On Friday the 18th June, England played Scotland in the group stages of Euro 2020. On Sunday 20th June all of the players due to take part in matches the next week had SARS CoV2 PCR tests done to make sure they didn’t have Covid-19. This was a standard routine precautionary test as part of trying to make Euro 2020 as safe as possible.
Unfortunately, one of the Scotland team, Billy Gilmour, tested positive for SARS CoV2 in this test despite having no symptoms. This is a blow for the young player, who has only just made his debut for his country and looks like a future star of the team, as it now means he has to isolate for 10 days and missed the next Scotland game (sadly Scotland didn’t qualify for the next stage of the tournament, so that means all of Scotland’s Euro 2020 games).
So why the controversy?
Billy Gilmour testing positive for SARS CoV2 didn’t just affect him. As a result of his positive test all of his contacts need to be traced and a decision made as to whether they need to isolate as well. This is where it got controversial….
None of the Scotland team had to self-isolate but two of the England team did, Ben Chilwell and Mason Mount. How did that happen? How did none of the Scotland team count as a contact but two of the England team did?!
According to Public Health England on the UK Government website:
A contact is a person who has been close to someone who has tested positive for COVID-19. You can be a contact any time from 2 days before the person who tested positive developed their symptoms (or, if they did not have any symptoms, from 2 days before the date their positive test was taken), and up to 10 days after, as this is when they can pass the infection on to others. A risk assessment may be undertaken to determine this, but a contact can be:
- anyone who lives in the same household as another person who has COVID-19 symptoms or has tested positive for COVID-19
- anyone who has had any of the following types of contact with someone who has tested positive for COVID-19:
- face-to-face contact including being coughed on or having a face-to-face conversation within one metre
- been within one metre for one minute or longer without face-to-face contact
- been within 2 metres of someone for more than 15 minutes (either as a one-off contact, or added up together over one day)
Were the England players’ contacts of Billy Gilmour?
England played Scotland on the 18th June (2 days before the positive SARS CoV2 test). In case you’re wondering Scotland were by far the better team, but the result was a draw! After the game Ben Chilwell and Mason Mount were chatting to their Chelsea team mate, Billy Gilmour, off the pitch for about 20 minutes. They were therefore rightly flagged as contacts of a positive case. Bad luck, off to the self-isolation area of the training ground!! This means that these two England players will now have to miss the next two England matches in Euro 2020.
The controversy is that no one from the Scotland camp had to isolate!
What? Really?? Do we honestly believe that no one in the Scotland camp, players, coaches, team staff, no one at all qualifies as a contact of Billy Gilmour?
Look at the rules as to what constitutes a contact again. Face-to-face within 1 metre, within 1 metre for > 1 minute, within 2 metres for >15 minutes or if they have travelled in the same vehicle. I do not believe no one was in contact with him! Someone must have been in contact with him, or did he walk to Wembley Stadium?! There are even pictures of the Manager, Steve Clarke, holding Billy Gilmour’s face after the game. Surely that is a contact. And we all know footballers share a post-match bath, don’t they? The Scotland training ground (Rockliffe Park, Darlington) is 4 ½ hours’ drive north of Wembley Stadium and at the very least they must have been all together in the dressing room for half time, that’s 15 minutes?!
In my opinion, and I believe the opinion of Public Health England, ALL the Scotland team should have been self-isolating! A new 13 players should have been selected and at the very least the manager, coaches etc. would need to be “separated” or isolated in the grounds away from the rest of the game. However maybe PHE doesn’t cover Scotland!!
Don’t tell the players this…
Okay, there is something else that might be a little controversial here too, and that’s the accuracy of the tests available for SARS CoV2. I have previously blogged about diagnostic testing and sensitivity and specificity but the most important statistics are positive and negative predictive values. Basically, the positive predictive value (PPV) is the probability that a positive test means the person has the disease and the negative predictive value (NPV) is the probability that a negative test means the person doesn’t have the disease.
These values are NOT set in stone AND CHANGE as the prevalence of disease in the population changes! As prevalence increases (the disease is more common) the PPV increases and the NPV decreases; as the prevalence decreases (the disease is less common) the PPV decreases and the NPV increases.
Based on the published values for SARS CoV2 PCR tests in the UK (sensitivity 95%, specificity 99.9%) and the current UK average prevalence of Covid-19 being 0.1% the calculated PPV of a positive SARS CoV2 PCR would be 90% and NPV of 99.9% (if you don’t get this have another look at the earlier blog again). Basically, this means there is a 10% chance that Billy Gilmour’s positive test is actually a “false positive” and in fact he doesn’t actually have Covid-19 at all. Yep let me say that again, there is a 10% chance the test is wrongly stating he is positive. Meaning both he and the England players would be isolating and missing matches for no reason at all… did the test get repeated? If it was my “most important moment” and there was a 10% chance it was wrong, I’d want another confirmatory test! Now that really would be controversial… maybe we shouldn’t go there after all!
Football has rules, you have to kick the ball, you can’t pick it up and run with it (that’s rugby) and there needs to be at least 2 players between you and the oppositions goal when you are passed the ball (the basics of the off-side rule).
Covid-19 has rules too. Rules are rules. If you are a contact of a positive case, then you must self-isolate. In my opinion anyone in the Scotland camp who was a contact of Billy Gilmour (which has a high probability of being all of them!) should have to self-isolate. That would send the message loud and clear that the rules around contacts and self-isolation APPLY TO EVERYONE!
Okay, this would have caused havoc to the Scotland team but UEFA (Union of European Football Associations) who organise the tournament have rules in place for this type of situation. They have allowed teams to have larger than normal squad sizes in case players have to self-isolate, and they have a rule that means if a team has <13 players available for a match they can postpone for 48 hours in order to bring new players into the team to create a new 13 player squad. Okay, it’s not perfect, but having the Euro 2020s in 2021 isn’t perfect either and it does mean that public health Covid-19 measure can be followed safely… after all those are the rules!