As the coronavirus continues to spread in the United States, with more than 500 cases confirmed nationwide according to the Centers for Disease Control, a growing number of teams and venues are grappling with the complicated calculus of whether they should cancel their event.
The decisions so far have widely varied, and there's a reason for that, according to Dr. Nancy Messonnier, the Director of the CDC's National Center for Immunization and Respiratory Diseases. "It is really difficult to make those kinds of pronouncements broadly," she said Monday. Local health departments and event organizers have to take into "consideration of the local situation. Consideration of what's going on in the locale where the event is being held and where people are coming from and what the event is and how big it is."
Using that criteria, Messonnier explained that a decision made in the greater Seattle area, which has so far been hit harder than anywhere else with at least 140 reported cases and 21 deaths as of Monday night, might be very different than what happens in another town. "A lot of it depends on the population," Messonnier said. "The risk of exposure but also the risk of individuals."
She cited research based on 70,000 cases reported in China. Only 2% were children under the age of 19. Nearly every one of those cases was labeled "mild." In comparison, the vast majority of severe illness occurred in older adults over 60 years old. The CDC said Monday that anyone over 60 years old was at "increasing risk," while those more than 80 years old or had underlying health risks were at "serious risk."
A good case study may be the BNP Paribas Open in Indian Wells, California. Organizers announced they would not hold the tennis tournament this week because of coronavirus concerns. According to a statement, health officials felt, "There is too great a risk, at this time, to the public health of the Riverside County area in holding a large gathering of this size."
At least 59% of the population in Indian Wells is 65 or older. The event typically draws 145,000 spectators from all over the world -- a massive number of people descending on a town where one out of every two people are at "increasing risk" to "serious risk" of becoming dangerously ill from the virus, according to the criteria laid out by the CDC.
Messonnier emphasized that decisions to cancel events will not be made by the CDC, but will instead be made by local and state health departments. Unlike France, which has issued a nationwide ban on events with more than 1,000 people, it's not federal but state laws that typically enforce quarantines and other rules relating to public health decisions.
As a result, it will often be a local health department, like Riverside County, working with a venue organizer, like the BNP Paribas Open, about whether a cancellation is warranted.
The CDC doesn't yet have enough information about how the coronavirus spreads to provide a specific number for what constitutes a "mass event" -- or how many people is too many people in one place -- but it is advising people to stay at least six feet away from one another.
In a joint statement, the MLB, NBA, NHL and MLS announced Monday evening that "given the issues that can be associated with close contact in pre- and post-game settings, all team locker rooms and clubhouses will be open only to players and essential employees."
But staying six feet away is next to impossible if you're sitting in a typical stadium-style seat. Last week, Johns Hopkins University barred spectators from attending the opening two rounds of the NCAA Division III men's basketball tournament on its campus in Baltimore, Maryland, the same day the state announced its first three cases.
Other NCAA tournament venues have not, so far, made any changes as of Monday night. That includes the Final Four at Mercedes Benz Stadium in Atlanta, Georgia, which is expected to host more than 80,000 people on April 4th.
But the situation is fluid and can change rapidly as cases climb each day. Fulton County, Georgia -- which includes the city of Atlanta -- announced the closure of all its schools Monday night after a teacher tested positive for COVID-19. About 12% of the population of Fulton County is 65 years or older, according to the U.S. Census Bureau.
"Decisions may be different for events in different locations," Dr. Messonnier said. Meaning fans shouldn't be surprised if games go on as scheduled in one state, with others played in empty venues elsewhere, with others completely cancelling their event all together.