Epidemiologist on UFC events: We’re not ready, you can’t do this safely

Photo by Luis Alvarenga/Getty Images

Bloody Elbow spoke to an epidemiologist about the UFC’s plans to host multiple shows in Jacksonville, Florida.

The UFC plans to hold three events in Jacksonville, Florida between May 9 and May 16. These fight cards will be the first for the UFC since a March 14 event in Brasilia, Brazil. Like that event, the Jacksonville cards will take place with limited staff on hand an no crowd inside the 15,000 seat VyStar Veterans Memorial Arena.

Bloody Elbow spoke to Dr. Zachary Binney, an epidemiologist at Emory University about the potential dangers that could arise from the promotion’s ambitious plans to bring fighters to Jacksonville for the three fight cards.

The conversation has been lightly edited for length and clarity.

Bloody Elbow: What do you think about what the UFC is doing by putting on three events in one week in the same arena?

Zachary Binney: It’s a little hard to comment specifically without knowing any details about the safety procedures that they’re putting in place and the infection control procedures that they’re putting in place, but I’m not inclined to give Dana White and the Florida Boxing Commission and the mayor of Jacksonville the benefit of the doubt. I would have liked to hear the public health authorities take on the plan and without hearing that, I’m pretty nervous about it.

BE: That’s my stance too. With Dana White and the Florida Commission, who’ve always been pretty lax, my concern is that they’re just going to kind of run this as a normal event and then Dana White will say that he is regulated by the government and he’s just going to follow what they say. From what the commission did at the last event in Florida, which was held during the pandemic, but in the early stages, the only thing Florida did was temperature checks at the weigh in and before the fighters entered the building.

ZB: I’ll speak generally about the event and bringing everybody to Jacksonville. So you’re bringing fighters from all around the country to a single area, which means they’re going to have to travel. Some of them are going to have to fly. And even with the smaller number of Americans flying, that still involves a lot of contact and a lot of potentially close contacts like in an airplane, close extended contacts and that’s where the risk for transmission tends to be higher rather than when you’re outside. You’re always supposed to maintain six feet distance from somebody and long, close contacts are where the real concern is. So there’s certainly a chance that that fighters might get sick en route or on the way home.

There’s also the risk that they would bring cases of COVID-19 to Jacksonville and could spark a larger outbreak in Jacksonville depending on how many contacts they’re going to have at the event, which again, we don’t have a lot of details on how many people are going to be in the building at any one time and so on and so forth. We know there aren’t going to be fans, which is the absolute minimum that you could do.

Another major concern that I would have is not just people bringing the virus to Jacksonville, but if there is a chain of transmission at one of these events and then these fighters and their entourages go back to where they came from, they could seed multiple outbreaks in other areas that had otherwise been doing a pretty good job of controlling the virus. So one thing that I would certainly advise is for fighters to quarantine in Jacksonville for two weeks after the event before they travel home.

BE: The UFC is pushing these three events into one week, so there’s going to be even more in and out of the area for the fighters and teams. I’m going to assume they’re staying in a hotel. This is also just an assumption, but if we can work from this assumption, the UFC is going to do this as a regular event, because it’s probably too late to do what you had suggested to quarantine for two weeks. So if they fly in all three of these groups during the week of the fights and then they all fly out a day or two after the fights and there’s no quarantine, how concerning is that?

ZB: I mean, it’s not great. It really all boils down to how many contacts everyone has while they’re there. If you are, say, sanitizing the arena really, really well between fights and you’re only letting two fighters and their entourages in at a time then I don’t know that there’s too much danger to holding a bunch of fights in sequence. It’s like the damage is already done. You’re already getting fighters and their entourages together and you’re making them travel and you’re making them interact with one other entourage. But the damage is done. Doing that over and over again. Yes, it increases the risk because you’re doing this, you know, 2, 3, 4, 20 times. But it doesn’t increase the risk for any one person. So doing them in rapid succession isn’t the issue as much as the number of them that you’re doing, if that makes sense. It’s like even if you were spreading these 20 out over say you had 20 fights and you spread them out over three days or over 20 days if you’re only ever having two entourages in the arena at one time. I don’t think that makes a huge difference.

