Swine flu an uncomfortable reality

In Stephen King's classic novel "The Stand," a super-flu roils out of control, decimating the population and setting up a biblical clash between survivors.

Given that New York Islanders forward Doug Weight -- one of four NHLers who have been publicly diagnosed with swine flu -- returned to action against the New York Rangers on Wednesday night, it's safe to say we're not yet on the path to global ruin through swine flu epidemic.

Other Leagues Take Steps

Here is a quick look at what a few of the other pro leagues are doing to combat swine flu:

" Established rule that if you have at least six confirmed cases of swine flu on your team, you can activate up to eight players off your practice squad up until four hours before kickoffs.

NFL is working with the Duke University Infectious Disease Outwork Network to keep a flow of information going to teams, coaches, doctors, trainers and players. They have trainers and doctors from teams compare notes on what they've learned. As seen in Houston and Cleveland, once a player shows signs of having any flu, they are sent home and isolated immediately. The protocol is information and education. Once a team learns something after going through an episode, they share it with the retained doctors and Duke University. Since the summer, the NFL has been proactive.

-- ESPN.com's John Clayton

Earlier this month, NBA vice president of basketball communications Tim Frank said the league was taking these precautions:

" A full pandemic plan was put together after consulting with experts on infectious disease (retained an expert in March) and the NBA was following all recommendations of the CDC and WHO. NBA was also following direction from local authorities in our team markets and will look to those cities for local guidance throughout the season.

" Currently communicating with teams to review their pandemic plans as the season gets under way.

" All league employees have been offered [regular] flu shots.

" In terms of how the league would handle sick players, Frank told True Hoop last month, "I know from my days working for a team, we would keep guys from coming to practice if they had the flu. The last thing you want them to do is spread it. And that's just for the basic flu. I mean, with this, you'd obviously be more careful."

Added Frank: "We are planning for all eventualities, from hand sanitizers through what happens if we have to cancel games. The planning book is something like 300 pages long. We're trying to have contingencies for everything that could happen now, but obviously a lot of these contingencies ... you hope you never have to make that decision."
-- Henry Abbott, True Hoop

But somewhere between panic and puns, there is the uncomfortable reality for the NHL and its players.

Players and staff have been joking uneasily in recent days about declining to shake hands or sharing hotel rooms as a trickle of players have been diagnosed with the potentially deadly strain of the flu.

Still, it's not as though the NHL and its players were taken by surprise by swine flu, which is caused by the H1N1 virus.
Even before there was H1N1 -- back when there were fears about a pandemic of bird flu -- the NHL was talking to pandemic specialists about the potential impact on groups of people who spend a lot of time hanging out together, sharing dressing quarters, buses and planes.

"These are things that we are looking at all the time," NHL deputy commissioner Bill Daly told ESPN.com on Thursday. "Our approach is to be as proactive as we can be."

When swine flu concerns began making headlines, league and NHL Players' Association officials began ensuring that information was readily available to players and management to educate teams about how to be proactive in keeping the disease at bay.
On the players' internal Web site, frequently asked questions and answers were provided, including who is most at risk, how to safeguard against contracting the disease, what the symptoms are, how to react when those symptoms are present, and the pros and cons of taking the H1N1 vaccine.

Players have consulted with the union's doctors in recent days, and team doctors and officials are in regular contact with the league regarding possible cases on their teams.

When Buffalo Sabres forward Clarke MacArthur showed flu-like symptoms, he flew home with the team fitted with a medical mask. When Washington forward Quintin Laing was diagnosed with H1N1, he was quarantined, not just from the team but from his family, which includes two small children. Players who might have indiscriminately shared water bottles are using individual bottles exclusively now. Separate towels are a must, as well.

Tarik El-Bashir, The Washington Post's Capitals beat writer, wrote this week that security personnel asked journalists to use hand sanitizer before entering the Caps' locker room after a win over Philadelphia.

All 30 teams will make the swine flu vaccine available to their players when the vaccine becomes available in their cities. Some teams, including the Atlanta Thrashers, already have offered flu shots to their players, although they were not required to take the shot. The same has been the case in other cities, with some players taking the shots and others preferring not to.

All NHL teams are required to keep in contact with the league about the H1N1 threat. Daly said the league is not insisting that players have the shots. "We're in the role of encouraging, not mandating," Daly said.

"I think everybody's worried about it," Capitals coach Bruce Boudreau said Thursday morning before his team took on the Thrashers. "We're trying to put everybody's mind at ease a little bit. Some of the cases are very mild, but they still use the same words. Some of the cases -- especially for guys that have children -- they worry about it a little bit more, I think."

The other players who have been publicly identified as having been diagnosed with H1N1 are Colorado Avalanche netminder Peter Budaj and Edmonton defenseman Ladislav Smid. Another defenseman, Lubomir Visnovsky, left the Oilers' last game with the flu, but it was not believed to be related to Smid's illness. (Some players might not have been formally tested for the disease but rather revealed symptoms that suggested they were not suffering from the common flu.)

Toronto GM Brian Burke noted that, almost every year, every team goes through a period when the flu strikes down a number of players. It goes with the territory, spending so much time in such proximity. But, Burke said, reports of deaths related to H1N1, including the recent death of a young minor hockey player in the Toronto area, have raised concerns beyond the norm. "I am a little more nervous," Burke said.

Daly pointed out that the demographic of the NHL community -- males between the ages of 18 and 35 -- isn't a high-risk group for the disease. And the fact that no team has reported more than one case at this point suggests the league's strategy is working.

"You never want to be in a position where your players are getting sick with swine flu, but it is what it is," Daly said. "You're going to clearly be more cautious because it's the strain of flu we're talking about."

Although the four cases reported appear to be mild in nature -- as mentioned, Weight returned to the lineup and Budaj was expected to rejoin the Avs on their current road trip -- no one knows whether it will get worse before it gets better.

Dr. Eric Braverman, a noted author and internist and professor of neurological surgery at New York Presbyterian Hospital/Weill Cornell Medical Center, said it might come to the point that teams will want their players wearing masks when they fly.

"I think the masks have to be considered. Everybody has to be prepared if this gets worse," Braverman told ESPN.com on Thursday. "I think the airplane is where people are getting it. It just seems prudent to me."

Braverman also noted there is evidence that vitamin D helps battle flu symptoms and that travel to warm climates might help.

Scott Burnside covers the NHL for ESPN.com.