Gunner Thoughts

Given it’s a health crisis, shouldn’t doctors lead the way?

Given it’s a health crisis, shouldn’t doctors lead the way? “As doctors, how can we ‘approve’ guidelines that still carry risk of death?”

As Germany’s Bundesliga aims to restart on May 15th and conversations for the Premier League are ramping up in efforts to push toward a restart sometime in June, there has been an odd silence from one of area of the league when it comes to solutions – medical staff. During a global pandemic, this silence has been noted by a few people, but most of the spotlight has remained on the Premier League’s governing body, the PFA, or owners. That is, until yesterday.

David Ornstein and The Athletic broke the news that Club doctors representing the Premier League Doctors Group (PLDG) wrote a detailed document to the Premier League medical advisor Mark Gillett and director of football Richard Garlick, in an effort to gain answers to a wide array of roughly 100 questions and concerns surrounding the return to training.

 Ornstein writes:

“The communication, seen by The Athletic, is split into 10 subject areas and within each of them it warns of multiple COVID-19 concerns that the medics say have not been addressed, including:

  • Approving guidelines that still carry risk of death
  • Liability, insurance and testing for players, staff and their families
  • Possible transmission via sweat and goalkeeper gloves
  • Suspicions that some clubs are already ignoring guidelines
  • Increased risk for black, Asian and minority ethnic (BAME) groups
  • Ability of emergency services to attend training ground incidents

Medics were invited to send their points anonymously to the PLDG on Sunday and these were collated before being forwarded to [Mark] Gillett and [Richard] Garlick on Monday.”

This is a crucial point in the journey that is Project Restart and, as you would expect, many of their questions and concerns are extremely valid. Who is responsible for health risk assessment, the club or the league? Should they consider heightened risk for BAME groups? Who is liable and does current insurances cover this? There are conflicts between guidelines and the inevitable needs of these players that will interfere with medical staff performing their job. Ethical dilemmas. Can the virus be transmitted through sweat? Should goalies be advised to wear gloves underneath their goalkeeper gloves? How long does the virus live on goalkeeper gloves?

The questions in the article continue on and on and I strongly urge those interested in the topic to read The Athletic article, but I think the highlighted bits above shed some light on the granular details the PLDG are seeking. They even site a case involving a young, 23-year-old midfielder from Montpellier who was hospitalized with COVID-19 as an example of this virus not being limited to only elderly patients.

To add to the worries based on Coronavirus, the document also suggested a few worrisome details surrounding clubs themselves. “Suspicions that some clubs are already ignoring guidelines” and “Lots of pressure on individual medical teams to reassure players and staff on something we are very uncertain about…”

In a follow-up on The Ornstein & Chapman podcast, they discuss these two aspects in order to shed a little bit more light on the respective situations. Ornstein adds that some members of the PLDG not only fear there are already clubs breaking guidelines and protocols, they are doing so for the purpose of gaining a competitive edge over other clubs.

Potentially more worrisome is the suggestions that medical staff may be facing pressure from their club to reassure players and staff everything is okay and not to impede on the League’s attempt to restart given that other suggested outcomes for the season may have a negative effect on them.

There is a lot of information to take in between the article and follow up podcast. On a positive note, the Premier League has assured The Athletic that this document was produced because they were actively seeking feedback and they were committed to answering and responding to each of these questions and concerns.

However, if there is one aspect and quote that sums up the severity of these concerns and this attempt at a restart it’s this:

“As doctors, how can we ‘approve’ guidelines that still carry risk of death?”

To clear the air on some additional details that surround this. It is unclear how many or which of the PLDG doctors contributed to these concerns. They submitted it as a group, but that does not expressly tell us if this was all 20 club representatives contributing or if most of these concerns were put forth by a handful of the group.

Secondly, the Premier League should be given some praise in all of this since it was noted that they apparently were actively awaiting and seeking this information. While they intend to respond to these concerns, it is unclear the extents in which the issues raised will affect what’s to come.

However, it cannot go unacknowledged that 100 concerns are a LOT of concerns and to make matters worse, these are simply the questions and concerns medical staff has over clubs returning to training. While a lot of these the answers for these concerns will also answer similar worries for matches, from the phrasing used in the article we can assume, if asked, there would potentially be even more.

What we will need to wait and see is if these concerns are mitigated by the league which will be satisfied with supplying some degree of response, or if this amount of anxieties from medical professionals will give some pause to rushing a restart. According to Ornstein himself, in the podcast, the league is determined to see games resume in a timely fashion, so it is hard to imagine this will prevent that from happening unless it is the players themselves that refuse to play.

Which brings me to my largest question. Given that this is a health crisis which deems this group of medical professionals as experts on the matter, shouldn’t their lack of clarity, immense amount of fears, and hesitations weigh heavily in the decision-making process? Shouldn’t it be our doctors at the forefront of this decision?

In yesterday’s blog, I wrote about the ranking of priorities seeming to differ from what the league was verbally saying and what the potential solutions to the league were showcasing. In every sound bite, we are assured that safety is the more important factor, and yet here we have some serious hesitations that safety can be assured, and it is coming from experts.

We will have to wait to see how the league reacts to this document and the now public knowledge of the issues raised in an effort to quell fears, but in the absence of serious adjustments, answers, and measures – it is hard to believe player safety is the true top priority in forcing a restart. The economic side of this issue is easy to understand, it’s a microcosm of what global economies face but the PLDG said it best, “how can we ‘approve’ guidelines that still carry risk of death?”

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