  • Persons who live in a nursing home or long-term care facility.

Post-Tournament Return

Teams will revert to existing league and club health and safety protocols when they return to their home market. These protocols were created in line with guidelines established by local public health and local government entities.

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