StarTalk Radio - The Science of the COVID Bubble

Episode Date: November 6, 2020

How has COVID-19 impacted athletes? Neil deGrasse Tyson and co-hosts Gary O’Reilly and Chuck Nice investigate with cardiovascular disease specialist Dr. Saurabh Rajpal, MD, and Head Team Physician Dr. James Borchers, MD, of The Ohio State University. NOTE: StarTalk+ Patrons can watch or listen to this entire episode commercial-free here: https://www.startalkradio.net/show/the-science-of-the-covid-bubble/ Photo Credit: Maize & Blue Nation, CC BY 2.0, via Wikimedia Commons. Subscribe to SiriusXM Podcasts+ on Apple Podcasts to listen to new episodes ad-free and a whole week early.

Welcome to StarTalk, your place in the universe where science and pop culture collide. StarTalk begins right now. This is StarTalk Sports Edition, and we're going to do an entire episode on COVID-19 and athletes. You know, we've done COVID-19. We do athletes all the time. We're putting them together. Yeah, but we're not actually putting them together. It's not like we're giving athletes COVID-19. Oh, sorry. Okay, Chuck. Just so people don't get confused. Those two voices. Chuck, nice. Chuck, good to have you, as always. Always a pleasure. Gary O'Reilly, former soccer pro, sports commentator.

And now we've got you for StarTalk. Lucky us, huh? Yeah, and everyone knows Chuck is my longtime co-host. And I am Neil deGrasse Tyson, your personal astrophysicist. I'm director of New York City's Hayden Planetarium, right here in New York City, part of the American Museum of Natural History. Now, none of us have expertise

in COVID-19, especially not COVID-19 with regard to athletes. We had to bring, we had to find somebody. Find somebody who's got the medical chops to get us through this. And we found Dr. Saurabh Rajpal.

Dr. Rajpal, welcome to StarTalk. Thank you, Neil. Yeah, excellent. Excellent. And so you're a cardiovascular disease specialist. And as an academic, I always see and respect people's academic titles. You're an assistant professor at The Ohio State University's Wexner Medical Center. And you're also an assistant professor at Nationwide Children's Hospital.

That's right. That's a thing? Where is that? What is that? So Nationwide Children's Hospital is a children's hospital in Columbus, Ohio. And it's a subspecialty, super speciality hospital. Provides care to kids, adolescents, and adults. And I am a part of their congenital heart disease team.

So as the, yes, as, as kids get older, they get into the adolescent and adult ages. They're not kids anymore, of course. We take care of them. Okay. So part of the value of that is you get to see it, see the entire arc of heart problems from, as you said, congenital up through adulthood. That's got to be an important data there.

Yes, that's right. That's right. And that's how it gets us in touch with adolescents who participate in sports. And because that's the age group, the adolescent and the young adults who, you know, are in the competitive athlete age group. That's the birth of varsity sports, right? Basically, adolescence and onward. And so we've all read that if you're young, you know, the COVID is not so bad. So you had a study that came out recently that looked at COVID, the effects of COVID

on the hearts of young athletes. And, you know, we're not trained to think of COVID on our hearts. We think of it in our lungs and, you know, maybe some other part of our circulatory system. So what is this connection and what did you find? Yeah. What made you do it? I mean, like seriously, what makes you go COVID, athletes, heart?

Young athletes, right. Young athletes. Somebody's got to ask that question. Yeah. Early on in the pandemic, we were getting information that in people who were hospitalized, so sick patients, they had a very high percentage of them had this marker called troponin, which was high in the blood. About 20 to 30% of patients were seen to have troponin levels which were abnormal. That made people think that- Abnormally high. Abnormally high. Yes, abnormally high.

And also we were seeing that COVID had devastating consequences on people who had underlying heart disease, especially devastating. So the early risk groups that had a worse outcome with COVID were people who had underlying hypertension, coronary artery disease, and heart failure. So that made people think that, is that, does COVID have this tropism or affinity for causing heart trouble? does COVID have this tropism or affinity for causing heart trouble? As we were going through, this was seen not in multiple studies, similar findings came out. We got involved when the Ohio State Sports Clinic asked us what would be the best way to make sure that the athletes are safe to compete. One of the things that we don't like to see is sudden cardiac death in athletes.