BE: So are you saying that they should disinfect the fighting area between fights or between events or both?

ZB: Between fights. They have already moved beyond what I feel is an acceptable plan at this stage. So everything that I’m talking to you about right now is damage mitigation. They’ve already screwed up or they’re planning to screw up. I am suggesting ways in which they can screw up less.

They should only have two fighters and their entourages in the arena at any given time along with the minimum support staff for that individual fight. And then they need to completely sanitize everything. They need to completely sanitize it. And then they can bring the next group of two fighters and their entourages in and they should keep that number down to an absolute minimum.

BE: On a normal flight card, I believe teams share locker rooms, I think just because of a lack of space. A fighter who is competing earlier in the night will share the same locker room with someone fighting later in the night.

ZB: That simply put, will increase the risk because it increases contacts between fighters and between entourages.

BE: But say they could disinfect between them, would that help a little or a lot?

ZB: That would help a little. I would say even more than disinfecting the surfaces, which is important, the key is to keep people separate as much as they can while they’re there.

In other words, the number one thing to do is make sure that only one fighter and their entourages in a given locker room at any time. A secondary, but still important concern would be to sanitize that locker room between each and every use.

BE: Is it just wiping things down or is it deeper than than, a deeper clean?

ZB: Yeah, I’ve been a little vague on that because that’s getting outside my area of expertise, so I don’t want to make specific claims on that. I would just say whatever an infection control person says is what they should do.

BE: You’d feel better if they talked to help someone from the Health Department on this?

ZB: I hope they’ve talked to someone from the Florida Department of Public Health. And I hope that they’ve taken what they have to say seriously or that they’ve consulted with outside experts who are telling them the safest ways that they can make this happen. But I haven’t seen any of that or heard Dana White say any of that. So I can only go by what’s been said publicly.

BE: He’s been real vague. He’s just said that he won’t tell the media anything because the less the media knows, the better. I think they probably need to know a little more, otherwise the UFC looks like it’s hiding something.

ZB: Like I said, I don’t feel inclined to give Dana White the benefit of the doubt that he’s doing this safely. Well, I don’t think that you can do something like this safely right now. I hope that we get to that point soon, you know, in the next couple of months.

It varies by the day whether I’m more optimistic or pessimistic about that. But the more that we try to force things like this back too quickly, the higher the risk that we lose it all for a long period of time. We all need to be pulling together and doing our part and that includes the UFC not holding fights in the US right now where they’re flying fighters in from all over the country with insufficient infection control procedures and risking a large outbreak.

It might be fine and then Dana White’s going to go out there and he’s gonna brag and say, “see everybody thought that this was going to be a big, horrible deal and nothing happened.”

The prevalence of infections in this country is it’s still more likely that you haven’t had the virus than you have. So that means there are a lot of susceptible people. But, you know, it also means that there is the possibility that if you’re dealing with a small enough number of people, you get lucky, but that’s not an excuse for rolling the dice, right?

BE: White has bragged about the UFC safety history and that has been good. Its had broken bones and concussions, but if you look at smaller MMA organizations, there have been deaths. I think the UFC has gotten lucky more than anything, but we’ll see what happens here.

ZB: Broken bones and concussions aren’t contagious.

You’re good at preventing fight-related deaths. That’s good, right? That has nothing to do with infection control. Your past history is not your your future here with this situation.

The UFC has some experience with preventing blood borne infections, but this is a respiratory infection and that requires totally different precautions.

BE: Anything you would like to add?

