The Nexus of Sickle Cell Trait and Football Death Is Not Fit to Print in the New York Times

by Irvin Muchnick

On December 28, New York Times medical writer Gina Kolata did an article about how African-Americans are inadequately alerted to the basic probabilities of sickle cell trait – specifically, that asymptomatic trait carriers can still pass along to offspring not only the trait, but also full-blown sickle cell anemia. See “Sickle Cell Math Is Brutally Simple, but Not Widely Taught,” https://www.nytimes.com/2021/12/28/health/sickle-cell-genetic-testing.html.

Seeking to supplement this important information with additional important information about how sickle cell trait carriers are also themselves susceptible to sudden death from exertional sickling – which causes an unaccountable percentage of the underreported large numbers of deaths in football conditioning drills – I submitted the letter below.

The Times, in its wisdom, did not publish the letter.

Following the text of the letter is a note on my subsequent friendly exchange with reporter Kolata.

*****

The story of the tragic toll of sickle cell trait is incomplete without open discussion of a wrinkle your article does not address. Non-symptomatic carriers of the trait not only are in danger of genetically transmitting sickle cell anemia. They also are at risk themselves from sudden collapse and death during extreme exertion.

Exertional sickling, or ES, is a vastly underreported aspect of the sport of football’s overall vastly underreported public health crisis. This is sociologically significant because African-American males, around 8 percent of whom carry the sickle cell trait, comprise well over half of all National Football League players and nearly half of all National Collegiate Athletic Association players, as well as disproportionate percentages of the athletes in high school football and the sport’s other youth feeder systems.

Groups such as the Sickle Cell Disease Association of America consciously downplay ES, both because it is seen as a distraction from awareness and fundraising for the full-blown disease, and because it highlights how Black men could be stigmatized in those areas of national life – sports and the military – that function closest to the ideals of equal opportunity. (A 1987 Army study found that Black recruits with sickle cell trait were 30 times likelier to die during basic training.)

Claiming incomplete scientific evidence for ES – which can cause the poisonous entry into the bloodstream of dead muscle tissue, especially in extreme heat or cold – the SCDAA opposes the screening of Black athletes for the trait. Yet the Centers for Disease Control acknowledges the reality of the phenomenon, and the NCAA mandates that football programs offer voluntary screening.

Screening, which revealed that he was a trait carrier, did nothing for Ted Agu, a University of California football player who died of ES in 2014 during a bizarre extreme conditioning drill. The coroner, with an assist from a misleading and legally exposed university, labeled it a generic cardiac event until discovery and depositions proved otherwise during the family’s wrongful death lawsuit, which wound up settling for $4.75 million.

Experts on football conditioning deaths have isolated ES as the cause in up to three dozen cases this century. The true number is surely multiples higher, because of flaws in our autopsy system, low awareness, and cover-ups such as in the Agu case. The experts believe that up to half of all football conditioning deaths are from ES. And kids are more than four times as likely to die non-traumatically, during conditioning, as they are from blows to the head or other body parts during games or practices.

In our exchange, Gina Kolata told me that she realized that people with sickle cell trait can have health risks. She said that this angle didn’t make the cut in the Times because only a minority have “medical reason to be concerned’ for themselves” (an opposed to the larger number who have reason to be concerned about sickle cell anemia for their children).

FURTHER READING:

“Football’s unknown epidemic: When Black players die suddenly, the cover-up begins,” Salon, November 13, 2021, https://www.salon.com/2021/11/13/footballs-unknown-epidemic-when-black-players-suddenly-the-cover-up-begins/