These are the news items that we see. I'm pretty devastating to see. It's headlined whenever it happens. Yeah, everybody knows when that happens. So because of this, the sports medicine clinic at OSU asked us, you know, how could we make sure that our athletes stay safe while they're training,

while they're practicing? And these are not regularly exercising people, which is great. I mean, these are people who compete at a high level. So we decided at our university that to make sure that the athletes are safe, in addition to getting the usual workup, which is a clinic visit and asking symptoms and physical examination, we will do an electrocardiogram and an echocardiogram. But we went a step further and we said we now have a test, cardiac MRI, magnetic resonance imaging of the heart, which can look at the structure of the heart muscle. And if what we are looking for is myocarditis or inflammation of the heart muscle, the best test to look for that would be an MRI.

Just a quick question. So just to be clear, when you do the traditional EKG, you're only seeing the heart beat, the signature of the heart beat. You're not actually analyzing the structure of the heart. Yes, yes. So now with the MRI, especially combined with the EKG, you know everything at this point about the heart. Is that a fair assessment? We know a lot. So, you know, echocardiogram is another step in between ECG and MRI. So ECG will tell you about the electrical activity of the heart. Echocardiogram, which is an ultrasound-based technique,

will tell you the pumping activity of the heart. Echocardiogram, which is an ultrasound based technique, will tell you the pumping function of the heart. And the MRI, in addition to that, it will show you the characteristic of the heart muscle. What is that tissue like? Is there swelling in the heart tissue? So that is the advantage of MRI. Dr. Rajpul, don't athletes quite often present with enlarged hearts anyway because of their cardiovascular exercise. That's right. That's something we call athletic cardiac adaptation. Athletes tend to have slightly larger hearts, not too large, but I would say within 10 to 15% larger than what is considered normal.

And that is acceptable. Wait, did the heart grow that large because they worked hard at it or did they start out with a heart that large and thereby became better athletes? Well, that's a good question. I don't think we know the answer to that question. But, you know, when we see that athletes stop exercising, some of these changes, you know, get back to within the normal range. So more than likely, it's the first thing that you said.

So what did you find? So we found that of the 26 athletes that we report in our study, four had evidence on cardiac MRI of inflammation, which means swelling and necrosis or cell death. And those athletes, two of those had symptoms, but the other two did not have any symptoms or had very mild symptoms when they had the COVID. Okay. So, is this bad or good? I mean, inflammation, you know, that's like a bad word these days, right? But why is that bad with regard to the heart? So, that's bad from an

athlete perspective. If athletes continue to perform strenuous exercises and competitive sports, continue to perform strenuous exercises and competitive sports, when they have that inflammation in their heart, this can worsen. This can develop into something that is more sinister, like heart failure or sudden cardiac death, some of those things that we see. And is there any damage to the heart that would be long-term or is this something we we understand there's a danger associated with him for a sudden cardiac uh uh death or heart failure but long term if you suffer this inflammation is there damage to the heart muscle is there a damage to electrical signaling is there anything that is long termterm from the inflammation? Yeah. So most of the athletes, they recover is what we have seen. This inflammation goes away.

However, some of these can change into heart failure or low heart function later on in life. Some of these changes can persist in a minority of patients, I would say. some of these changes can persist in a minority of patients, I would say. Doctor, does the scar tissue that appears in a normal wound or injury to skin appear in the tissue in the heart? And therefore, and does that then bring its own legacy of problems? That's right. So what we see on MRI in an acute stage versus in the long-term stage, we see on MRI in an acute stage versus in the long-term stage, it carries a different meaning, even though it might look similar. So one of the findings in cardiac MRI that we see is called late gadolinium enhancement or LGE. That could mean necrosis, which is cell deaths or a dying heart cell, or it could also mean scar tissue, like you're saying. So in the acute stage, when

you see that cell death, these are able to regenerate and this goes away. So the swelling will go away. But in a minority of these, it can turn into scar tissue, like you're saying, and can lead to long-term consequences like heart failure. What is COVID doing in anybody's heart? We've always only thought of it as a respiratory illness. Yeah, exactly. Yes, which is true. I mean, COVID is primarily a respiratory virus, and we see it that way. However, it has some tropism or affinity to the heart.

We think that it's probably due to its affinity to an ACE2 receptor, which it affects the heart more frequently than other viruses. However, you know, viruses affecting the heart is not new. We have seen that other viruses affect the heart as well. Maybe this is an effect of so many people having this virus that we are seeing this more commonly. Oh, so what you're saying is the more people get the same virus, the greater is the range of symptoms you get to log for what the virus can do.

