At last week’s presidential debate, Donald Trump claimed he “brought back Big Ten football.” The college conference reversed course earlier this month and voted to send football players back on the field this fall—a decision that came only days after researchers at Ohio State University published a study of athletes who had contracted mild COVID-19 cases, but showed signs of myocarditis, a potentially serious and long-lasting heart condition.

Staff writer James Hamblin and executive producer Katherine Wells ask cardiologist Amy Kontorovich what we know about COVID-19‘s impact on the heart. And Hamblin calls staff writer Adam Harris to ask why schools are putting student athletes at risk—and whether the controversial decision could change college athletics.

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What follows is a transcript of the conversation between Hamblin and Harris:

James Hamblin: Football is not a socially distanced sport. Just this week, the Tennessee Titans had a COVID-19 outbreak and paused team activities. It’s especially interesting at the college level though. These are unpaid student athletes at risk and going to college campuses. How is this being handled right now at the college level?

Adam Harris: It’s being handled in different ways. You’ve seen some institutions in some conferences completely shut down their college football seasons. You saw some colleges say that we‘re going to postpone it until we learn new information. And then you saw some institutions go ahead with it. They started practices. They started playing games. They had stadiums with limited capacity. Some of these smaller schools that ended up doing this, they now have national television games because they’re some of the few that are playing college football right now.

Now, some of the conferences that canceled or postponed their seasons are making plans to come back. Each individual conference has had to make their decision on its own. The Big Ten, for example, said that there was “too much medical uncertainty and too many unknown health risks” and that’s why they were going to postpone the Big Ten’s fall sports.

The Big Ten, of course, is now one of the conferences that is planning on bringing football back. But there hasn’t been much that’s changed. What we know about the science, what we know about how outbreaks are happening on campus ... The thing that is different is the public pressure—the pressure from boosters, from politicians. When you have the president saying that we need college football back, it’s just applying a different level of pressure.

Hamblin: Is money driving these decisions?

Harris: It’s hard to say definitively that they’re doing this because of the money. But if you look at the Power Five conference schools where college football is a major revenue driver—from the television contracts to merchandise to just the entire package—college football makes a lot of money. And the prospect of going without that money was a very difficult decision to have to make, particularly in this situation where they’re also scaling back the capacity on campuses where some institutions are only at 40 percent capacity.

Hamblin: Is this hitting state schools harder than private schools?

Harris: There are different pressures applied to public schools than private schools. Over the last several years, public institutions have faced severe budget cuts and increasingly partisan      higher education boards being     . You’ve seen this devolve into a form of culture war. When the president is tweeting that we need to bring college football back, that often more Republican board will likely fall in line and say: we need to bring college football back and you guys need to figure out a way to do it. Public schools are being put in this incredibly difficult position with public funding on the line. The legislature could very well say: if you guys don’t play football, then we’re going to cut your budget by X amount over the next few years.

Hamblin: Oh wow, so it’s not just branding, TV deals, jerseys, what have you ... it’s also actual threats that they might lose funding from the state because of political pressure.

Harris: Absolutely. This has been in the water for a while, but when you have these culture war things happening on campuses, they can have long term consequences for a player’s health.

Hamblin: Has the debate about restarting the season run into this older debate about unpaid student athletes?

Harris: It has. Back in June, when colleges initially decided to bring student athletes back to campus to do their workouts and get ready for the fall season, it immediately created this line that says: these athletes are fundamentally different than the rest of your student body. And if you are not willing to bring back the rest of your students, why are you willing to bring back these unpaid athletes to provide a different service for your institution?

It immediately ignited this idea that, if they’re different, and if they’re being brought back in the same way that you’re bringing back some of your employees, that means they could be an employee of the institution. That means they’re being classified differently and they should be paid for this labor, for putting themselves at risk. It exposed some of the hypocrisy of the idea of amateurism. This is a money game and the players are the most essential part of that game and they’re not being adequately represented or compensated for their work.

Hamblin: Do you think student athletes could organize and protest?

Harris: Some student athletes organized around public health, around Black Lives Matter, and around labor rights—there’s #WeAreUnited—basically they were pushing for regular routine testing and all these measures to make sure that students stayed safe, and that, on the back end, that future generations of college athletes would be treated fairly, that they could be paid for their work, and that they shouldn’t be stuck with sports-related medical expenses, including COVID-19 expenses. They were trying to make sure that they weren’t going to be forced to sign documents that would serve as liability waivers, that they should be prioritized over the big salaries of the coaches. To make sure that the institutions were putting the student athletes first.

If something like that catches on and becomes a massive movement, then I think that you could really start to see some change in the system because, at this point, the athletes do have the power here. If all college athletes said: We are going to stop playing. We don’t feel safe. We don’t want to play. The NCAA would be forced to shut the season down.

Hamblin: I have complex feelings about introducing payment to athletes, just in this moment. It’s something that seems very obviously necessary in normal times, but if suddenly we were like, Oh, you feel unsafe and you’re putting yourself at risk of serious disease? Would you do it if we paid you $50,000 dollars? That is not the reason that payment should begin.

Can fans do something? Is there something they can do to not just be complicit in a system of exploitation that may be putting people’s health at risk?

Harris: It’s really difficult to say that there’s something that individual folks can do. I think at this point, it’s on college leaders to do an honest assessment of where they are, where the science is, and follow the science.

Hamblin: I remember when there were announcements of people stopping watching NFL football because of concern about head injuries. I remember when Ta-Nehisi Coates wrote for us about his decision to do that as the science was emerging about just how much risk people were putting themselves at. He didn’t feel like he could be part of supporting it in any way, even by turning on the TV to watch the NFL on Sunday. Should people who are consuming or planning to consume college football—even just passively by turning on the TV—should they be trying to figure out their moral guidelines right now?

Harris: I was talking to a researcher the other day, and they basically said "if CTE wasn’t the thing that got people to stop watching football, I have a hard time believing that this would be the thing that gets people to stop watching football." If you do not feel that this is a thing that should be happening, then yeah, maybe it is time to turn off college football. Maybe it is time not to watch anymore.

And I’ve seen people who’ve said as much: that they won’t be watching the Wisconsin Badgers or whoever this year or next, because of how they handled this decision to bring college students back and have them play football when nothing has fundamentally changed about the science from when they postponed the college football season. They’re just seeing other institutions playing and making money. And they are also in need of money.

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