By: M. Walker Upchurch
On August 11th, the Universities’ Presidents within The Big Ten Conference met and decided to cancel football for the upcoming season. The Presidents of the Universities cited public health concerns and a startling correlation with myocarditis as one of the primary reasons to cancel the season. However, after mounting public pressure and the forging onward by three of the power five conferences, on September 16th, The Big Ten Conference announced that the college football season is back. Additionally, The Big Ten Conference is scheduled to start the season on the weekend of October 23-24.
While it is in the best interest of the fans and the college-students dreaming of going to the National Football League to have college football this season, The Big Ten Conference may have made a mistake by choosing the short term gain of a season over the long term effects of serious litigation.
The Mayo Clinic has defined myocarditis as “[A]n inflammation of the heart muscle (myocardium). Myocarditis can affect your heart muscle and your heart’s electrical system, reducing your heart’s ability to pump and causing rapid or abnormal heart rhythms (arrhythmias). A viral infection usually causes myocarditis, but it can result from a reaction to a drug or be part of a more general inflammatory condition. Signs and symptoms include chest pain, fatigue, shortness of breath, and arrhythmias. Severe myocarditis weakens your heart so that the rest of your body doesn’t get enough blood. Clots can form in your heart, leading to a stroke or heart attack.”[1]
On August 31st, 2020, a team Doctor at Pennsylvania State University painted a grim picture of what the future could hold for many college athletes. Dr. Wayne Sebastianelli, an Orthopedic Surgeon and Sports Medicine Doctor who serves as Pennsylvania State’s Director of Athletic Medicine, stated that many student-athletes had not recovered their full pulmonary function.[2] He also said that: “When we looked at our COVID-positive athletes, whether they were symptomatic or not, 30 to roughly 35 percent of their heart muscles (are) inflamed.”[3] While this number of 30 to roughly 35 percent has been met with some scrutiny, a separate report is coming out of Ohio State University from Cardiologist Dr. Curt Daniels. [4] It reports to have found that almost 15 percent of athletes who had contracted COVID-19 had myocarditis.[5] The procedure that was performed to uncover the myocarditis at Ohio State was a cardiac M.R.I., and additionally, nearly all of the athletes who developed myocarditis had mild or no COVID-19 symptoms.[6]
According to a paper published in the Journal of Heart and Lung Transplant by Dr. Edward D. Moloney FRCPI FCCP in 2005: “Myocarditis is a major cause of end-stage heart failure and is responsible for up to 10% of cases of idiopathic dilated cardiomyopathy (IDC). Worldwide, approximately 45% of all heart transplants are performed for IDC and up to 8% for myocarditis. Early reports suggested that survival after transplantation for myocarditis was poor and patients had an increased risk of rejection.”[7] While these statistics are from patients who did not develop myocarditis due to COVID-19, it sheds light on how severe the long-term effects of COVID-19 may be.[8] Last year, according to the United Network of Organ Sharing, 3,552 were performed. [9] Thus, approximately 285 of the 3,552 heart transplants that were performed last year result from the new condition that the student-athletes have been diagnosed with.[10]
As of September 3rd, 2020, according to the Center for Disease Control, there have been 6,087,403 total diagnosed cases and 185,092 deaths involving COVID-19.[11] These statistics translate to a fatality rate of 3.04%.[12] Likewise, in the past week, 288,357 people have been diagnosed with COVID-19.[13] If this newfound effect is lingering in the population that is the most resistant to COVID-19, than it seems likely that it could also affect many others who have had COVID-19 that have not had a cardiac M.R.I.
Many legal questions will need an answer. How will these athletes receive treatment? Who will be responsible for paying for the necessary treatment? And, if an athlete was never diagnosed with COVID-19, but had the viral infection and developed myocarditis after they had played at the University, who will be responsible for their care? There are two certainties in the fluid time of the COVID-19 pandemic. First is that we do not know all of the long-lasting effects of the virus. And lastly, when the time comes, litigation will occur.
[1] Mayo Clinic, Myocarditis,https://www.mayoclinic.org/diseases-conditions/myocarditis/symptoms-causes/syc-20352539
[2] See State College Area Board of School Directors Meeting | 8/31/20 LIVE 7:00 p.m., YouTube (Aug. 31, 2020), https://www.youtube.com/watch?v=4Ju2PRFyDK4&t=4059s
[3] Id.
[4] See Billy Witz, Doctors Enter College Football’s Politics, but Maybe Just for Show, N.Y. Times, Aug. 24, 2020, at D1.
[5] See Id.
[6] See Id.
[7] Moloney ED, Egan JJ, Kelly P, Wood AE, Cooper LT Jr. Transplantation for myocarditis: a controversy revisited. J Heart Lung Transplant. 2005;24(8):1103-1110. doi:10.1016/j.healun.2004.06.015
[8] See Id.
[9] UNITED ORGAN SHARING NETWORK, https://unos.org/data/transplant-trends/ (last visited Sep. 4, 2020)
[10] See Id.
[11] CENTER FOR DISEASE CONTROL, Covid Data Tracker, https://covid.cdc.gov/covid-data-tracker/#cases (last visited Sep. 4, 2020)
[12] See Id.
[13] See Id.