That's right. And do we know what the connection is? I mean, cause you know, there's some years ago now I can't remember the study, but I read about certain bacteria that actually affects the heart and can lead to you know heart and can lead to, you know, heart failure. With respect to dental care and not or a lack thereof, a lack of dental hygiene. Yeah. So do we know the connection between viruses and bacteria and the heart?

Because they just doesn't seem, it just doesn't seem right. It doesn't seem right. It doesn't seem right. I shouldn't have to worry about viruses and bacteria in my mouth and in my lungs messing up my heart. It shouldn't happen. Calm down. Yeah, yeah, calm down. We got to talk Chuck off the ledge.

Yeah, talk me off the ledge, Doc. You know, there are a few pathways how this can happen. One is that all these organisms that you talked about, viruses, bacteria, or we're talking about this virus, can affect the heart directly. It can invade the heart cell, the heart tissue cell directly and cause damage. Another way is these viruses or bacteria can sometimes lead to inflammatory reactions or inflammation in the whole body and heart can get affected. In other situations, it can cause like an autoimmune reaction. So the body starts

damaging itself after an infection because the body makes inflammatory markers to save itself from the virus, but they're detrimental to the body itself. Is that what's called a swarm? Is it? Storm. Yes. Cytokine storm. Yeah. Well, okay. So the heart, this is me being highly qualified in this field. The heart is a muscle, right? Yes. And if I, bear with me, if... You got to start there. heart 101. Okay, go. Right, here we go. So if I damage a thigh muscle and it gets inflamed, I go straight to an anti-inflammatory drug. I go to an ibuprofen, something like that. Is this too simplistic to treat a heart or have I just, should I just say nothing else?

to treat the heart or have I just, should I just say nothing else? So, you know, one of the treatments that is given if this inflammation persists for some time is steroids, which is like an anti-inflammatory drug, right? So we do use it for the heart as well. But then that has its other effect, doesn't it? If you take the steroids, does that not damage your immune system? It does damage the immune system, but here the immune system is going haywire and causing, doing things that we don't want it to do. All right. So tell me about blood clots that we read about intermittently, because that seems like the heart would matter in that one.

Yeah, definitely. So blood clots, this whole inflammation that we're talking about, inflammatory changes in the body also lead to a procoagulant condition, which means that there is an increased tendency to form clots when you're ill with COVID. So this clot formation can form clots in the heart, the blood vessels of the heart, the blood vessels of the lungs, which is what we call pulmonary embolism or PT, which is a very dangerous condition. So we are seeing that as well. called pulmonary embolism or PT, which is a very dangerous condition. So we are seeing that as well. All right. The fresh information here for all of us is even people who got COVID, who thought it was mild and want to just get on with their life, if they subject their bodies to some level of performance stress, that might not be a good thing. All right. So we see that there's a lot of sports coming back to television,

you know, during this recording, you know, we just saw the completion of the World Series. There's some people in the audience. So athletes are trying to just be athletes. So whatever this symptom was for the younger athletes, could it be worse for the older athletes? It depends, you know, it depends how much, what sport they play, what the type of infection they had, how long were their symptoms. So it depends on a lot of things. Or if it's an endurance sport versus just one of pure skill,

that presumably that matters as well. Yes, yes. We think it matters. And when the sports come back, if people have symptoms or if they're recovering from COVID, they need to be especially careful as they go back.

Absolutely, yeah. Speaking of what you just said, Cam Newton, who now plays for the New England Patriots, so I hate him. He got COVID and he returned and we saw a significant drop-off in his performance. Is it possible? Because I think this is the pressure upon all athletes is to return as quickly as possible. Yes. Right, and if you're a professional athlete and you are at the top of your game,

and that's a stratospheric level of performance, and if that gets taken out, you just become an ordinary good athlete rather than the premium athlete that you once were. So, Chuck, I didn't know it was that noticeable. So, yeah. So the thing is, Neil, he's a franchise player and the pressure on him to be there, not away from the sidelines or in the game is immense. And the doctor will tell you, if you bring an athlete who's been through this back too soon, you get that kind of performance levels, Chuck. And it's because we're human, funny enough.

Okay, so we need like the COVID Olympics. We just lower expectations. Oh dear, don't. What is the timeline on legacy here for recovery? Is it a week, two weeks? You know what? Take the rest of the year off. What's the deal?

