Health and Medicine

Gillings alumni and student played crucial role in NBA’s COVID-19 “bubble”

When the NBA restarted its 2019-2020 season with playoffs in a “bubble," UNC Gillings School of Global Public Health alumni and a current graduate student helped the league protect its players and close out its season successfully with zero cases of COVID-19.

A basketball with a mask on it.

According to Christina Mack, the National Basketball Association made a call in the name of public health when it suspended the 2019-2020 season in response to the COVID-19 pandemic. The plan to restart its season — and hold playoffs in a controlled environment, or “bubble,” at Walt Disney World Resort’s ESPN Wide World of Sports Complex in Orlando, Florida — was ambitious.

On Oct. 11, 2020, the season concluded with zero cases of COVID-19 in the bubble for its entire duration. Mack notes that the NBA’s history of relying on scientific expertise and data to drive decisions greatly contributed to the success of this novel approach.

Mack is vice president of epidemiology at IQVIA and both an alumna of and adjunct associate professor in the UNC Gillings School of Global Public Health. Her surveillance and analytics team at IQVIA, which includes current epidemiology doctoral candidate Kristin Shiue, was a key NBA collaborator on planning and operationalizing the Season Restart. On the NBA’s side, Tom Ryan, who received a Bachelor of Science in Public Health from the Gillings School’s Department of Health Policy and Management, is an associate vice president in the Strategy group who was vital to the bubble’s success.

The IQVIA team, a longtime NBA partner for injury prevention and monitoring, also includes Gillings alumnae and UNC adjunct faculty members Nancy Dreyer and Mackenzie Herzog.

Getting the NBA season going again was no small feat. In fact, Mack calls the task of creating a safe environment during the global COVID-19 pandemic one of the most challenging epidemiologic endeavors that she has seen, and one of the most impressive evidence-driven operations. She recalls that, in the planning stages, new data and evidence about COVID-19 testing, transmission and control were constantly evolving: “We learned something new every day as we put these protocols in place, and the goal was to respond appropriately at each turn.”

Dreyer, the chief scientific officer of IQVIA Real World Solutions, pointed out that this type of agile data collection and analytics depends on strong teams and good technology support: “You hear people analogize to building a plane while in flight. This was more like building a rocket during launch!”

The Orlando protocols involved daily testing, which produced copious streams of data to analyze to determine how best to keep the population safe. Shiue worked with Mack and the IQVIA/NBA team to make sense of the data in real time, conducting fast-paced analytics that informed operations.

“UNC’s epidemiology program provides foundational public health and epidemiologic methods knowledge,” Shiue said. “I was able to apply that training in approaching the data management and analytics for the NBA bubble.”

Mack stresses the importance of having robust protocols in place in advance, along with the necessity of taking an evidence-based approach to strengthening protocols on an ongoing basis.

“This approach — the willingness to take the time to understand the science and evolve protocols and operations with a constant eye toward safety and public health — is a key to the success we saw in the bubble, despite increasing population rates in the surrounding community,” she explained.

When asked if this experience yielded lessons of value for the larger pandemic, Mack noted the universal utility of effective testing for SARS-CoV-2 and working behavioral protocols to avoid transmission. She points out that masking, physical distancing, handwashing and sanitizing, alongside strong communication and diligence among all individuals in the “bubble,” were key drivers of success. She credits the NBA, the players and everyone else living on the Orlando campus for the team effort that make the experiment work.

Ryan leads the Technology and Innovation function of the league, which focuses on advancing the game through cutting-edge initiatives, programs and partnerships. During the 2019-2020 season relaunch, he was responsible for building one of the key technology platforms to monitor population health. These systems collected the data needed for analytics: COVID-19 test results; daily symptom questionnaires, including temperature and oxygen saturation trends; and contact tracing results.

When reflecting on the success of this project, Mack, Shiue and Ryan all point to the importance of a firm grounding in the basic principles of public health and epidemiologic research.

“I chose the Gillings School because the UNC epidemiology program has the best methods in the business and a foundation in data science,” said Mack. “Being able to create a strong methodologic framework and employ robust data science to solve tough public health problems across disciplines, be it injury or infectious disease, drives our ability to take on these big challenges, parse through large amounts of data to generate useful evidence, evolve and find success. Working in this emerging disease setting as a pandemic unfolds is one of the hardest things we as scientists have ever done. The ability to think critically about how to approach these problems, anticipate what biases might exist, understand how we get to the right answer and apply those learnings are concepts that were ingrained during my training at UNC.”

Ryan also has fond memories of his time at Carolina, but is surprised at the degree to which his undergraduate public health training has proven useful in the sports industry.

“My experiences at UNC have profoundly impacted the trajectory of my life and career,” he said. “UNC was critical in sparking my intellectual curiosity and refining problem-solving capabilities that I apply to my daily responsibilities at the NBA. That said, I never expected to work on an NBA project squarely at the intersection of my two majors at UNC – public health and business. The Gillings School’s health policy and management program provided an incredible public health foundation that helps me contribute to the NBA’s strategic and operational plans for navigating the pandemic. In the future, I hope to continue using my background to spur innovation in health and wellness for all athletes.”

Dreyer adds that she and Mack have a long track record of successfully recruiting Carolina alumni to IQVIA — including encouraging them to get their epidemiology training at UNC-Chapel Hill and then hiring them on completion.

She said: “We see UNC as a great resource for people who can think well and then execute their ideas.”

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