Kerr Report Q&A: National High School Federation Executive Director Dr. Karissa Niehoff
A conversation on #ReturnToPlay and potential changes in how sports are classified
(Photo Credit: Belleville News-Democrat)
This week, the state of Illinois moves closer to #ReturnToPlay.
As more regions roll back to lesser tiers, it increases the odds of all sports returning in the next few weeks and months of 2021, including football and basketball.
Later today, Jan. 27, the Illinois High School Association and its Board of Directors meet to map out the sports calendar for the remainder of the 2020-21 school year.
Also Wednesday, the Sports Medicine Advisory Committee of the National High School Federation is scheduled to meet. In this meeting, discussions are expected to be had on risk classifications of individual sports. The outcome of the NFHS meeting could have a direct impact on the future of sports such as football, basketball, wrestling, hockey and lacrosse, all currently labeled high-risk by the Illinois Department of Public Health.
Jon J. Kerr, publisher of The Kerr Report, recently interviewed NFHS Executive Director Karissa Niehoff. Here is an edited transcript of that conversation.
The Kerr Report: What is the National High School Federation’s role in return to play?
Dr. Niehoff: I think a lot of people equate the NFHS with the NCAA. The NCAA is an association by design so they have naturally a lot more governance, or intended governance, oversight and accountability. Their main office in Indianapolis has something that’s required, schools must comply. We are a federation by design which essentially means our 51 members, which are the 50 state associations and Washington D.C., have their own associations. So we have 51 member associations that they develop their own by-laws and regulations that serve their member schools in their state. If you look across the country you’ll see well over 90 percent commonality in how they implement their particular sport and activities, you will see some differences. In each of the state associations they are generally governed by member schools. The member state associations govern up to the NFHS board of directors. On most days, I really like the federation model. For the last 10 months I’ve really liked it.
TKR: Why so? Why the last 10 months?
Dr. Niehoff: I don’t say that to be glib. I say that because at the state level the situation and politics you described are very real. If we were to say that the NFHS requires something regarding return to play, and it’s a non-negotiable rule, our state associations would be in very tough soup. Perhaps our requirement wouldn’t meet with the belief of the state medical, health agencies, education agencies, things like that. In this particular crisis, the federation model has worked. All that being said, however, our member associations really do look at us for leadership and guidance. Throughout our 100-year history, pretty much if the NFHS says ‘this is the guidance we recommend’ because we have our own Sports Medicine Advisory Committee, if our SMAC says ‘we are releasing this as guidance’ our state associations then will say, ‘it behooves us to follow our mother ship.’ With COVID-19, we came out of the gate early after consulting with the NCAA, USOPC, CDC; our states needed a place to start very quickly. So we released our guidance in May of 2020 and most of our states have said, ‘thank you, we are using this’. In a lot of places it’s been very helpful, there has been some tweaking but in most states the guidance has been followed without much of an issue.
TKR: That’s not the case in Illinois. The governor and public health department have created their own protocols, some that notably conflict with the NFHS. Are there examples of conflicts in other states?
Dr. Niehoff: In Connecticut, the state health agency said we are following what the NFHS guidance says but the state’s sports advisory committee said, ‘well, we think we can be more lenient.’ So they are in an internal battle in their state over boys lacrosse. We categorize it as high risk and Connecticut has a big lacrosse community. Some of these things, the energy around tension is really getting stronger at the state level. To circle back to your first question, we provide national guidance, a lot of national resources that are specific to sports that are research-based, medical-expertise based, that are collaborative and when they are not requirements, they tend to be very strong recommendations that are followed.
TKR: How are the classifications for each sport, such as lacrosse or football or wrestling being high-risk or basketball moderate-risk (which conflicts with Illinois, that has the sport labeled high-risk), determined?
Dr. Niehoff: What little we knew about COVID-19, we did our best with it. Back then (when the NFHS first published their guidance document in May 2020) we were more concerned about the spread of the virus through contact on surfaces. So when we were looking at sports like wresting, football, competitive cheer and dance and then of course boys lacrosse. We were looking at sports that involved very closed, sustained contact between participants, lack of significant protective barriers and the high probability there would be respiratory particle risk. We’ve learned since then that surface contact is not as much of a risk. So looking at basketball right now, you’ll see where a bag of balls on the sidelines, the are sanitized and if a ball goes out of the hands of either a player or an official, let’s say it goes out of bounds and gets picked up by a ball boy, they have to throw in a new ball and clean that one. So we’ve figured that out.
TKR: Is there room to revisit risk classifications as new data becomes available?
Dr. Niehoff: We had a call last night, a subcommittee to exactly look at this question. Is it time to re-classify? (On Jan. 27) there is meeting with the Sports Medicine Advisory Committee where they will look at the tiered classification system. Undertaking that activity would mean looking at every single sport, not just lacrosse or basketball that have been in the spotlight, but looking at all sports. If they are going to to it, they are going to look at it comprehensively. There very well may be a decision to re-classify.
