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Sport How the masterminds behind the WNBA's bubble successfully avoided an outbreak in the heart of a COVID-19 hotspot

07:05  31 october  2020
07:05  31 october  2020 Source:   msn.com

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How the masterminds behind the WNBA ' s bubble successfully avoided an outbreak in the heart of a COVID - 19 hotspot . Once they informed a person of a positive result, the medical team would instruct the individual to gather their belongings before transporting them to isolation at a separate

How many additional refutations do we need for people to stop suggesting the use of lockdowns? pic.twitter.com/5xZehDtNAB. The one thing everyone will agree on is that the Chinese don’t seem to be too concerned about Covid - 19 anymore. Think your friends would be interested?

Here's the story of the WNBA bubble, as told by WNBA Commissioner Cathy Engelbert, Lynx star Napheesa Collier, and medical staff in the © Provided by INSIDER Here's the story of the WNBA bubble, as told by WNBA Commissioner Cathy Engelbert, Lynx star Napheesa Collier, and medical staff in the "Wubble." Julio Aguilar/Getty Images
  • The WNBA hosted its full 2020 season in a bubble at IMG Academy in Bradenton, Florida.
  • Despite being tasked with protecting the players and staff in the "Wubble" for 97 days, the league and medical professionals JobSiteCare managed to avoid an outbreak and keep more than 300 people safe.
  • Insider spoke to WNBA Commissioner Cathy Engelbert, Minnesota Lynx star Napheesa Collier, JobSiteCare founder and CEO Dr. Dan Carlin, and nurse Laura Bartos — who was in the Wubble all season — about the monumental feat.
  • Visit Insider's homepage for more stories.

Less than a week after the Seattle Storm completed their three-game sweep of the Las Vegas Aces to win the 2020 WNBA title, Laura Bartos was still in disbelief at what she and her colleagues had accomplished.

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On December 31 of last year, Chinese authorities alerted the World Health Organization of an outbreak of a novel strain of coronavirus causing severe The resulting genomic sequence data has shown that Chinese authorities rapidly detected the epidemic and that the number of COVID - 19 cases have been

Also, that he has been comparing Covid - 19 to influenza, in terms of how serious it is. What is now happening is extremely disturbing. Covid - 19 has certainly been a serious disease, but the flu epidemics of 1957 and 1967 were just as The reality is that Covid - 19 has all but gone in the UK and Europe.

"It's super hard to comprehend and weird to think that I'm part of that type of history," Bartos told Insider. "I think in a couple of weeks it will like hit me that I was part of it. I was there for this. I stood by these women for this."

But Bartos wasn't a member of the Storm, nor was she suiting up for the Aces. In fact, she isn't a WNBA player at all. She's a nurse.

Bartos spent a whopping 97 days living in the "Wubble" — as the WNBA's bubble at IMG Academy in Bradenton, Florida, became affectionately known — while working tirelessly to keep the players, coaches, and staff inside safe and healthy amid the COVID-19 pandemic. She is one of three medical professionals in the Wubble working for JobSiteCare, the telemedicine practice tasked with formulating and executing the league's health and safety protocols throughout the 2020 season.

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Find out how previous health crises came to an end, giving us clues as to how our future may unfold. Three major outbreaks , the earliest recorded in 541 AD. Back in the Dark Ages, about 60 generations ago, Jasmine' s relatives lived through a Covid - 19 - the unprecedented coronavirus.

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a sign in front of a building: IMG Academy in Bradenton, Florida, played host to the 2020 WNBA season. Kim Klement-USA TODAY Sports © Kim Klement-USA TODAY Sports IMG Academy in Bradenton, Florida, played host to the 2020 WNBA season. Kim Klement-USA TODAY Sports

Despite having hundreds of players, coaches, trainers, and support staffers to care for day-in and day-out, Bartos and her colleagues successfully avoided a Wubble outbreak. They enabled the WNBA to crown a champion at the end of its abridged season. And that constitutes "a small moment in medical history," at least according to JobSiteCare founder and CEO Dr. Dan Carlin.

