'Caught in the middle': Coaches are at higher risk in pandemic but not opting out

Philadelphia Eagles offensive line coach Jeff Stoutland is 58 years old and a survivor of triple bypass surgery. While with theMiami Hurricanesin 2010, some discomfort during his daily workouts prompted him to see a doctor. He was given a stress test, which revealed significant artery blockage that would require immediate open-heart surgery to save his life.

"They said, 'Do you understand you're 99% blocked in the 'widower' vein?" Stoutland said later that year. "I don't even know what that is, but it doesn't sound good."

He spent 10 days in the hospital. Ever dedicated to his work, he planned to conduct film sessions with his players from his hospital bed, until head coach Randy Shannon found out about it and shut the idea down.

Stoutland is one of the many coaches considered high risk as a result of age or underlying health conditions to become seriously ill should they contract the coronavirus. They are among those taking the greatest health gambles by participating in the 2020 football season amid a pandemic, but Stoutland didn't relay much concern over returning to the workplace during a videoconference in late July, his confidence bolstered by the protocols in place at the Eagles' facility.

"Coming through the front door, going through the gate, getting tested each morning, I've got to tell you, I've never felt more safe in my life," Stoutland said, pulling down his mask to address the media virtually from an otherwise empty room. "I told my wife that. I told my kids that. For every little detail that's going on right now -- [sanitizing] the door handles, everything that I notice -- I'm like, 'Oh my goodness, they think of everything to keep us safe.'"

The same week Stoutland made those comments, the virus slipped past those safeguards and found its way into Philadelphia's NovaCare Complex, carried unknowingly by head coach Doug Pederson, who tested negative multiple times following initial exposure outside the building before a positive test developed. Pederson was sent home, as was quarterback coach and pass-game coordinator Press Taylor, because he had been in close contact with Pederson.

While the incident did not lead to a serious outcome -- Taylor has since tested negative, Pederson remains asymptomatic and both have returned to the complex and the Eagles' protocols appear to have helped prevent further spread -- it illuminated the cracks in a bubble-less operation where the virus can be picked up outside the fortress walls and brought in undetected because of imperfections in the testing system. More infiltrations are expected across the NFL, and as social distance gives way to the physical closeness that football demands -- teams begin padded practice next week -- the chances of greater internal spread naturally increase.

To date, at least nine NFL coaches have tested positive for COVID-19, according to a source familiar with the situation. Eight of those cases have occurred since June 17. The exception is New Orleans Saints coach Sean Payton, who announced he had the coronavirus in March. Los Angeles Chargers coach Anthony Lynn told his players by Zoom recently that he had contracted the virus -- a moment that served as the opening for this season of HBO's "Hard Knocks." Lynn, Payton and Pederson are the only coaches whose positive tests have been reported publicly to date.

There are 102 team staffers across the league with known positives since June. That is compared to 107 players this offseason -- 64 which have occurred since reporting for training camp -- who have tested positive for COVID-19.

Safety is no sure bet

While most NFL players are in their 20s and 30s and in great shape, the average age of head coaches and coordinators is 49 years old, including 20 from that group who are 60 or older. According to the Centers for Disease Control and Prevention, the risk goes up as you age -- eight of 10 COVID-19 deaths reported in the United States have been in adults 65 and older -- and increases for those with underlying conditions, including diabetes, cancer, heart disease, sickle cell disease and obesity. People of color have been affected disproportionately by the virus, with African Americans 4.7 times more likely to be hospitalized and 2.1 times more likely to die from the coronavirus, according to CDC data.

Houston Texans associate head coach Romeo Crennel is 73. New England Patriots coach Bill Belichick and Seattle Seahawks coach Pete Carroll are 68. Tampa Bay Buccaneers coach Bruce Arians is 67 and a three-time cancer survivor. Minnesota Vikings coach Mike Zimmer is 64 and had eight eye surgeries in 2016. Chicago Bears defensive coordinator Chuck Pagano, 59, was diagnosed with leukemia in 2012. The list goes on. Some coaches routinely log 16-to-18-hour work days. It's a stress-filled lifestyle in which sleeping in an office is normalized and personal wellness often isn't highly prioritized.