TKR: How would re-classification potentially look? Some sports would go down a risk level, others go up?
Dr. Niehoff: I think the fair analysis is to look at everybody and say ‘is it in the right place? If it’s an easy yes, keep it there.’ But for example, we have basketball as ‘moderate-risk’. Some places they have basketball as ‘higher-risk.’ If we have pressure from the boys lacrosse community to move lacrosse down, then do we have to do what basketball is doing in some places and move that up? Our sports advisory committee wants to make sure it’s tethered to decision-making that’s evidence-based as much as possible and not just based on anecdotal influence and pressure from a certain national governing body or do something just because someone else did it. They are really going to look to see, do we have new evidence? Are there good arguments for shifting a particular sport because we know more now? And they will look at all of that and very well may re-classify a few things.
TKR: There are a lot of questions about data and how it is compiled and disseminated. Some states have released studies on playing sports during Covid. Most don’t test athletes, at least at the high school level, due to cost and the logistical managing of such an undertaking can be prohibitive. Bottom line, every state is different. So how would the NFHS make a decision to re-classify a sport, say drop football or lacrosse from higher-risk to moderate-risk?
Dr. Niehoff: They will kind of go back to what they did in the beginning. They are going to look at any new, if there is, any new research relative to COVID-19 transmission from the CDC or the USOPC (United States Olympic and Paralympic Committee) or the NCAA and re-assess are we in alignment with those really respected medical guidance bodies and fellow sports agencies. They will look there, where to do we sit with that. They will certainly look at any data we might have…you mentioned football we had 35 states that held football seasons in the fall. We had 15 states that delayed until the spring and we only had one that cancelled. Really, hearing from the states that finished, we just wrapped up Michigan, they were the last to have their championships and they finished. We have not heard from our state associations around the country that there has been a documented case that transmission occurs due to play. That doesn’t mean that we didn’t hear that there were teams that had a few to eight or 10 players that tested positive but there was no way to prove that it happened as a result of time on the field. We still don’t hear that. We don’t know if they pile into the suburban after practice and go out for pizza. What we do know is the adolescent body seems to tolerate COVID-19 fairly well. We know now and what has been an influence since May, is we have research on the impact of not playing on the mental and emotional well being of our young people. That data is significant. Our young people have reported a vast increase in depression symptoms, anxiety, quality of life dramatic decline, apathy, lack of physical exercise, lack of disengagement; we have to worry about that. The whole idea of quarantining as well. We still don’t have a good system of contact tracing. At a high school level, there aren’t the resources to do more than temperature checks on a daily basis. When you throw all of that in the pot, we need to have a hard conversation about yes, we have to pay attention to Covid and prevent transmission as much as we can but we also need to consider what the lives of our young people are missing. So the Sports Medicine Advisory Committee will take all of that into account and will look at where states have been successful and where there were concerns and certainly look to say, ‘is there a more appropriate place to put this sport so we can get more kids back to playing?’ They always want to look to get kids into participation situations with as much risk minimization as possible. That’s at the core of their mission.
TKR: Is there any new information the committee will look at about transmission of the virus?
Dr. Niehoff: We don’t have much more information about transmission other than aerosol. We know aerosol is the greatest risk of transmission and there are factors associated with that—time and contact or time and proximity, distance, air quality, air movement quality, hygienic practices and of course some of the other mitigation strategies. We have research to prove that aerosol mitigation works.
TKR: Part of the frustration in Illinois and in other states I’m sure is a lack of public access to what information is being used to make decisions about return to play. What specific categories of data does NFHS compile?
Dr. Niehoff: The data that we keep in our office is not about Covid cases in states as reported by state associations. It’s about seasons start/stop, rules modifications, dates/times, just to keep a handle on where the movement is and how rules are being adjusted and other changes in protocols. We have some anecdotal information from states to their best estimate, how many contests were postponed/cancelled due to Covid? We have sort of informal surveys about that. We’ve asked our states, ‘can you give us your best?’ Our state associations are doing their best to talk to one another. In Illinois, working with Indiana and Wisconsin and see what our neighbors doing. For example, we had one of our state association members reach out to his colleagues and ask a few questions about fall seasons. Again, this is not a research study it’s an informal survey. One of the questions was ‘approximate the percentage of contest cancellations in each activity due to Covid?’ For Illinois in cross country, (the answer) was ‘none that I’m aware of.’ This is kind of what we see in Indiana, the same thing in Kansas, (the answer being) ‘none that I’m aware of.’ It’s tough to see that Covid has been a significant issue. We are not hearing from our states that it has been a significant problem. It is a significant concern? Yes. A problem? We’re not hearing that.