"Not to overstate it, but it was," Carlin told Insider. "This was telemedicine, infectious disease, population healthcare, nursing. There were like 20 different components of this thing. And they came together, and they defined a little bit about what the future's gonna look like, especially with telemedicine."

In addition to Bartos and Carlin, Insider spoke with Minnesota Lynx superstar and 2020 All-WNBA second-teamer Napheesa Collier and league commissioner Cathy Engelbert about their experiences with the Wubble and how the 2020 season came to fruition.

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"First and foremost, I'm incredibly proud that we've reached this point and accomplished what we did related to COVID-19 health and safety," Engelbert told members of the press on October 1. "That, again, was our principle number one. ... Zero positive COVID-19 cases for players and team staff during the regular season and playoffs."

"The health and safety measures got us here, and it led to 87 nationally televised games."

a woman talking on a cell phone: WNBA Commissioner Cathy Engelbert takes in a game in the Wubble. Douglas DeFelice-USA TODAY Sports © Douglas DeFelice-USA TODAY Sports WNBA Commissioner Cathy Engelbert takes in a game in the Wubble. Douglas DeFelice-USA TODAY Sports

Though daunting, shaping the Wubble was an "irresistible proposition" for curious scientific minds

As virtually every major sports league on the planet shut down operations in March, and the COVID-19 pandemic rapidly increased in both severity and scope, Engelbert and her colleagues at the helm of the WNBA were carefully evaluating the situation. Early on, it became evident that the upcoming 2020 season — slated to tip-off early in the summer — would not occur as planned.

The league pushed back its start date and began formulating its backup plan as the prospect of traveling between cities and inviting fans into arenas faded out of possibility. With rumors swirling about the NWSL, NBA, and MLB considering isolated bubbles to restart play, WNBA leadership began mulling over the viability of establishing a quarantine campus of its own.

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Soon enough, plans were in motion. In June, the league announced that it would host its 2020 season at IMG Academy in Bradenton, Florida, beginning the following month. But despite having a location and a start date hammered down, the logistics of caring for 144 players and countless others safely and effectively — and in one of the states hardest hit by COVID-19, no less — were still in question. That's when Engelbert and company tapped JobSiteCare — one of the country's oldest telemedicine practices — to take the reins.

"One of our sort of core values is curiosity, like scientific curiosity," Carlin said. "So the idea of 'Geez, can we jump in here and build perfect quarantine bubble in a relatively — high risk is too strong a word — but in a really challenging environment [and with] a lot of teams coming in all over the country?' ... It was irresistible and a little scary at the beginning."

Fortunately for Carlin and his staff, the WNBA was at a huge advantage by the time the JobSiteCare team came aboard; the NBA had already hashed out protocols for a bubble in Orlando and graciously allowed its sister league to adapt those plans to its own unique situation some 100 miles southwest.

"We had some pretty good protocols to work with that made perfect clinical sense, meaning they were really credible isolation protocols, testing protocols, responding to a positive," Carlin said. "We felt pretty good going, 'You know what? These make sense.'"

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a person wearing a costume: A WNBA staffer cleans and sanitizes the ball before gameplay. Julio Aguilar/Getty Images © Julio Aguilar/Getty Images A WNBA staffer cleans and sanitizes the ball before gameplay. Julio Aguilar/Getty Images

Those protocols — and the league's communication with players — were enough to convince many of the WNBA's biggest stars to participate in the 2020 season in Bradenton.

"That was everyone's biggest concern initially," Collier told Insider. "Is it going to be safe for us? And I thought they did a really good job of not only coming up with a great plan but also keeping us really in the loop with details about what it's going to look like. So that's why I felt comfortable going."

"I just felt that they were really prepared so that if anything did happen, we were going to be taken care of," she added.

But preparing health procedures for the Wubble and actually implementing them were two different beasts

"Scientifically, the tricky part is now to enforce compliance, meaning make sure everybody plays by the rules that gets tested every day," Carlin said.

