Florida continues to see record coronavirus cases and, at the same time, delays in getting test results.
But that's not the case for NBA and Major League Soccer athletes playing in the Orlando area. Their season restarts have included frequent and quick COVID-19 testing.
The discrepancy is raising ethical questions about the process.
Not helpful, and potentially dangerous
Florida Gov. Ron DeSantis has been criticized for his handling of the coronavirus outbreak, including opening the state early, in the beginning of May.
But this week, he's been sounding the alarm about delays residents are experiencing from the time they're tested, to when they get the results.
"If you have somebody go through one of the [testing] sites and then they get a result back ten days later, that is not really going to be very helpful," DeSantis said Wednesday.
In fact, it's potentially dangerous.
"Any delay in test results is another day that you, a normal person, can be walking around thinking you're negative when you're actually positive," said Zach Binney, an epidemiologist at Oxford College of Emory University. "You could be going to work as an essential worker while you're positive. You could be spending time around your family before you know you're positive. And so any delay, y'know even a few [days], could have an impact on somebody's health."
Ethics not optics
Major League Soccer's restart tournament rolled on this week in front of TV cameras but not fans. These athletes, and NBA players, are both living and playing in protective bubbles in the Orlando area. They've been getting daily or every-other-day testing with very quick results. For the NBA an average turnaround time of about 12 to 15 hours. For MLS, 12 to 24 hours.
It's not a good look, considering the delays outside the bubbles.
"I don't care about [the] optics," Binney said, "I care about ethics."
Binney would like to hear more from the leagues than their oft-repeated assurance that they, and the labs they're using, are not taking away testing capacity from the public.
"I would like to see a little bit of a deeper explanation of why they think that's not the case," Binney said, "when the same lab that's conducting MLS's tests, just a week ago, was saying that they weren't turning around some tests for six days on average."
BioReference Laboratories does the testing for MLS and the NBA, and many Florida residents. The lab's executive chairman, Dr. Jon Cohen, acknowledges the turnaround delays.
"[The lab] experienced a significant uptick in PCR COVID-19 testing demand," Cohen said, "which caused delays in turnaround times for results throughout June. In the beginning of July, BioReference cleared their backlog and stabilized the turnaround times from 5-7 days to 72 hours or less."
Still, the rapid returns with pro athletes stand out.
Asked whether those athletes are a priority, Cohen doesn't answer directly "yes" or "no." Instead, he says his company customizes testing to the needs of each client.
"It's no different in my mind than a hospital that needs patients tested within a certain period of time," he said, "which is not different than nursing homes that may need a certain turnaround time."
The sports leagues needed fast turnaround times so they could get up and running quickly, with narrow windows to complete their truncated seasons. And while many insist these young, rich, low risk [for COVID-19] athletes are getting preferential treatment, Cohen disagrees and notes the leagues are more than the athletes.
"I consider MLS, the NBA, large employers," he said. "Literally thousands of people work for these leagues. So we're supporting, in some sense, the economic return of the country when we support large employers. Whether it's a sports franchise, or a retailer, or large manufacturer, or a food service organization.
"A lot of people want to say, 'oh, this is about special testing' or whatever you want to call it. It's not about that. For us, it's about how do we support this industry so that people can return to work. And there are real jobs at stake here."
Cohen insists BioReference's commitment to pro sports leagues in Florida doesn't take away from its work with the public.
"We're testing an enormous amount for the general public," Cohen said. "We have quite honestly put more resources into Florida, brought more analyzers to Florida, our hospital clients, urgent care clients, physician clients in Florida, as they're needed, [have] increased in the last several weeks. We have delivered on those needs."
A person with knowledge of the NBA's testing program adds that the tests administered to the league's players, staff and other personnel were "brought in" for the restart. "The tests wouldn't have been in the community if the NBA weren't there."
Still, the NBA and MLS appear sensitive to the criticism.
Next week, the NBA plans to launch a mobile testing site and host a drive-through testing event for the public. MLS is working with BioReference to provide antibody testing for the Orlando community.
The ethical questions and moral judgments on who gets what, when.... ultimately are a symptom of a larger issue - the country's patchwork approach to the pandemic. Questions and judgments might fade if there were sufficient tests and enough testers to process them quickly.
But demand still outpaces supply.
"The problem is not one versus the other [when it comes to testing]," Cohen said. "The issue is the country's doing 700,000 tests a day and we probably should be doing two million tests a day. So that's the question. How do we get from 700,000 to two million?"