Yet coaches are being offered less protection than the players they lead. The NFL and NFLPlayers Association negotiated an opt-out window for the players that closed Aug. 6, with those considered higher risk receiving a $350,000 stipend while voluntary opt-outs received $150,000. Sixty-nine players in all opted out. NFL game officials also were able to opt out of the 2020 season in exchange for a $30,000 stipend and a guarantee that their jobs would be protected in 2021. The total number opting out was seven (five on-field officials and two replay officials), according to ESPN's Kevin Seifert.

The NFL does not have an opt-out policy for coaches. It is left up to individual teams to handle. NFL Nation reached out to all 32 teams to inquire about opt-out options for coaches. While some teams said they would be open to accommodating coaches who did not feel comfortable being in the workplace this year, none offered evidence of having a policy in place. A prominent coaching agent, when asked if he had heard of any team offering coaching opt-outs, responded, "Not a one."

"The players have a union. The coaches do not have a union. That is a tremendous problem," said agent Eric Metz, who represents about two dozen coaches at the pro and college levels. "They are, for lack of a better term, caught in the middle. They are not management, and they are not players. And they don't have anyone negotiating on their behalf to address certain issues that they can have."

There are zero known coaching opt-outs to date in the NFL. And the overwhelming sentiment is few coaches, if any, would take an opt-out offer even if one were presented.

"There's no way I'd opt out, but I don't even think they have opt-outs for coaches," Zimmer said. "I think we love to do what we do so much that this is important to us."

"It's just not in the DNA of Jeff Stoutland," added Allison Stoutland, Jeff's wife. "When they made him, that part wasn't put in, and most coaches are the same way. Coaches just don't give up."

The Eagles, like all NFL teams, have transformed their facilities and put numerous protocols in place to mitigate risk: Employees must submit a wellness questionnaire through an app every day before entering the facility and are tested daily; and teams eliminated seating in the cafeteria, gave each coach his own office, created auxiliary weight rooms and locker rooms for proper spacing, tore down walls to create bigger meeting rooms, and have all employees wearing contact-tracing devices. And that's just for starters.

Every team had to have its infectious disease emergency response (IDER) plans approved by the NFL and NFLPA in advance of training camp. The common refrain from coaches is they feel safe in their respective facilities, allowing them to focus on the task at hand. But that doesn't paint the full picture.

"They're nervous," agent Tony Agnone said. "Players have history on their side, where it looks like the virus isn't as potent overall for the younger people; but for the coaches, it is very potent, especially representing minority coaches.

"These guys are in a whole different category because of age. According to CDC guidelines, all these guys hit most of those areas: high blood pressure, preexisting conditions, age, all the things the CDC has listed; you can check one or two boxes with them. So they're nervous, they're anxious."

'Life of a football family'

Herm Edwards was exhausted.

He said it in such a way that makes it hard to believe -- his voice dancing up the octave ladder, his delivery as high-octane as ever -- but the task in front of him as the football coach of the Arizona State Sun Devils, before the Pac-12 season was canceled this week, was large enough to sap even the strongest of motors.

"When I go home at night, I'm exhausted. We haven't even practiced yet!" said Edwards, 66, the former head coach of the New York Jets and Kansas City Chiefs. "And I'm just tired because I'm thinking of all this stuff: 'Ooh, I didn't think about that!'"

Stuff like: How am I going to safely hold a team meeting with 100 student-athletes? (He split the group in two rooms, addressing half of his players live and the other half on a monitor.) How am I going to keep my starting quarterback healthy? (He moved his locker away from the other quarterbacks and starters and grouped him with players who don't see the field much.) How do I prevent a position outbreak? (He kept players of the same position separated in meetings, knowing a spread among offensive linemen, for example, could wipe out his whole front.) What if I get the virus? (Edwards had assistants Marvin Lewis and Antonio Pierce at the ready and a contingency plan in place for each of his coaches.)

Then there's what to do about his family. Edwards was considering moving into a hotel for the season to keep his wife and daughters safe from infection. Similar decisions are being made across football.

One thing Edwards didn't entertain much was the thought of the virus getting the better of him. He knows some fellow coaches who have contracted it -- "They say it's a son of a gun, now. They say it beat 'em up!" Edwards said -- but in his mind, if he gets it, he'll be fine and back at it after a couple of days. That's how it will go, he said.

Pondering the alternative is too unsettling to consider, according to Edwards.

"The worry part is when someone has to go to the hospital. It's a whole other deal now. Somebody is on a [ventilator], that's not what you want to hear for anybody. That's in the back of everybody's mind, probably. To sit here and say no one is thinking about that, that would not be telling the truth," Edwards said.

