'Flexibility is the Key': A Q&A with Dr. Stephen Paul

University of Arizona football players return to Arizona Stadium through Gate 8, where they were met with clear health protocols.

University of Arizona football players return to Arizona Stadium through Gate 8, where they were met with clear health protocols.

(Photo: Mike Christy/Arizona Athletics)

When the University of Arizona began developing its plan to bring students back to campus amid the COVID-19 pandemic, university leadership focused on a "test, trace and treat" strategy that would support efforts to keep students and staff as safe and healthy as possible.

Dr. Stephen Paul

Dr. Stephen Paul

The phased reopening of Arizona Athletics has also leaned on those three T's, plus some additional T's of its own – "talk, tweak and think," says Dr. Stephen Paul, a physician in the University of Arizona Department of Family and Community Medicine and one of the leaders of the reentry team for the Department of Athletics.

"We are constantly talking to one another, because things seem to change by the hour – by the minute," Paul said. "We have this constant flow of communication between our team, the Pima County Health Department and the campus reentry team led by Dr. Richard Carmona. We have had to tweak some of our timelines, but we have so many great minds on these calls thinking through every possible scenario and outcome."

Arizona Athletics initially began its reentry process in June, as members of the football team took part in voluntary workouts at Arizona Stadium. The department paused the process at the end of June as COVID-19 cases rose sharply in Pima County. As cases declined, Arizona Athletics welcomed many Wildcats back to campus on Aug. 3 in a phased, thoughtful entry plan. Ongoing participation in day-to-day activities remains a personal decision made by each student-athlete.

On Sept. 24, the Pac-12 CEO Group voted to bring back fall sports, starting with football in November. The University of Arizona was scheduled to open its abbreviated six-game season on Nov. 7 at the University of Utah, but the game was canceled at Utah's request after the Utes had multiple players test positive for COVID-19.

The Wildcats' first game – and its Homecoming contest – is now scheduled for Saturday against the University of Southern California at Arizona Stadium at 1:30 p.m..

Paul recently spoke with UANews about the university's efforts to reopen campus, his team's reliance on open communication and how other schools in the Pac-12 Conference have approached their reopening efforts.

Q: In what ways can the phased reopening of athletic activities provide a template for reopening the rest of campus and the Pac-12 Conference at large?

A: We are dealing with a large cross-section of individuals with different backgrounds from all over the world, and we're looking to demonstrate that there is a way to bring a group this size back safely. When you look at campus life, you have performing arts, ROTC – two major functions you cannot do remotely – and you also have research groups, study groups, social clubs. Then, you have something like the Greek system, which is a significant challenge. What we're trying to do is create a template to see if it's possible and feasible to open campus.

We've had to make significant changes in our timeline. We have a tremendous working relationship with Pima County Health Department Director Dr. Theresa Cullen and our athletics steering committee communicates with Dr. Carmona on a weekly basis. There is nothing left unturned.

We are constantly monitoring the local health system, too. We have continually adjusted our models based on guidelines from the Centers for Disease Control. Flexibility is the key in all of our planning.

Q: As you speak to other doctors throughout the Pac-12 Conference, what have you found to be the most significant challenges other athletic departments are facing?

A: There have been two major issues – the first of which is testing. If your school doesn't have its own system for testing, it's going to be extremely expensive. In order to ramp up to the necessary frequency to allow competition between teams, it is a significant challenge. Most Pac-12 schools are fortunate to have the testing capability, but that's the biggest hurdle. As one of our epidemiologists said in a recent Zoom meeting, the perfect test is quick, reliable and cheap – and you're lucky to get two of the three.

The second issue: Some programs may not be as fortunate as ours in terms of establishing a cooperative working relationship with their public health departments. At the University of Arizona, everyone is working together with a direct link to athletics. We have our advisory team – Kacey Ernst, Theresa Cullen, Dr. Carmona, Dr. John Galgiani, our Campus Health partners, Dr. Michael Stilson, Don Porter and also people representing the intensive care unit at Banner – University Medical Center Tucson.

In our calls with the other Pac-12 schools, we preach that you have to work with your county health department and ensure that everyone works together and shares as much data as possible.

Q: Have there been any surprising or otherwise unexpected logistical issues that your team has had to address in order to move forward?

A: Nothing has really been a shock to us, but every day I wake up and it feels like we're dealing with a moving target. Every day, we have to think through extremely complex protocols and how we can relate those protocols to the next phase, while communicating that information to all the various stakeholders. We have learned that you can't be locked into hard deadlines or policy.

Q: How are the student-athletes adapting to enhanced safety protocols?

A: Honestly, that's been the most pleasant surprise. When football reentered the first week and did their voluntary summer workouts, what we consistently saw was that everyone is doing their job. We can control what happens when they are on campus, but when they're off campus, it's harder to control. But from the evidence I'm seeing, they are doing an excellent job.

We are all super impressed with level of maturity and buy-in with football, and we expect the same with our volleyball and soccer players. It helps that we have had full commitment with the football team's coaching staff led by Kevin Sumlin. All of the other head coaches we have worked with understand this is a new world and are willing to do whatever we need to, to resume safely. It starts at the top.

Q: What protocols or strategies that have been implemented as a part of this process do you hope to see continue at the University of Arizona in a post-pandemic world?

A: If we can increase the rate of people getting flu shots this year and every year going forward, we can make a seismic change in improving the overall health of our country. The percentage of people getting a flu shot is still pretty low, even after we've made these big pushes in recent years. All of the misinformation is tough to overcome.

Hopefully we'll learn the model of mitigating risk when it comes to these sorts of things. People will wash their hands more often and be more aware of their environments. We preach that to our new athletes coming in. Look around you. Be aware. Find your entry and your exit. This pandemic is going to introduce a new reality.

On the bright side, I was impressed with the amount of people getting out and exercising during the lockdown in the spring. I've often thought to myself, "how many of these people were exercising for the first time?" It's important that we stay committed to exercising and cooking healthy foods at home.

We can't touch or hug anyone right now, obviously, but we might develop a new sense of connectivity. At Campus Health, we are figuring out how to do things in a more cost-effective way for the client. We might be able to use these new and emerging technologies to reduce costs, improve people's overall well-being and reimagine the ways in which we use our time.


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