Even though countless people were involved in generating the strategy to keep players and staff safe inside the Wubble, a small, tight-knit team of just three medical professionals — all women — were actually on-site in Bradenton to execute the plan.

Bartos, fellow nurse Linda Hydro, and nurse practitioner Rachel Lattner lived in the Wubble while running the league's coronavirus testing procedures. Each day, the trio would test each person in the bubble and update their temperature and symptoms in an app specifically designed to help monitor the situation.

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A medical professional in protection gloves examines and organizes COVID-19 test kits. Tang Ming Tung/Getty Images © Provided by INSIDER A medical professional in protection gloves examines and organizes COVID-19 test kits. Tang Ming Tung/Getty Images

Upon arrival, everyone self-isolated in their own rooms for four days and had to return multiple consecutive negative COVID tests to gain access to the WNBA's entire quarantine campus. If they had questions or concerns, players, coaches, and staff could communicate with the JobSiteCare team 24/7 via e-mail or text.

"It all happened so fast that you really don't know what to expect until you're there," Bartos said. "There was a little bit of fear that it wouldn't be successful."

"We were scared of failing," Carlin added. "We were terrified someone was going to sneak in with COVID. We couldn't let that happen — and we didn't, obviously — but there was some real anxiety, and I guess when you're a little afraid, you work even harder. But that was very real at the beginning."

Earning everyone's trust early on was crucial to the success of the medical staff's efforts, according to Bartos.

"Coming in and gaining trust of everyone was huge because then they would listen, and they understood that we're not telling you you have COVID because we're trying to be mean," Bartos said. "We're trying to keep you safe. The first weeks were huge with implementing our protocols because it set the tone that this is what we have to do to keep you guys safe so we can get you on the court so you can play."

The worst part about nursing in the Wubble was telling people they had COVID-19 when they arrived

With players, coaches, and support staff flying in from all over the United States and around the world, it was no surprise that Bartos' team had to deal with a handful of positive COVID tests right from the jump. The medical staff received a phone call from the lab right away if someone tested positive. Then, they would have to break the news to the individual in question.

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"Telling someone that they had COVID or tested positive was my least favorite part of this job," Bartos said. "You just felt so bad. And even though it could have been a false positive, it does make you realize how fearful these people are of COVID and that they don't know the medical background of it."

Glory Johnson on a court: Glory Johnson of the Atlanta Dream was one of a handful of individuals who tested positive for COVID-19 after her arrival at IMG Academy. Julio Aguilar/Getty Images © Julio Aguilar/Getty Images Glory Johnson of the Atlanta Dream was one of a handful of individuals who tested positive for COVID-19 after her arrival at IMG Academy. Julio Aguilar/Getty Images

Once they informed a person of a positive result, the medical team would instruct the individual to gather their belongings before transporting them to isolation at a separate hotel about a mile from the main Wubble campus. There, they would receive a second COVID-19 swab shortly to verify the first test.

If the second test came back positive, the person remained in quarantine for two weeks until they returned two consecutive negative results and a third negative test 24 hours later.

"It does take a mental toll," Bartos said. "It can take a mental toll on anyone. So as a medical staff, we, we would reach out to them very frequently with either a text message, and they would always get a FaceTime visit from our nurse practitioner. We just had to reassure them that we are here for them. And no matter what, if they need to talk to us, we were here. So a lot of the people, when we had to isolate them, they would text us just a normal conversation, just to know that they have someone on their side."


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Bartos estimated that she and her colleagues had to implement their predetermined protocol for positive COVID-19 test results a dozen times during their 97 days in the Wubble. And fortunately for everyone involved, the only true positives came within the first week, meaning that those individuals contracted the novel coronavirus before arriving at the WNBA's campus.