"That's the last thing you want to hear, because that makes your stomach hurt."

Pushing through health risks is nothing new in this profession. Before last year, Arians reportedly had never completed a season as head coach without at least one trip to the hospital. He has been diagnosed with cancer three times, including in December 2017, when it was discovered he had kidney cancer. Arians postponed surgery to February so he could finish the season.

Arians plans to be protected this season by wearing both a mask and a face shield, but he is adamant about coaching from the sidelines on game day.

"There's no chance of me coaching from a box," said Arians, who returned to the game last season following a year off because of health issues. "Once we get a shield that I like, I'll have my mask and shield on and I won't be able to spit on 'em anyway."

Health and safety is a family affair this season. Allison and Jeff Stoutland are being extremely diligent when it comes to coronavirus prevention. They do not have people in their home. They do not go out in public, with the exception of necessary trips to the grocery store, and they wear masks and practice social distancing whenever they do venture out.

The emotions tied to Jeff's previous health scare and concerns over the risks in front of him are put to the side.

"I compartmentalize most of my life; that's the life of a football family, really," Allison said."It's just another form of game planning, and he's a great game planner, and the Eagles are the best and he is in good hands. And yet there will be things we're not prepared for -- that's game time.

"He's not OK without football. He needs football. Football is a big part of who he is, and so if they're doing all they can to protect him and we do all we can to protect him here, you have to trust and hope the odds are ever in your favor."

'Always worried about that'

Epidemiologist Zach Binney called what's happening in Major League Baseball a "best-case assumption for the NFL."

"The NFL is essentially trying to run baseball's playbook, so if we saw outbreaks rip through clubhouses in Major League Baseball, you would have to assume that you would see the same thing at some point in the NFL," said Binney, an assistant professor of quantitative theory and methods at Oxford College of Emory University.

"The NFL has more people, meaning there's more chance for the virus to get into the organization, and there's more contact, meaning it's easier for the virus to move through the organization if it gets in."

Even with strict protocols in place, the turnaround time to get tests back from the off-site lab is up to 24 hours, so teams are always working off old information. The NFL is reportedly adding point-of-care testing, which would improve the turnaround time.

Another hurdle is it can take several days for enough virus to build up in an individual to trigger a positive result after exposure, according to Dr. Jill Weatherhead, an assistant professor of infectious disease at Baylor College of Medicine. That means a person infected with the virus can generate a false negative soon after contracting COVID-19 and unknowingly carry it into the building.

In other words, there are vulnerabilities despite the league's exhaustive efforts.

"I can tell you what I would tell my patient who came to me and asked me: I would say if you are high risk, work from home if you can," said Dr. Gretchen Snoeyenbos Newman, assistant professor of infectious disease at Wayne State University, "and if you can make the financial decision for you and your family, I would not go back into an in-person working environment if that's feasible for you."

That's not an easy ask for coaches, though. For one, it's not financially feasible for everyone. While head coaches (approaching a salary of $7 million, on average) and coordinators (averaging anywhere from $750,000 to $3 million a year) are doing well, entry-level NFL coaches are lucky to be making $50,000. In many contracts, those figures can be cut in half if the NFL is unable to finish the season, according to a source, due to language in the deals concerning work stoppages before the new collective bargaining agreement was agreed upon.

There alsois the fear that if they give up their spot in the league, they won't find another job -- a fear that's felt particularly among older coaches in a league in the midst of a youth movement.

"If you ask guys, they'd say that's probably 99% of why they're doing it, why they're all-in. You're always worried about that, for sure," one NFC assistant coach said. "I know if I opted out, somebody would coach [my position group]. They're going to hire somebody. Are you out? When the music stops, are you going to have a chair? It's hard. That's real."

Beyond that is a dedication to the craft. One coach we spoke with has missed one day of work in more than 20 years, and that was for his child's birth. Coaches don't abandon their station, even in the middle of a pandemic. Superagent Bob LaMonte, who represents Chiefs coach Andy Reid, Las Vegas Raiders coach Jon Gruden, Los Angeles Rams coach Sean McVay, Pederson and a host of others, cited Alfred Lord Tennyson's "The Charge of the Light Brigade" on the coaching mentality.

"I always say this: Coaches are like soldiers. Theirs not to wonder why; theirs but to do and die,"Lamonte said.

"I've heard numerous professional coaches say over the years, 'If I have to die, I hope it's on the sideline.' For them, it's a way of life."