ZB: One thing that I hope that we hear is that they are at least testing fighters when they arrive — fighters and their entourages are at least getting COVID-19 tests before they enter the arena. That still might not be sufficient because some of these tests produce false negatives, by which I mean they say you’re not infected when in fact you are.

Certainly nobody with symptoms should be allowed in. Nobody with a fever should be allowed in, but those temperature scans, as you alluded to, are totally insufficient because a lot of people don’t develop symptoms at all and they can still be contagious. Even those who do develop symptoms, not all of them have a fever.

Temperature checks are totally insufficient. It’s a little bit of security theatre. It’s not bad per say, as long as it doesn’t replace other more important measures like COVID-19 testing. And that’s a broader issue right now that we’re that we’re dealing with in this country with some focus on temperature scans, you know, before people go into work or something like that. They’re not bad, they’re just insufficient and they can’t be looked at as replacing everything else that we need to do. I think that’s the the overarching message.

One of the things we don’t understand yet is exactly how soon after you’re infected, do you become contagious. And exactly how soon after you’re infected, do you test positive. We’re not sure which one of those happens first and the danger with that is that it’s possible that even if you test negative, you might be in this couple day window in the disease where maybe you’re contagious to other people, but you don’t test positive yet.

On the other hand, it could be the other way where if you test negative, even if you’re in the process of developing the disease, maybe you’re not contagious. We just don’t know that yet. So that’s why even testing someone right before they arrive or right before they enter the arena carries some risk because they might still have the disease and be able to transmit it either because of a false negative or because the infection is just still in its early stages and too early to be detected. So that’s something to think about, and that’s why I advocate, if you really want to be safe, that two week pre-entry quarantine period so that we give the disease enough time to rear its head.

You have to be in a situation where you can’t pick up a new infection. And then we have to wait two weeks to make sure that you’re not going to develop an infection that you already had.

Bringing sports back, it’s all a risk benefit. I’m probably the epidemiologist in this country most eager to bring sports back. I don’t know that there’s any any epidemiologist or public health person in this country more eager to have sports back. And I’m telling you, we’re not ready.

The truth is, in most states, we still don’t have the tests we need to even accurately identify cases efficiently or to know the number of cases that we truly have out there. And so that leaves us flying blind. And we’re just hoping that whoever you’re coming into contact with doesn’t have the virus.

Maybe they’ll be wearing masks in the arena. You know, that would help some because of what masks do is they protect other people from you. But not you from other people. And that’s something that’s really hard for people to grasp. If you think about it like if you’re breathing hard or if you cough, you’re coughing into the mask that’s catching a lot of the liquid droplets that hold the virus, but those droplets can still sneak around the mask because it’s not forming an airtight seal with your face unless you’re wearing it properly, which is really hard even for trained doctors and nurses. So most people don’t wear them correctly.

The real risk is getting any substantial number of people together right now. And there’s no way to know exactly what that risk is, but to me, it’s it’s too high right now and we need to wait until we know that there are fewer cases, especially if you’re pulling fighters in from all over the country, which just increases the risk, both of pulling the virus in from one area and the risk of distributing it to a bunch of areas if there is an outbreak.

BE: The fighters and camps often intermingle during fight week and that hotel and whatnot. They all know each other, so that does happen.

ZB: If that’s not tamped down on it could be even more dangerous than the flights themselves and I haven’t heard anything about a plan to stop that. If you’re spending an hour in a hotel room or even, you know, around a table in a lobby bar with a few other entourages, I don’t know, 15, 20 people. We’re not doing that, we’re not having 15 or 20 people over to our house. We’re not going out to restaurants yet.

I would just encourage everybody to recognize the risk and that you’re asking for a benefit, like you want to see a fight. You’re gonna get fights, but there’s a risk with that and it’s unacceptable to me. Other people may feel differently, but that’s where we’re at.

*Bloody Elbow reached out to the UFC, the Florida Boxing Commission and the Florida Department of Health for comment on the health and safety of these events. We did not receive a response prior to publication.