The Premier League currently plans to restart in June. Its strategy is dangerously negligent, and poses a serious threat to the health of the players, the staff and anyone in close contact with them. I explained why on @TheExtraInch, but here is a quick summary (thread) https://twitter.com/aut_omnia/status/1260673012317200384

Project Restart depends on three basic measures to protect players and staff from COVID-19 as they return to training and playing;
1. Testing
2. Screening
3. Distancing
Unfortunately, all three of these have profound failings

First, testing. Project Restart basically depends on the COVID-19 Antigen Test (CAT). Companies that make these tests, such as E25Bio, claim these tests will be around 90-95% accurate. Sounds great, right?

However, these tests have a problem; 'Antigen testing for covid-19 would be a total game-changer, except for one aspect: it won’t work.'
Alan Wells, medical director of clinical laboratories, University of Pittsburgh.

Antigen tests for COVID-19 depend on using a swab to take a sample from deep within the nasal cavity. The problem is, the quantity of the virus in this area varies massively between different people.

The sensitivity of the antigen test for influenza (i.e, the probability it identifies someone who does have the disease) is *less than 50%.* Worryingly, this is a problem for testing all respiratory viruses.

A test with a sensitivity of 50% will correctly return a positive result for 50% of people who have the disease, but will return a negative result — a false-negative — for the other 50% of the people who have the disease and should have tested positive. This would be a disaster.

E25Bio's claim of 90%-95% accuracy (calculated from sensitivity, specificity and prevalence) seems to depend on the covid-19 test working like their tests for dengue and zika virus - which would be great, except for the fact that neither dengue or zika are respiratory viruses.

These claims of 90% accuracy are based on reliable samples, not swabs from the nasal cavity that will contain vastly different quantities of the virus.

The whole of Project Restart hinges on a test that may tell more than 50% of people who have the virus that they dont have it. These false negatives will lead to players and staff proceeding to training/games thinking they are negative, when they actually carry the coronavirus.

Second, screening. So the Premier League also proposes to screen players every day to check for temperature and other symptoms. There is one huge problem here too: people without symptoms can have coronavirus.

It can take anywhere between five days and two weeks for someone with the virus to start showing symptoms. At this presymptomatic stage people can still be infectious. Some people never develop symptoms, but may also be infectious.

Relying on symptom screening to catch players or staff who may have coronavirus seems absurdly irresponsible.

Third, distancing. Honestly, I dont even know why we are discussing distancing as a strategy in a fucking contact sport. That the PL apparently suggested players turn their heads away when they tackle someone shows how unserious this is.

We are asking players and staff to make substantial changes to the way they play and train. Most of the players have been playing and training in the established fashion since they were old enough to walk. This change simply will not be effective overnight.

Due to fundamental flaws in testing, screening and distancing, I believe project restart will fail to protect players and staff. If we push on with this, people involved are going to start getting sick. Project Restart simply does not provide a safe working environment. (END)

Sources and further reading:
Project restart protocol: https://www.telegraph.co.uk/football/2020/05/05/revealed-premier-leagues-seven-page-protocol-document-clubs/
Great explainer of antigen testing flaws: https://www.technologyreview.com/2020/04/24/1000486/antigen-testing-could-faster-cheaper-diagnose-covid-19-coronavirus/
How to understand medical tests: https://www.healthnewsreview.org/toolkit/tips-for-understanding-studies/understanding-medical-tests-sensitivity-specificity-and-positive-predictive-value/
Covid-19 spreading without symptoms: https://www.npr.org/sections/goatsandsoda/2020/04/13/831883560/can-a-coronavirus-patient-who-isnt-showing-symptoms-infect-others