So, if you have evidence of inflammation in the heart or swelling in the heart, we recommend rest for three months. That's how long it takes

for the heart to recover. Season three. That's, that's why, that's why it's never going to happen. You're talking about a whole season

for most athletes it's an entire season you've got to sit out because you've got COVID and they're not going to do that maybe we do need the COVID Olympics oh god I love it I'm sorry just think the Olympics has been postponed a year

imagine you're building up to perform in 2021 in Tokyo and you catch COVID and you're out for three months. That's really going to blow. That's the end of your whole thing. That's the end of your whole thing. Man. Man. What's this mean for the average person?

Fat guy on the couch. I mean, we're talking about like elite athletes. What does this mean for fat dude eating chips watching a football game? Okay, you're talking about the effect on the athletes and the effect on the people watching the athletes. Exactly. All right. So, you know, we know that people who are at risk of heart disease, so those people who have hypertension or obesity or things like that, they are predisposed to cardiovascular effects of COVID. disposed to cardiovascular effects of COVID. So if they have symptoms that are suggestive of heart disease, like chest pain, shortness of breath, abnormal heart rhythm, palpitations, as we call

it, they should see their doctor. Okay. Wow. Okay. So the point is the couch potato surely is on the brink of having some cardiovascular problems if they're just sitting there eating chips. There you go. So our real takeaway here, people, is don't get COVID. Don't get COVID. Yeah, yeah. So we do the smart thing and we pay attention to medical professionals. That's right. Yeah. So thank you, Dr. Rajpal, for bringing us this information that none of us knew. And now we have more to think about and worry about. When we return to StarTalk Sports Edition, we're going to talk about ways of containing COVID-19 when we return. We're back. Star Talk Sports Edition.

Chuck and Gary. Hey. Co- Sports Edition. Chuck and Gary. Hey. There you go. There you go. We're now going to talk about just containing COVID in the athletic vistas that was so, you know, we've been realizing over the months that life without sports has changed the culture. You know, sports seems to be such an

important fabric of our social interactions and the things you talk about at the water cooler, but it's not even the water cooler, right? So what are we doing? So we're bringing somebody in, a medical doctor who's thought about this. So Dr. Borchers, did I pronounce your name correctly there? Yeah, you sure did. Thanks for having me. Excellent. Excellent. You're a sports medicine doctor. You're my favorite kind of doctor because I used to be very active in sports and you guys just knew, you know, you knew how to get us back out there. You didn't say, oh, just, you know, take this pill and call me in a week. No, you just know, I'll have a week. Get me back out there tomorrow. all right? You're Ohio State Department of Athletics, and you're the head team physician. Is this team for all athletic teams of Ohio State?

Yeah, that's correct. I'm the head team physician and medical director for the athletic department at Ohio State. So you'll handle football injuries as well as golf injuries or something. And everything in between. And everything. Wow. And everything. Wow. Okay. Neil, you get hit with a club,

it's just as bad as getting hit by a linebacker, trust me. Yeah, okay. I don't know about that. I do. Depends whether they hit you. You've been hit with both? You're like, Chuck, I'm speaking from experience. Yeah.

So the primary reason why we have you on here is that you are one of the four executive committee members of the Big Ten Return to Competition Task Force. Yeah. All right. And remind me, who's in the Big Ten? Or at least let's see if we can get five out of the ten, just so we know who you're talking about here. We know what we're talking about here. So we're talking about institutions, Ohio State, Michigan, Michigan State, Penn State, Rutgers, Maryland, Indiana, Purdue, Iowa, Illinois, Nebraska, Wisconsin, Minnesota, and Northwestern.

So 14 institutions. Ding, ding, ding, ding, ding, ding, ding, ding. Better known as your Saturday afternoon television football. Television football. There you go. Absolutely, yeah. That's all you have to say. Who's the Big Ten? Turn on TV on your Saturday afternoon television football. You have television football. There you go. Absolutely, yeah. That's all you have to say. Who's the Big Ten?

Turn on TV on a Saturday afternoon. If you see somebody playing, that's the Big Ten. It's Big Ten. Wait, so you listed 13? Is that what you did? 14. So the Big Ten are 14 schools. That's correct.

That's become 14. Gotcha, gotcha. That's my kind of math. And you play for Ohio State as a football player. What position did you play? A long time ago. So I was a linebacker, but I did all the long snapping for extra points, field goals, and punts. Wow, linebacker.