"The protocol we put in to get them to that place to keep them in a bubble format was huge," Bartos said. "And it was such a sense of accomplishment."

a woman holding a football ball: Staff wore gloves and masks in the Wubbl AP Photo/Phelan M. Ebenhack © AP Photo/Phelan M. Ebenhack Staff wore gloves and masks in the Wubbl AP Photo/Phelan M. Ebenhack

With roughly 2 weeks to go before the end of the season, an improbable scare rocked the WNBA playoffs

The Wubble and the vast majority of its inhabitants had returned 80 consecutive negative COVID tests as the eventual champions prepared to face the fourth-seeded Lynx in a best-of-five semifinal series. But one day before Game 1 was set to tip-off, the Storm had a big problem on their hands.

Three players returned inconclusive COVID-19 tests at the same time.

"We all sat around the table just trying to brainstorm what could have happened," Bartos said. "I prayed the whole time. I thought they had to be false positives, like what could have happened?"

"You know, for all of us, it was like, where did we miss? Did we misfire?" Carlin added. "What happened here? So it was very anxiety-provoking."

Rumors began flying around the Wubble about how the virus could've made its way inside after a nearly three-month clean record, according to Carlin. Had someone secretly left the confines of IMG Academy and returned after having contracted the virus? Had someone snuck someone onto campus?

"We did assume that because there were three on one team that someone actually did have it," Collier said. "So we we're just worried about, one, that person recovering. And then, you know, what's it gonna look like going forward for the series? Are we going to have to postpone games, or does that mean they're forfeiting a game?"

"I wasn't so worried about my personal health, but just the health of the other players and then what it might look like for the series," she added.

a person holding a basketball: Minnesota Lynx star Napheesa Collier shoots over the Seattle Storm's Jewell Loyd and Breanna Stewart. Douglas DeFelice-USA TODAY Sports © Douglas DeFelice-USA TODAY Sports Minnesota Lynx star Napheesa Collier shoots over the Seattle Storm's Jewell Loyd and Breanna Stewart. Douglas DeFelice-USA TODAY Sports

Though the medical staff was deeply skeptical that the coronavirus had infiltrated the seemingly-impenetrable bubble, Bartos and her colleagues on the ground once again executed the pre-planned isolation protocols. All three Seattle players gathered their belongings and moved over to rooms in the quarantine hotel.

Game 1 was postponed "out of an abundance of caution," according to a league press release, and subsequently rescheduled for two days later. In the meantime, the three players took a second test.

"We were evaluating this very closely because we hadn't had multiple people [return inconclusive tests] on one day," Engelbert said on a media call on September 22. "That's why, again, we consulted and made the decision to postpone the game. But we had not had a lot of experience [with multiple people on one day]."

In the first 24 hours following their initial inconclusive tests, all three players tested negative. Then, on the day of the rescheduled first game of the Storm-Lynx series, two of the players returned yet another negative test that morning. The third player's test came back later that afternoon, and the entire Seattle roster was available in time for tipoff.

"For everyone, that 72 hour period was definitely very stressful — from the team standpoint as well as from the medical standpoint," Bartos said. "It just didn't make sense that to me. It just didn't make sense."

Three Seattle Storm players returned inconclusive COVID-19 tests — all at the same time during the WNBA playoffs. Mary Holt-USA TODAY Sports © Mary Holt-USA TODAY Sports Three Seattle Storm players returned inconclusive COVID-19 tests — all at the same time during the WNBA playoffs. Mary Holt-USA TODAY Sports

Even without a much-feared coronavirus outbreak, the medical staff had plenty of challenges to overcome

Thanks to its medical staff's arduous efforts, the WNBA successfully avoided the worst possible outcome for what undoubtedly constitutes the most challenging season in its 24-year history. Still, Bartos, Carlin, and the rest of the JobSiteCare team were forced to navigate several obstacles while ensuring the health and safety of the players, coaches, and staff in the Wubble. The first week or two of the WNBA's stint at IMG Academy left the JobSiteCare team scrambling to address various issues they either overlooked before arrival or assumed would be handled differently in theory than in practice.

"We had so much change to deal with in those early days," Carlin said. "It was like the mission's changing [and] our infrastructure isn't quite what we thought."

