Ohio State football players carried cardboard boxes when they emerged from the Woody Hayes Athletic Center following their first voluntary workouts on campus last month.
The boxes included T-shirts and shorts. Rather than hitting the shower inside the locker room after their workouts, they returned to their apartments to wash off sweat and change into clean clothing.
The routine has not shifted. While training facilities have been open for the Buckeyes since early June, the locker room remains closed. Among many health and safety precautions put in place by the school, players continue to dress and undress at home.
For Ohio State and other college football teams across the country, reopening locker rooms presents a thorny challenge amid a coronavirus pandemic that has seen a sharp rise in cases nationally in recent weeks.
As much as locker rooms give players a spot for changing clothes, storing equipment and socializing with teammates, they also provide an environment that can facilitate the spread of COVID-19, infectious disease experts say.
"Those are enclosed spaces," said Dr. Carl Fichtenbaum, a professor and infectious disease specialist at the University of Cincinnati. "People are taking showers, people are changing, people are in close proximity to one another. And there’s a lot of joking and kidding around and people yelling. There’s music. There is a social and cultural atmosphere to a locker room that is similar to a household where transmission can occur. I would worry a lot about that kind of setting."
If teams in all manner of sports are to see the field this fall, it is critical they avoid outbreaks of COVID-19 in the months ahead.
Ohio State already was prompted to pause voluntary workouts in seven sports, including football, for a week earlier this month after multiple athletes tested positive. Workouts resumed July 15.
Among other Big Ten programs, Indiana and Maryland have also halted workouts due to positive cases.
The risk of transmission in a locker room largely stems from the close proximity of players who converge around tightly packed locker stalls and come into close contact in other areas.
That is especially true for programs with large rosters; in major-college football, teams can have as many as 85 scholarship players, plus dozens of walk-ons.
In cramped spaces, experts say virus-containing particles more easily travel among people and can circulate longer in the air while indoors.
"Those are all things that make any indoor facility, if you’re going to pack a lot of people in it, inherently more high-risk than just having practice or scrimmage outside," said Dr. Dean Winslow, an infectious disease specialist at the Stanford University Medical Center.
While the airborne passage of viral particles represents perhaps the greatest risk of transmission, other areas could also pose trouble.
Dr. Jennifer Hanrahan, the chief of the division of infectious diseases at the University of Toledo Medical Center, raised concerns about players who could come into contact with contaminated surfaces.
Locker rooms previously have been sources of MRSA infections, another type of infectious disease. Staph bacteria spreads through infected surfaces that athletes share in the close quarters, potentially a similar path for viral particles.
"Every piece of equipment, whether it’s in a locker room, weight room or wherever, there has to be a regular cleaning schedule," Hanrahan said. "Preferably that should be every time somebody uses it. That may not always be possible, but that would really be the preferred thing."
If schools reopen their locker rooms for teams, experts recommend they limit capacity and require athletes to wear face coverings, among other measures for limiting transmission of the virus.
Some have proposed dividing players into smaller groups that can enter the room at different times. Other areas of athletics facilities could also be converted into changing areas.
But each proposed step involves some difficulty.
"What are you going to do with the mask while you’re in the shower?" said Winslow, who was also a cross country and track runner at Penn State in the 1970s. "How do you keep it dry while you’re getting in and out of the shower? Anyone who has played varsity sports and been in a locker room realizes that a lot of these things are easier said than done."
The measures also will require adjustments from athletes accustomed to using the locker room as a gathering place.
UC’s Fichtenbaum recognized camaraderie-building likely would be affected, but stressed it was important to remind teams that "this is a very different time."
"The point of you being in a locker room is to take a quick shower, put your clothes on and leave," he said. "The goal being that you get in and out of a locker room in 15 minutes.
"Explain that this is not a place that we want to assemble and (that) we will look for opportunities to be appropriately socially distanced and spaced outdoors, where we can spend more time together talking."