The most underrated, under-celebrated person on the team until they screw up. Correct. It's like nobody cares about the long snapper at all. Oh, man. Goes out there, play after play after play, does his job, gets the ball where it belongs. Soon as he does it, it's high, low, hits the ground, takes it. They're like, that guy has got to die. We got to kill that guy.

All right. Back to the subject of this segment. Oh, yeah. So we just came off of a conversation with Dr. Rajpal, one of your co-authors, as we understand it, on this study that we talked about, finding that COVID has affected the hearts of young athletes in ways that perhaps were not expected or imagined. So

how did that report influence in any way your decision, the decisions you made in the return to competition task force? You know, it was just a piece of something that we needed to think about when we think about this virus. You know, we said all along, we're not to be alarmist about things. We need to study them. We need to learn and understand them. You got to remember this virus has really only been with us now for, you know, about eight months time

and in this country. And so there's a lot that we don't know about it. And so to make certain that we're studying it and moving forward and looking at it and taking a cautious approach was important to us. And so that's exactly what we did. Where did the task force land with regard to reengaging competition? Yeah, so our primary objective was to make certain that for the chancellors and presidents of the universities that, you know, we could bring to them solutions that answered their questions. So we landed on a very cautious, conservative approach, utilizing a number of resources around labs, cardiac imaging, studying cardiac function

in these athletes that would give us the best feeling that they were safe to go back to play if they did happen to become infected with COVID. So let me ask you, Doctor, what are the sort of standard protocols that are at through the Big Ten, not just at OSU, but through the Big Ten that are basically mandatory? And were you thorough enough at that so that other athletic conferences had said, hey, they did it right. Let's use them as a model. Well, so to answer the first question, you know, every athlete that is COVID positive has to isolate appropriately, which is 10 days of isolation if they're asymptomatic or until their symptoms resolve. And then they have to go through a series of cardiac tests, including labs and EKG and echocardiogram and then a cardiac MRI scan. Yeah. Those have to be reviewed and then they have to be, you know.

So you might not have thought to do that were it not for this other study is that a fair statement um i think that the data that we were looking at certainly was one of the studies that led us to think that we need to make certain we're appropriate and looking at this uh risk back when we looked you can't have athletes dropping dead on the field right we should yeah no no, no. Okay, so what would the difference be between your flu recovery protocol and, say, what you've put in place now for COVID? That's a good question. Yeah, so I think with flu, we know a lot more about it. There's a vaccine out there. We know, you know, we're much more educated about it.

What we don't know is what we don't know with COVID. And so we have to continue to understand and study it. And I think to make certain that we were taking a safe approach, you know, for our conference, that's exactly what we did. And by the way, I couldn't emphasize your previous sentence more. When COVID arrived on our shores and it hadn't really been studied, at least not by us, at least. I don't think the public fully embraced how new and novel the virus was. Because if you do embrace it, you will allow scientific studies to sort of run their course. And to say, oh, we just learned this. We didn't know that a month ago.

And here it's doing this. Oh, and these people. And I don't think the public was allowing discovery to take place. Did you experience that as well? Yeah, I think we wanted to extrapolate what we knew about other viruses to this virus. And that just doesn't work. This virus acts differently. There's things about it that we had not seen how it affects individuals. So I think that you're right. We're still learning about it even now. So are you involved with any protocols for teams with respect to reducing, flattening transmission? Because I would think, especially when you're dealing with a novel virus, the number one precaution you want to make sure is that people don't get it.

That's our best defense against this virus right now is don't get it. So what have you guys done and are you involved in that at all? Yeah, really involved with that. That was our number one impetus when we put protocols out was that all these protocols do is either identify people, you know, that have already had the virus, what they need to do, or reflect the behaviors of those individuals. So when we talk about testing and those sorts of things. So our number one priority was to make certain that student athletes knew that they still need to wear a mask when they're out in public. They should be physically distanced at all times from individuals, you know, making certain they avoid

large gatherings, practice good hygiene, don't travel frequently, you know, all the things that are going to help them to, as you said, avoid getting the virus. And that is the best advice is to prevent the infection. All right. Now, suppose you have it and now you have the antibodies to it. Can you, are you still, can you still transmit it? Can you get it a second time? I mean, are these unknowns about the virus? These are unknowns. This is exactly what we're studying and looking at. And so I think you've probably seen even recently, we don't know how long immunity lasts.