The medical staff quickly realized that their original method for tracking who within the Wubble had been tested each day would not suffice. So after Bartos, Hydro, and Lattner already had a few days of testing the Wubble community for COVID-19, JobSiteCare Chief Technology Officer Adam Wooten tackled the problem head-on.

Wooten — who has a Ph.D. in Computational Chemistry — conceptualized and coded original software that allowed the nurses on the ground in Bradenton to manage better who had been tested each day. If someone missed a task, the software would alert the medical officials in the Wubble and allow them to call the individual back in for PCR testing.

a person in a blue shirt: A medical assistant administers a COVID-19 test in Fridley, Minnesota. Aaron Lavinsky/Star Tribune via Getty Images © Aaron Lavinsky/Star Tribune via Getty Images A medical assistant administers a COVID-19 test in Fridley, Minnesota. Aaron Lavinsky/Star Tribune via Getty Images

"It was a big deal to organize all of the testing, so it was reportable and then ultimately actionable for anybody who had a positive test," Carlin said. "It was a rapidly developed piece of essential technology that I think all of us had assumed was already there [via the testing company]."

And in addition to shouldering the already-hefty responsibility of preventing a COVID-19 outbreak, Bartos, Hydro, and Lattner took on yet another full-time job in the Wubble. Thanks to the countless bumps and bruises that necessarily come along with athletes competing night after night, the trio was tasked with building and running a full-service sports medicine orthopedic clinic for the WNBA.

"It was clear within a week or two, the primary need was for a sports medicine clinic," Carlin said. "The patients were all injured athletes, aging athletes with arthritis, jammed fingers, or rotator injuries."

For Collier, that was "not surprising" in the least.

"There were so many injuries this season with people getting hurt and having to see those doctors," she said. "But everything I heard from people on other teams or anyone who had to see them, their experience was great."

Connecticut Sun star Alyssa Thomas exited a playoff game upon dislocating her right shoulder. Douglas DeFelice-USA TODAY Sports © Douglas DeFelice-USA TODAY Sports Connecticut Sun star Alyssa Thomas exited a playoff game upon dislocating her right shoulder. Douglas DeFelice-USA TODAY Sports

Bartos, who is trained as an Intensive Care Unit nurse, had to learn and adapt on the fly with the help of sports medicine physicians who were brought into the Wubble. Dr. Valerie Cothran — a sports medicine physician from the University of Maryland whom Carlin called "a superstar" — did two separate stints in Bradenton and made it clear to the JobSiteCare staff that their general purpose clinic would quickly need to shift into one focused almost entirely on sports medicine.

"The biggest thing was we had to be flexible," Bartos said. "I adapted to sports medicine. The doctors were really great who we worked with. They really helped us to learn quickly and easily."

But meeting the demands of the WNBA players in the Wubble was even more complicated than that. Since Carlin and the company hadn't anticipated facing the slew of sports medicine cases coming their way, they didn't prepare the materials necessary to handle them adequately.

Whereas the NBA had X-Ray and MRI machines inside Orlando's bubble, the WNBA had no such imaging tools at its disposal. So any time a player suffered an injury that needed more serious attention than the medical team on IMG Academy's campus could provide, Bartos, Hydro, or Lattner had to accompany them to an imaging center located outside of the Wubble's confines.

a group of people standing on a basketball court: Las Vegas Aces forward and back-to-back WNBA Sixth Woman Dearica Hamby suffered a season-ending knee injury during the 2020 WNBA playoffs. AP Photo/Phelan M. Ebenhack © AP Photo/Phelan M. Ebenhack Las Vegas Aces forward and back-to-back WNBA Sixth Woman Dearica Hamby suffered a season-ending knee injury during the 2020 WNBA playoffs. AP Photo/Phelan M. Ebenhack

"We had to go across town," Carlin said. "We had a great relationship with imaging center. They were wonderful. They would literally sterilize the facility for our guys coming in, but someone's got to take [the players] over there and get them through the procedure and get them back. So we were constantly short-handed and running really, really long days because we had lost a person to transporting one of the athletes."

