Although Ben Roethlisberger was placed on the reserve/COVID-19 list Tuesday, the Pittsburgh Steelers are optimistic their quarterback will be available for Sunday's game against the Cincinnati Bengals.
The team placed Roethlisberger and three others on the reserve/COVID-19 list after they were deemed high-risk close contacts with tight end Vance McDonald, who returned a positive test for the virus Monday.
"Those guys will be working remotely throughout the week and testing daily," coach Mike Tomlin said Tuesday afternoon. "As long as their tests come back negative, we believe that all four guys have an opportunity to be made available to us on Saturday."
As high-risk contacts, Roethlisberger, OL Jerald Hawkins, RB Jaylen Samuels and LB Vince Williams must isolate for five days after their last contact with McDonald, and they cannot return to the UPMC Rooney practice facility for at least those five days. They are allowed to participate in team meetings virtually.
All four will be tested throughout the week. The protocols put in place for COVID-19 high-risk contacts have been shown to be especially effective, NFL chief medical officer Allen Sills said in a conference call Tuesday. In the past two weeks, three people identified as high-risk close contacts ended up testing positive during the period of isolation, Sills said.
"That's a big validation of that approach and what we're trying to accomplish," he said.
If Roethlisberger continues to test negative and doesn't display any symptoms, he'll be able to play Sunday -- though he would be doing so without any practice reps. He would be eligible to participate in the team walk-through Saturday.
Tomlin, though, isn't worried about Roethlisberger or fellow veteran Williams playing without practicing.
"I'm not overly concerned about it," Tomlin said. "This guy has been doing it for 17 years. He has snap experience that he can call upon. We're still going to work extremely hard virtually to prepare. Lot of his work is above the neck anyway. In terms of preparation, I have very little concern about it, to be quite honest with you."
Dealing with "bumps and bruises" to his knees stemming from Sunday's win in Dallas, Roethlisberger likely would have rested some during this week's preparation, according to ESPN's Jeremy Fowler, and the extra rest will benefit both Roethlisberger and Williams, Tomlin said.
The sore knees, though, would not have affected Roethlisberger's availability for Sunday, Tomlin confirmed.
Mason Rudolph and Josh Dobbs will take practice reps in Roethlisberger's place. While Rudolph will take the bulk of those snaps, Tomlin didn't rule out using either if Roethlisberger is unavailable Sunday.
"We'll play it by ear as we proceed through the week," he said. "I'm not opposed to playing anybody that increases our chances of winning based on what we're looking at."
While Roethlisberger is said to have "been diligent" with his behavior around others in regard to the pandemic, he has been seen on the sideline talking to McDonald without wearing a mask. The two are friends and have lockers close to each other. Roethlisberger, however, has not tested positive.
Sills previously said the deciding factor for high-risk designation is often determined by whether the person had close contact while not wearing a mask.
Throughout the season, Roethlisberger has been a vocal advocate of taking precautions to minimize the spread of COVID-19.
"We need to be cautious, be careful and protect each other," Roethlisberger said in October. "Fans are allowed in the stadium, which means we're allowed to have guests in town and things like that. In the Roethlisberger family, we're not changing anything. No guests are coming in town. But there are a few challenges that have been presented, and so hopefully guys can continue to be as cautious and as careful as we have been to this point."
McDonald was placed on the COVID-19 list Monday night after his positive test and must isolate for at least 10 days.
The Steelers believe they followed protocols with McDonald, a league source told Fowler. Despite missing Friday's practice with an illness designation, McDonald traveled with the team on a plane to Dallas on Saturday, and all people on the plane were wearing masks, Tomlin said. Before Saturday's departure, McDonald came into the Steelers' facility feeling good, and he consulted with the team's in-house infectious disease director, a league source told Fowler.
Because of its range of symptoms and delay in positive test result, diagnosing COVID-19 is a "challenging medical situation," Sills said. "I think the approach that our team physicians are taking is, we always assume something is COVID until proven otherwise."
Sills added that team physicians don't rely on testing to completely rule out a COVID-19 diagnosis.
"We all recognize that people can develop symptoms in absence of a positive test," Sills said. "It's something you have to treat on a case-by-case basis. ... We've seen many cases throughout the year where that has been the case. We've said consistently. We probably will have more cases where players, coaches and staff will miss a game, even without a positive test, simply because they report symptoms."
While the NFL and NFLPA are in frequent communication with teams on COVID-19-related matters, teams are not required to contact the league over a player having flu-like symptoms. It's not clear whether the Steelers officially contacted the league about McDonald.
"Those aren't decisions that are made by us," Tomlin said of McDonald traveling. "It's really cut-and-dried. It's all in the procedural policy of COVID established in New York by the NFL. As long as he is negative and not showing signs of COVID, he's able to travel, and he was and we did.
"We utilize all the mechanisms at our disposal to minimize the potential of interaction. We're all masked up, we're all exercising good personal hygiene and social distancing. We're doing all the things that are asked, and that's our mindset regarding it."
McDonald's positive result stemmed from a test performed Sunday, and the results were returned Sunday night or Monday morning, Tomlin said.
The team remains in the intensive COVID-19 protocol dating to last week after Baltimore Ravens DB Marlon Humphrey tested positive following the Steelers-Ravens game.
Tomlin and the organization were fined $350,000 in total for violating face-covering protocols in that game, but Tomlin said Tuesday that they did not inquire about the nature of the violations.
"I didn't ask, to be quite honest with you," he said. "We just accepted it, the punishment, and went on with our day. We're working extremely hard to comply in all areas, and those efforts will continue."
This week, the Steelers have implemented additional precautions to further isolate any potential spread of the virus and are conducting all meetings virtually. Visits to the training room and weight room will also be done on a rotational schedule, Tomlin said.
The Steelers can look to the Ravens' timeline with Humphrey's positive test on Nov. 2 for an idea of this week's timeline.
Humphrey was placed on the reserve/COVID-19 list Monday to begin his 10-day quarantine. The next day, the Ravens placed seven players identified as high-risk contacts of Humphrey on the list. Matthew Judon was removed from the list Thursday, while the other six were activated Saturday. Six of the players played in Sunday's win against the Indianapolis Colts. Now only Humphrey remains on the list.
"How we manage it, the players that we choose to utilize, how we highlight their positive traits, how we work to minimize some of the negative traits or lack of experience is a big component of us pushing through this," Tomlin said. "These are issues that everybody in the league has to deal with, and so from that standpoint, it's fair and the playing field is fair. We're working our tails off to adhere to the protocol."