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Big Ten Medical Protocols for football season explained

Daily testing and clear guidelines for being cleared to play was the basis for the league to decide to move forward with the football season.

Michigan v Maryland Photo by Joe Robbins/Getty Images

With the Big Ten announcing on Wednesday that the football season will begin on October 23, originally postponed on August 11, the decision in a statement released by the league was due to having “adopted significant medical protocols” in regard to Covid-19. It was an unanimous decision by the 14 members of the Council of Presidents driven by the plan to include “daily antigen testing, enhanced cardiac screening and an enhanced data-driven approach when making decisions about practice/competition.”

“From the onset of the pandemic, our highest priority has been the health and the safety of our students. The new medical protocols and standards put into place by the Big Ten Return To Competition Task Force were pivotal in the decision to move forward with sports in the conference,” said Morton Schapiro, Chair of the Big Ten Council of Presidents/Chancellors and Northwestern University President, and Chair of the Return to Competition Task Force Steering Committee. “We appreciate the conference’s dedication to developing the necessary safety procedures for our students and the communities that embrace them.”

Each Big Ten team will designate a Chief Infection Officer (CInO) that will oversee testing data for Covid-19, which will be reported to the league office. Thresholds have been established so there is a clear course of action for teams to proceed based on positivity rates for each team and the populations for each campus. Daily testing for teams will begin on September 30.

The positivity rates will be based on a seven day rolling average. Here is an explanation of the system:

A team positivity rate of less than 2% and a population positivity rate of less than 7.5% means that normal practice time and games can take place for those programs.

A team positivity rate between 2% to 5% and a population positivity rate from 3.5% or higher results in teams being mandated to proceed with caution and enhance COVID-19 prevention by altering its practice and meeting schedule, while also determining whether they are able to play games.

A team positivity rate higher than 5% and population positivity rate higher than 7.5% triggers teams to be forced to stop practice and not play any games for a minimum of 7 days. They won’t be cleared until those positivity rates improve.

“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,” said Dr. Jim Borchers, Head Team Physician, The Ohio State University and co-chair of the Return to Competition Task Force medical subcommittee.

“The data we are going to collect from testing and the cardiac registry will provide major contributions for all 14 Big Ten institutions as they study COVID-19 and attempt to mitigate the spread of the disease among wider communities.”

It’s encouraging that the Big Ten instituted a system with clear guidelines established along with rapid, daily testing. However, with an anticipated schedule for eight games in a nine week period, it will be difficult to reschedule any potentially cancelled contests due to teams not being cleared to play based on the postitivity rate guidelines. Hopefully, with over five weeks until the season begins and daily testing beginning at the start of October, the league will be successful in completing the modified schedule. More on the schedule once the Big Ten releases it.

As for guidelines for the student-athletes, coaches and other personnel, here is a detailed explanation from the Big Ten:

1. The Big Ten will require student-athletes, coaches, trainers and other individuals that are on the field for all practices and games to undergo daily antigen testing.

2. Test results must be completed and recorded prior to each practice or game.

3. Student-athletes who test positive for the coronavirus through point of contact (POC) daily testing would require a polymerase chain reaction (PCR) test to confirm the result of the POC test.

4. The daily testing will begin by September 30, 2020.


1. All COVID-19 positive student-athletes will have to undergo comprehensive cardiac testing to include labs and biomarkers, ECG, Echocardiogram and Cardiac MRI.

2. Following the cardiac evaluation, student-athletes must receive clearance from a cardiologist designated by the university for the primary purpose of cardiac clearance for COVID-19 positive athletes.

3. The earliest an athlete can return to game competition is 21 days following a COVID-19 positive diagnosis.

4. In addition to the medical protocols approved, the 14 Big Ten institutions will establish a cardiac registry in an effort to examine the effects on COVID-19 positive student-athletes.

5. The registry and associated data will attempt to answer many of the unknowns regarding the cardiac manifestations in COVID-19 positive elite athletes.