There was just a study in the UK that was just published yesterday that looked at, you know, immunity may not be as long as what people thought. So we don't know how long immunity may be for people. We don't know what viral load you need to have immunity. And we certainly don't know if you can or cannot be infected twice. And there are some rare cases, but certainly we have not seen the full effect of that yet. So the limit, the possible limits on your immunity, is that because of some mysterious reason we're still figuring out? Or is it because the virus is mutating

and then it just manifests slightly differently? Yeah, I think a lot of people believe that, that similar to the flu virus, you might need to be vaccinated every year because the virus can change and become different and affect people differently. So it's unlike some of the other diseases where you are affected once

and you build a lifetime of immunity. Doctor, do some viruses elicit a stronger immune response from the body than others? And are we looking at that with COVID where there's a less of an, what am I saying, antibody response? Well, yeah, immunity is not just antibodies, right? It's memory T cells and other things

that can cause immunity. But that being said, the viral load can affect that. The type of virus can affect that. You know, all of those things become an issue. And then we have to think about, you know, that effect moving forward. And I think that's one of the things that's very challenging about this virus, this SARS-CoV-2 virus, is that we don't know those answers. And so we have to be more cautious, I think, when we approach that, especially when we're talking to patients or athletes.

So sports, especially the Big Ten sports, is big business, right? And so there's surely financial pressure to get these athletes back on the field. And everyone wants them back on the field. And they want to go back. And they want to go back. And they want to go back. Right. It's win, win, win if you can actually make it happen. But here's my question.

If you test everyone right now and everybody shows up negative for the virus, then tomorrow they all go to some spreading event and then return. What is the next time you're testing people? Is it three days? Is it, and, and by then it's too late. So shouldn't you have be testing people every six hours or something? I mean, what is the, you know, or just stick a, stick a swab and leave it in their nose with a, with a channel to the lab. I mean, how do you do this? Yeah. So we're testing daily. Daily?

Wow, look at that. So if you look at some of the epidemiological evidence, we believe that if you test every day, you can isolate individuals, even if they are infected, before they can infect someone else. There it is. There it is.

Okay, so you get a positive while before they're contagious, in a sense. Before they can infect someone else. That's correct. And remove them from that population before they would infect someone else. Is there a window of contraction to contagion? Or is it immediate? Okay, so let's say it's 12 noon.

I go out. Super spreader event. I'm in the White House Rose Garden. And I leave, right? Now it's 4 p.m. I have the novel coronavirus right now. Okay. I just contracted it. Okay. I then go to another super spreader event. Let's just say some kind of rally. And I'm in contact with other people. Can I transmit it right then? Or is there a window of non contagiousness? Yeah, there is a latency period. So you actually, the virus has to replicate itself in your body and make enough copies so that it can

become infectious. And then it can become to a load where you can actually pass it and infect someone else. What's that window? It's 18 viruses, Chuck. Is that what you want to, what kind of, how many? It's thought to be around three to seven days in most individuals, five to seven days. So you can walk around with this for a while before you may actually, and that's part of the issue is you can be asymptomatic and walk around with it and not know it and then spread it to other people. But if you're testing people frequently, you can identify them before they get to the point where they would spread it to someone else. So in that period of latency, you could remove that person and boom, that leads to a greater containment.

Yeah, that's correct. Wow. And that's been a discussion around public health and how we need to be approaching this if we're really going to make an impact and stopping the spread of this virus. Let's look at your football team at OSU. You've got, what, 150 plus members where you look at staff as well as players, coaches, first tier, whatever level you've got around them. The ball boy. Don't forget the ball boy.

Or the water boy. The water boy, yeah. Adam Sandler. So there you've got testing daily for that amount of people. You're already under pressure financially because college sports has been decimated. What is this protocol costing to be able to put this in place? It must be immense. Yeah, I don't know the total cost, but I agree with you. It's not an inexpensive venture, that's for sure. Sure. Well, wait, there's the cost of testing people, but then there's the

opportunity cost of sports that you might have conducted that you're not, and not filling the stadiums, which itself was revenue, right? So there are two costs, the cost of sports that you might have conducted that you're not and not filling the stadiums, which itself was revenue, right? So there are two costs, the cost of implementing and the cost of not making money combined, right? And the cost of keeping these athletes and the staffs and the coaches healthy and safe when we're asking them to do this in a, you know, in a pandemic and making it as safe as we can for them. Are you familiar with any of the protocols for professional teams? Now, you know, of course, yeah, the NBA had the bubble. Okay, but let's look at professional football, which doesn't have, are you guys, are they learning from you? Are you learning from them?

