In 1993, Celtics star Reggie Lewis, the inheritor of the mantle of Boston’s Big Three days, the franchise cornerstone who was going to lead the Celtics into a new era after Larry Bird and Kevin McHale retired and Robert Parish went on his farewell tour, passed away from a heart condition that first manifested itself in an on-court collapse in the playoffs and finally claimed his life in a practice session on July 27.
In 2015, your intrepid basketball columnist checked into the emergency room at Oregon Health and Science University in Portland with a rapid heartbeat of 240 beats per minute that would, over the course of the next week, nearly prove fatal before I was brought back from the brink of “make your peace with the gods” on the operating table.
The cause? Acute myocarditis. I nearly went full Reggie Lewis while walking around the streets of Portland enjoying some sightseeing on a weekend getaway from my home in the Seattle area.
What’s the connection here?
Simple. Myocarditis is one of the known side effects of COVID-19, and with both Major League Baseball and the National Football League finding themselves riddled with coronavirus cases just like the rest of the United States during the ongoing pandemic, the NBA is going to have to face the reality that some of its players, as a purely statistical matter, are going to potentially have their careers ended by a condition that could do to them what a condition similar enough in effect to it (Reggie Lewis died from exercise stress due to hypertrophic cardiomyopathy) did in 1993.
This is scary stuff. This is the kind of stuff that even off the basketball court leaves people at high risk of complications from COVID-19 stuck choosing between going to work and making a living vs. staying home and avoiding a condition that could literally kill them.
The YouTube channel SciShow just released a video about myocarditis in athletes.
Between 7 and 17 percent of patients hospitalized for COVID-19 had heart damage. And more recent studies are beginning to show that the damage is even showing up in people who had otherwise asymptomatic cases of coronavirus; it’s possible that some forms of viral infection aren’t causing traditional respiratory symptoms because the bulk of the infection’s happening in cardiac rather than pulmonary tissue.
And while I’m not a doctor, that still suggests that between one in fourteen and one in six NBA players who get the virus may be at risk of going full Reggie Lewis on the court.
So far this hasn’t happened in baseball or football. The NFL only plays once a week and there have only been a couple of months’ worth of games. Baseball is a relatively low-intensity athletic endeavor, all things considered, so it’s similarly less likely that enough events have accumulated to give the law of averages a chance to work to worst possible effect.
The NBA is about to go out and play a 72-game season, and they don’t have a bubble to protect them the way they did to put on the 2020 regular-season finish and playoffs.
What happens when a player gets COVID, gets cleared to play, and runs around the court for 35 minutes of action per game with a compromised heart?
What happens when the NBA, perhaps seeing this coming and knowing the risks—unlike MLB and the NFL, the NBA has shown far higher regard for player safety—mandates cardiac monitoring for any COVID-positive player even after his recovery and doctors say “he’s got heart damage, he’s at risk”?
Does the league shut down that player even though he’s otherwise healthy? And what if—gods forbid—the player is someone like LeBron James or Giannis Antetokounmpo, someone who if his team were to lose him would have disastrous consequences not just for, say, the Lakers or Bucks, but for the entire competitive balance of the league?
What if the battle for the 10 seed and a shot at the play-in tournament comes down to one team that beat the Bucks post-Giannis shutdown and the Lakers post-LeBron diagnosis vs. another team that lost to those two teams at full strength and the race for 10th is decided by just one game?
Nobody’s suggesting that a 25-win team in a 72-game season (or about a 30-win team in a full 82-game version) is going to win the title, but the whole point of the playoffs is that everyone there has a chance. The 8 seed Knicks made the Finals in 1999, after all.
The NBA has 22 days to think this all the way through. Because there’s a real chance that a player will have his career ended by COVID-related heart trouble. And there’s a smaller but non-zero chance that a player who otherwise looks healthy will die on the court just like happened nearly 30 years ago.
And short of shutting down the league until the vaccine is ready, the only thing the NBA (and all sports—hockey, are you watching this?) can do is try their best to be safe.