TUSCALOOSA, Ala. – About a month ago, about 600 miles west of here, a Texas A&M football player registered positive for COVID-19 during a routine PCR test performed by the SEC.
Convinced that she was not doing anything to endanger herself, the player sought her own test from the student health center on the College Station campus. The result was negative. Over the next few days, the school tested the player three times more and produced all negative results.
The football player was cleared by the SEC office, and then, days later on October 3, the conference’s COVID task force drafted a new topic for its 34-page medical guidance policy to address false positive tests. The new 1
Then last Thursday, completely under the radar and without any fanfare or announcement, league presidents and chancellors voted unanimously to implement the change.
They did not know how consistent it would be.
Nine days later, the game’s most successful active college football coach, Alabama’s Nick Saban, has been cleared to pursue the sidelines of what is the sport’s biggest game to date, with No. 2 Crimson Tide hosting No. 3 Georgia.
He has Aggies to thank for that.
“It’s interesting to sit here and watch it unfold,” Texas A&M athletic instructor Ross Bjork said in an interview with SI on Saturday. “The origins were here in Texas A&M. If it benefits Coach Saban or another player, that’s why it’s been put in place. ”
Without the football incident, without the rapid change of policy and without an urgent test for a mobile-based laboratory on Saturday morning, Saban would not be in such a position. He would instead be quarantined for several days during an initial positive test, which doctors say was probably due to either a laboratory defect, defective equipment or perhaps probably step-by-step traces of viral substance that were first detected but which had then spread during subsequent testing.
“We will no doubt discuss the Saban situation in the future,” said Jeff Dugas, Troy’s team doctor and an orthopedic surgeon in Birmingham, who chairs Sun Belt’s COVID-19 advisory panel. “Is this opening of Pandora’s box a bit, so anyone who tests positive, we should test again and test again and test again?”
Saban’s positive test, taken Tuesday and announced Wednesday, sent waves through college football pond, exacerbated by the timing – four days before one of the most anticipated games in the most powerful conference of the most bizarre season college football has seen in decades.
But the door to Saban’s return was always open, rooted in the little-known, brand-new policy. In appearances he made both Wednesday and Thursday nights, he subtly hinted at a potential return.
There were other clues that something was abnormal in this case. A strict supporter of COVID guidelines, always wearing a mask and keeping his distance, Saban’s test result stunned those close to him. His first positive test was not performed by the SEC’s lab, but with a lab that Alabama contracted with its own more improved test protocol, even stricter than the league’s model three times a week.
He was then administered PCR tests on Thursday, Friday and Saturday mornings, this time each to one of the league’s own laboratories in Mobile. They all returned negative. The last one was transported to the laboratory around noon. 7 Saturday for a three-and-a-half-hour ride and was treated within 90 minutes – a quick but possible time frame, doctors say. The result returned to Alabama officials in time to release a statement at. 11:20
And with that, Saban is training Saturday night using a policy that did not exist until last Thursday, five days before he tested positive.
It all goes back to College Station, Texas.
Without revealing the player’s name, Bjork explained that one of his football players tested positive on 20 September. Seven other players and staff were considered to have been close contacts and triggered a 14-day quarantine. The Aggies even had to postpone their next match against Auburn.
After the player recorded four consecutive negative tests, Bjork and his staff brought the matter to the league, whose medical task force had already considered the possibility, led by Florida team doctor Jay Clugston.
“There was no policy at the time to clear her unless there was a true lab error,” Bjork says. “We worked through the SEC to get it fixed as a lab error, and then we made a recommendation to the task force to review the policy and check positive tests.
“Our agreement was that we must use common sense and make sure we are accurate. If you test that much, there will probably be fakes. If we were to be the example to get it started, so be it, ”he says. “As soon as the news happened on Friday [about Saban] that it could have been a false positive, I texted our medical people: ‘Hey, the policy could work!’ “
In an interview earlier Saturday morning on the SEC Network, Commissioner Greg Sankey spoke about how the league had seen a similar false positive last month.
“It has happened in other sports before it actually happened in football,” Sankey said. “This happens to be one of the more prominent conferences and one of our more prominent programs at the center of history.”
But still more questions hang. What exactly is a false positive? How was Saban’s initial test of the PCR variety, the gold standard in the industry, registered positive?
Exclusively a laboratory defect or defective equipment is the most plausible explanation that the test was actually accurate and that very small traces of viral substance were detected in Saban’s nasal cavity, says Geoffrey Baird, interim chair of the Department of Laboratory Medicine and Pathology at the University of Washington, who is an expert in COVID testing.
Saban’s viral load could have been so low that subsequent tests found no trace or not enough trace to detect another positive.
“It could be that he had a very mild case and could only be detected for a short time,” says Baird. “He could have had a brief interaction with it, but he did not become symptomatic or problematic.”
However, there are many variables that are played here. Tests are not all created equal. Laboratories treat tests differently, and Saban’s first positive was treated in a different laboratory than the other three. Methods of administering the test are also different (was his initial test method administered in the same way as his other three?). Different equipment is used, some more valued and respected than others. But in this particular case, the most important variable is the virus threshold: How much virus does it take to trigger a positive?
“Say you’re looking for viral particles and there’s a million in a sample,” Dugas says. “You put a drop of the sample on the cotton swab and you have the cotton swab in [reagent] liquid and then it goes to the slide and into the machine.
“Maybe the machine picks up 20,000 of the viral particles because that’s what happens in the small part of the sample. It can trigger a positive. But what if the 20,000 were 1,000? ”
Laboratories have different thresholds for what registers a positive and what does not. In fact, Baird says that a person with a small amount of viral substance can detect a negative result.
As for false positives with PCR tests, they are rare without a lab error. Baird’s lab has performed 900,000 tests, and although he does not have a specific number, he has seen a false positive “only a few times.”
“It’s at most 1-2%, but it’s probably a whole lot less,” he says. “It’s incredibly unlikely.”
However, the figures do not necessarily take into account retesting of all positives. “Very few people can afford or have the ability to get three subsequent tests,” he says.
In fact, many other college football conferences do not include such a policy as the SEC, which was implemented last month – the one triggered by the A&M football player. Now in the spotlight, politics can be scrutinized by some and praised by others.
But everyone agrees that the “Saban situation,” as Dugas says, will send more ripples through the college football landscape.
“It’s a strange time,” says Bjork. “It’s another example of fluidity in all of this.”