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Buffalo Bills effectively managed player health through 2020 season

Only two starters ended the year on IR.

Not enough can be said about the ways that 2020 upended our preconceived notions of healthcare. The coronavirus forced a fundamental change in medical care as well as everyday life. And, of course, that meant a major impact in the way the NFL operates.

Facing the prospect of sweeping infections in a sport where the players line up face-to-face and gang tackle each other 100 times per game, the NFL adopted several new policies for risk mitigation. They created a COVID-19 reserve list, independent from typical injured reserve, allowing for the temporary quarantine of players and easy replacements in their absence. They expanded the practice squads and allowed those players to be promoted on game day with very few strings attached.

Most importantly, the NFL completely revamped their Injured Reserve list. Instead of allowing two players to return from the list each year, any number of players could be reactivated from IR in a season. Instead of forcing the players to wait eight weeks before a return to action, the new policy allowed a player to be activated after only missing three games.

In other words: Take everything you conventionally understood about measuring a team’s population health in previous years, and throw it out the window when considering that performance in 2020.

To understand how this changed things for the Buffalo Bills, consider Matt Milano—a pectoral injury landed him on Injured Reserve in early November. Ordinarily, that would’ve ended his regular season entirely, and possibly taken him out of the running for the playoffs. Instead, he was activated after missing only three games.

In 2019, the Bills were one of the healthiest teams in the league: Only six players on season-ending IR, zero starters there, and 120 player-games lost due to injury.

This year, between injury scratches, injured reserve, and the COVID-19 reserve list, the Bills lost 112 player-games in the regular season due to some sort of health reason (source: Pro Football Reference injury reports). They finished the year with two “starters” on injured reserve: guard Cody Ford and running back Zack Moss (though Moss didn’t break his ankle until the playoffs). Three other players finished the year on IR: linebacker Del’Shawn Phillips, cornerback Cam Lewis, and wide receiver Isaiah Hodgins. (Note: For the purposes of this exercise, Star Lotulelei and E.J. Gaines, who opted out of the season, do not count as players who missed time for health reasons)

The stats suggest it was an even better year of healthy Bills, but we need to take the shortened IR cycle into account—112 games could’ve easily been 142 games, if not for that change.

The Bills also suffered more from injuries to starters than they did in 2019. In fact, more than half of their starters missed at least one game. Levi Wallace and Josh Norman both landed on IR in the season, and Tre’Davious White spent three weeks nursing a back injury. Tremaine Edmunds had a shoulder injury, and Matt Milano was hurt for basically half the season. Cody Ford only played seven games between groin, knee, and ankle injuries, and Jon Feliciano missed seven with a torn pectoral. Micah Hyde and Mitch Morse both missed games with concussions. A toe injury hampered Zack Moss early, and a knee and ankle injury were big problems for John Brown. Even Josh Allen, though he didn’t miss any games, spent half the season on the injury report with a shoulder ailment.

After the 2019 season, I remarked that we didn’t have enough data to tell us whether Buffalo’s healthy season was a case of a great infrastructure or just luck. The 2020 season was a regression to the mean, with many starters forced to sit out games, but it was still a pretty great season. The Bills only saw two season-ending injuries to starters, and their whole roster was available deep into the playoffs. Despite rashes of injuries to their linebackers and cornerbacks, the team had enough depth to hold down the fort and win games until their health improved.

We can’t say that the Buffalo Bills have figured out the secret sauce for a remarkably healthy team. But two years of well-managed injuries suggest the start of a promising pattern. There’s evidence that could explain these results: the state-of-the-art training facilities in Orchard Park, and the forward-thinking COVID-19 policies that helped the team avoid a dramatic outbreak in their facility. With an optimistic look to the future, here’s to another healthy Bills season in 2021, and to a continuation of the smart, flexible policies the NFL introduced this year.