Are they about the same? Yeah, I think we're both testing daily. I think we're both learning from each other. Their protocol is slightly different than ours with the combination of PCR and antigen testing. And so I think there is no perfect protocol. The protocol is that you have to stick to it and you have to reinforce behaviors. But we feel like what we're doing has thus far helped us to identify where there are problems and stop them before they get out of control. We got to take a quick break. And when we come back, normally, you know, Chuck, Gary, and I just sort of reflect on what had just happened in the two segments. If you could hang on, we'd love to bring you as part of that. It's

more of sort of a chew the fat segment. Can you hang out for that? Sure. Okay, excellent. So when we come back on StarTalk Sports Edition, we're going to talk about containing the coronavirus in the sports universe when we return. We're back. StarTalk Sports Edition. I've got Dr. Borchins here, who is a sports medicine expert at the Ohio State University.

That's one of the universities that carries a the proudly. Yeah. I think there's the Johns Hopkins University. There's a few. I grew up in the Bronx. We have a the. The only borough with a definite article before it. Yes, exactly, because we've always been definite about our situation.

Oh, look at you. Is that so? Look at you. There you go. So we use this segment to just sort of reflect, it's almost free form on what has just come across our table in the last two segments. And let me just sort of lead off. There's all this attention given to sports because there's so much money involved. Is there someone in the administration saying,

hey, you guys are doing something interesting and you found interesting results. Let's apply that to the rest of the campus where the learning happens. I mean, that's exactly right. Yeah. Take being able to take this information and apply it to the community, to the university, to businesses, to schools is really important. And so that's part of the, you know, part of the responsibility we have. And so you're exactly right. But let's be frank that you got the priority because you're worth more money than just a single a simple student getting taught by a professor in a classroom but but also you got to understand that they they have a specific enclosed community as well so they're a perfect microcosm to study you mean the athletic athletics yeah the athletic organization within the school you know so yeah it really it really does. It is a smaller group.

And I think the other thing it's done is reinforced at our university, the behaviors that you need to do, and it's driven the infection rate way down at Ohio State. You're becoming exemplars. Yeah. And I think people want to support these athletes. They want to model their behavior. And I think it's great when, you know, sports in many

different areas, and again, not just to COVID, but can be a great example and leader and galvanize people for common causes. And I think that's one of the things that can do in this pandemic. They speak of winter as the flu season. And I presume that's because we have more tendencies to stay close together and indoors. Given the habits that most of us have developed, constraining the transmission of the coronavirus, will this be devastating to any seasonal flu virus that wants to infect us? Because the normal ways it would have now been closed off because we're washing our hands and we've got the masks on. It certainly should affect the spread of the flu as well if we can

stick to those behaviors, you're right. And I think we saw that even last year in the, you know, in the late springtime, flu was down compared to where it had been. And certainly these measures don't just affect COVID, they affect other, you know, infectious diseases as well. Right, right, right, right. Doctor, we've talked about the body and the effect and how you protect it. But how are you dealing with the mental well-being of everybody involved in this? Because not just the athletes, not just the coaches, but the extended family and literally coaches' family. Yeah, does the medical department have have a

psychology division for the athletes yeah we do we have a significant sports psychology group that works with our athletes and i will tell you this one of the byproducts of the pandemic is that mental health issues and athletes skyrocketiety, depression, adjustment disorder, stress. So it's a huge stressor for athletes in general not to participate in their sport. And we lose fact of all the, I think sometimes the perspective of the other health issues around when we're so focused appropriately on this pandemic and the issues that it can cause. But we've got a lot of byproducts from that. And that was certainly one of the largest and I think one of the biggest concerns, that has subtracted from my self-identity and some fundamental, how I express myself and how I feed myself, but my own sense of even

self-worth, if I can take it that far. So yeah, I'm glad to hear that you've got all sides of the health profile figured. Doctor, I must ask this because you've got such a massive and brilliant football program. You'll have players in there that will be going to the NFL. They're that good. They're drafting. Happens every year. Right.

