Lakers life inside the NBA's COVID-19 bubble

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With the Los Angeles Lakers’ season wrapping up in style, Sunday night, Oct. 11, with their 17th NBA championship, the players and support staff are leaving the isolated, coronavirus-free “bubble” they’ve lived in since July.

That includes the Lakers’ team doctors — UCLA Health physicians — who’ve rotated into the self-contained complex at Orlando’s Walt Disney World established by the National Basketball Association to safely resume its 2020 season amid the pandemic.

“The dedication our doctors showed in the midst of a remarkably challenging situation shows not only their commitment to the team, but their commitment to the Los Angeles community,” says Johnese Spisso, RN, MPA, president of UCLA Health. “We’re very proud of their work and we congratulate them on their success.”

Comprising multiple resorts within a 4-mile circumference, the bubble was home to 22 NBA teams and their associated coaching and medical personnel for final portion of the NBA season, after the league shut down early in the pandemic. Sports reporters, chefs and barbers were also on site, with the two finalists – the Lakers and the Miami Heat – the longest-standing tenants.

While there are ample amenities to make the environment as comfortable as possible: chef-made meals, multiple workout facilities, a swimming pool, even a lake for fishing — and, most critically, not a single case of COVID-19 — bubble life still has its challenges.

“For me, personally, the greatest challenge has just been being away from my family,” says Kristofer Jones, MD, an orthopedic surgeon and head team physician for the Lakers who has been in the bubble since Sept. 5. “My wife is a physician as well, and we have a 5- and a 4-year-old at home, so they’re dealing with a lot of new changes with my 5-year-old going to kindergarten and starting Zoom school — just the familial things that are going on at home and not being able to participate there.”

Bonding in the bubble

Two other team doctors from UCLA Health, Daniel Vigil, MD, and Thomas Kremen, MD, also said being away from loved ones (including their dogs: Rocco and Oso, respectively) has been the hardest part of bubble life.

“It’s tough being away from family, from work, from familiar surroundings,” says Dr. Vigil, who’s been inside the Orlando, Florida, confines since Sept 20. “I think everyone is looking forward to going home, despite the success of the bubble.”

“Honestly, I think it comes down to family, food and having some downtime,” adds Dr. Kremen, who spent nearly six weeks in the bubble before returning to Los Angeles. “There were lots of activities, but it’s still different than being in the real world.”

For the NBA players and staff who’ve spent more than three months in isolation, the emotional burden is even more profound. There are specialists in behavioral medicine onsite, Dr. Vigil says, and the daily questionnaire every bubble resident has to complete about potential symptoms of COVID-19 includes an opportunity to talk with a mental-health professional.

But players are also finding creative ways to handle the prolonged separation.

“Human beings find ways to adapt, and that has been a very interesting observation on my part, just watching how people deal with the repetition and monotony despite this glorious resort that we’re staying in,” Dr. Vigil says. “Just watching people play cards, go swimming, go to the gym, create businesses — apparently one of the players from one of the teams has established a coffee espresso service out of his hotel room — it goes to show how people cope with the need for connection, socialization and just camaraderie.”

The bonding between players, staff and physicians has been one of the best parts of the experience, says Dr. Jones, adding that it will benefit their ongoing work together.

“It’s almost like going back to a college environment. We all have rooms on the same floor. We eat together every single meal. The team will put together a Monday Night Football viewing party in one of the lounges and the staff, players and everybody gets together,” he says. “And as a physician, you want that type of relationship with your patients, so that level of trust is there.”

Medical realities in the bubble

All bubble residents undergo coronavirus tests every morning. Everyone wears masks and practices physical distancing. Other potential medical needs have been carefully considered, too, doctors say.

If a player gets hurt, for instance, “we can obtain an MRI within 15 minutes of an injury,” Dr. Jones says. Prescriptions are filled within hours and delivered to a clean room onsite.

The only thing missing is the range of experts and services that would typically be available, says Dr. Kremen. “Especially being at a place like UCLA, where we have a seemingly infinite number of specialists and resources,” he says. “It’s a very distinct difference from what was available inside the bubble.”

The physicians also have maintained their usual patient loads in Los Angeles while away in Orlando, handling appointments by videoconference before attending to the Lakers’ needs.

“I still have a day job. I’m not on vacation,” says Dr. Vigil. “I’m trying to be available to my colleague doctors and my own patients.”

Dr. Jones says one “silver lining” of the pandemic is how accessible telehealth practices have become. “I’m surprised at how much we can accomplish with just a video visit,” he says.

Lessons from the bubble

The success of the bubble — no infections despite the large number of players and other participants — offers important insights for restoring some normalcy to a pandemic-plagued world, doctors say.

“From the standpoint of epidemiology and knowledge of how this particular pandemic is evolving, this is a really good experiment that will add information to what mechanisms can be applied to regular society,” Dr. Vigil says. “The concepts of wearing a mask, physical distancing, adhering to protocols of sanitation — that’s really all this is, and it works.”

The safety of the bubble has created “a false sense of security,” Dr. Jones says, that will be shattered upon return to non-bubble life.

“It just makes you feel like you’re in a protected environment where there is no COVID,” he says.

Still, lessons learned from the zero-infection rate inside the bubble can apply to everyday life.

“The NBA has all the right ingredients here for establishing how to make a large group gathering work,” he says. “In some ways, yes, this was about the NBA finishing the basketball season. But if you look at it also as a social experiment in the times of COVID, it shows we can get large groups of people together and accomplish whatever we’re trying to accomplish. What’s interesting is we can take these ingredients and apply them to something else in the near future.”