"My last image was the Monday before I left, and I think I cried," Bartos added. "I just felt so accomplished because we did over 150 images, and not one person got COVID."

Everyone involved would do it again — but they'd all suggest some changes

Nobody wants to find themselves in a position where a second WNBA bubble is the safest way to complete a season.

"Hopefully, the fire is under control [by next season]," Engelbert told the press during a call on October 1. "We get anti-virals, we get a vaccine, we get rapid testing that's affordable that fans will feel comfortable getting tested, coming into the arena."

But if a Wubble 2.0 is necessary, Engelbert said that she would certainly "revisit it."

"A lot of people are asking that question: would you do it again?" Engelbert said. "We may be in a position where we have to do it again, but we need to be prepared for a variety of outcomes here. I think our teams would like to get their fans back in their arenas, but certainly, would we do it again? We'd revisit it because, again, I think it's so important to stay in the sports landscape."

Isolation in Bradenton was undoubtedly taxing for players. In an interview with JJ Redick and Tommy Alter on "The Old Man and the Three" podcast published on October 14, WNBA legend and Storm point guard Sue Bird admitted that having her girlfriend — US Women's National Team star Megan Rapinoe — with her in the Wubble was crucial "to keep me sane."

Sue Bird standing next to a woman: Sue Bird (right) celebrates her fourth WNBA title with her girlfriend, USWNT superstar Megan Rapinoe, by her side. AP Photo/Chris O'Meara © Provided by INSIDER Sue Bird (right) celebrates her fourth WNBA title with her girlfriend, USWNT superstar Megan Rapinoe, by her side. AP Photo/Chris O'Meara

"Every time I even went to complain with my teammates, I'd be like 'Ah, let me pull that one back' because I actually have someone here," Bird said. "You couldn't get away from basketball. It was surrounding you. There wasn't much to do to distract from that. But I was one of the few ... who had their significant others. I was very lucky."

So it was no surprise, then, that Collier would call on the league to allow more guests — in a safe manner — next time around.

"The only thing I would change was, hopefully, they would let more people bring plus-ones," she said. "Or, you know, at least an animal, because we weren't allowed to bring those either. Just because it's such a long time to be there by yourself."

"But from a how they handled everything aspect, I thought they did a great job, and there was nothing really that I would change," Collier added. "I would do it again."

When it comes to "how they handled everything," Carlin acknowledged that he and his JobSiteCare team could have done everything more efficiently and with less strain had "a little bit more advanced notice" to prepare.

"If we had a month or six weeks advanced notice, or even eight weeks advance notice, you can line up things in a less hurried fashion," he said. "So that's stressful. I mean, that would be number one. And I would actually use that time to sort of check our assumptions."

For Bartos, just one important change comes to mind: "If they could do imaging — the MRI — actually on site, that would have been a really big help."

According to Bartos, as Carlin anticipated before the 2020 WNBA season even began, the Wubble experience was "a once in a lifetime" event. And even though she described struggling with the confines of the Wubble and having been separated from her loved ones for so long, Bartos said she thinks she "would do another bubble."

a man sitting at a desk: An announcer prepares for a WNBA game in the Wubble. AP Photo/Phelan M. Ebenhack © AP Photo/Phelan M. Ebenhack An announcer prepares for a WNBA game in the Wubble. AP Photo/Phelan M. Ebenhack

"It's funny because I was the one that they would say, like I would really have to think about it," Bartos said. "But since I've been home and I got out of the bubble, I think I would be up to do it again. The last couple of days with the sense of accomplishment, it was really awesome."

And even though he was never living in the Wubble, Carlin felt a similar sense of achievement after all that his team had done throughout the season.

"It was really great to validate our expertise, so to speak," he said. "This was a moment to say we can really prove we knew what we were doing. We've been at this for almost 20 some odd years at this point. So this was for us a moment of triumph. Like it works, our system works, we did a great mission, and great service in a really unique environment. So it was very validating."

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