So what are they doing? How are they coping in there with the fact that this thing is unseen and can derail not just me for the next couple of weeks, couple of months, but it could take away if I get a bad case. How are you coping with them? Are players dropping out of the program? Are they engaging? What's the deal? Yeah, we haven't seen any attrition from our program of any players. I think hopefully that means that they feel that we've communicated well, we've been transparent, we're discussing with them what we're putting in place to keep them safe. We're continuing to communicate frequently. And I think that there's a lot of

credit that goes to the institutions, their staffs, and their commitment to do that, not just with football, but with all the athletes to be honest and open about what the risk is. So let me ask you, speaking of that, well, speaking of communication and the psychology, does the team, I think team players might, here's the thing, with COVID, you're only as good as the person who's not willing to do what they're supposed to do, okay? If we all say, okay, guys, we created this social bubble,

we're all cool now, we gotta make guys, we created this social bubble. We're all cool now. We got to make sure that we keep this social bubble closed. And then somebody sneaks out in the middle of the night. Right, and I'm going, I just got to go out because I need some bunions.

And, you know, that's what I call, that's what I call sex. Anyway, but... You may have been in the bubble too long, Chuck. Oh, God.

Anyway, oh, please. Uh, but is, is that, do you find that advantageous? The fact that these guys are as a team and is that used to help keep them? I won't say in line. I'll say aware. I think definitely. I think when you're motivated, when you have an end goal, when you have something that motivates you to, you know, behave appropriately and you have peer pressure. And when you see that everyone else is acting that way, when you know you got to test the next day, you got all kinds of reminders that you need to, you know, stick with the program. And I think that there's a, there's real power in, in being accountable to, you know, your teammate and

the other people that you're embedded with in this mission so to speak so what we could do and i'm talking in a greater society if we were to instead of looking at this as a national thing instead of looking at this as like oh we got to test the whole if we looked at this in each individual social construct so i work with my company, my company, I'm responsible to my coworker. And then you create that same kind of environment, but you do it on a smaller scale in many, many, many places. We might be able to overcome this thing.

Yeah. Wow. I think you're exactly right. I think being more granular. It becomes a state of mind and being more granular and creating that impetus to be accountable to the people that you're closest with drives your behaviors. And I think to think about it that way is, you know, is a great way to think about it. And we've seen great success with that happening on our campuses. New sport could be useful

from the former professional sportsman. But it is, it's about your network. If you're good and everybody is trusting in their network and doing the right thing, that network then springs out into that person's network and that person and it grows and grows and grows and itself becomes viral pun intended. There's no question. There's a way to defeat this. There's no doubt about it. Yeah, so I want you to predict the future.

So how soon will a magic serum be available? I think you're going to see a vaccine become available in December, and I think it'll be available to the general population sometime in the spring of 2021. Okay, so that time delay would be the discovery of the vaccine versus the production. And the testing is going on now, is that what you're saying? That's correct, yeah. Okay, wow, that's cool. So the lesson to us will be, in the future, we want a vaccine before a virus

shows up. That's what we want, okay? So, doctor, get back to work, and that's what we want. So you can head this thing off in advance. And maybe that's how I understood the concept of a coronavirus is a category of virus. That's correct. Different from other categories where your hope and expectation is that what you would have developed for one of these coronaviruses could help the others.

Is that a fair statement? That's correct. Yeah. Yeah. Okay. Wow. I'm looking forward to that. Well, I'm looking forward to it.

Wait, I got one last thing. Are bats dying of coronavirus? I mean, they're mammals and we got it from them. Do they have coughing fits? I'm not a veterinarian, so I don't study bats, but I know that, as you mentioned, it can certainly originate from them. It can originate, but maybe they just chill with it, right? They're dying from the novel human virus.

Which we wouldn't know again. Right. Wait, wait, wait, wait. So the vampire bats are saying, whose neck did you bite last night? Where did you get this virus? So if they're not suffering, does that mean all we have to do is hang upside down?

I'll leave that to you guys. Yeah, yeah, yeah. We'll figure that out. We'll get a full report back on your desk in the morning. That inversion table out. We'll figure that one out. We'll get a full report back on your desk in the morning. That inversion table out. I'll be upside down. So, Dr. James, thank you for joining us from the Ohio State. The country loves Ohio State University.

It's like benchmark university, academic, athletic example of America at its best. So I'm glad to see you in the middle of that, keeping that safe. So thanks for joining us, Gary, Chuck, as usual. Thank you. Always a pleasure. I'm glad to share this table with you. Thanks, Doug. All right, I'm Neil deGrasse Tyson, your personal astrophysicist,

as always, bidding you to keep looking up