Why every NBA player is getting a ring

Welcome back to work! Take a thermometer. Here's your pulse oximeter. And don't forget to grab a proximity alarm that beeps if you're too close to someone for too long.

But for all the futuristic measures awaiting NBA players in their Orlando, Fla. bubble, maybe the most ambitious is a wearable device called the Oura ring.

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Each player will have the option of wearing this smart ring that comes equipped with a temperature sensor -- which is how a $300 piece of titanium finger jewelry has been repurposed into an unexpected weapon of public health.

Researchers say they hope this ring that calculates someone's "illness probability score" will be a valuable warning system that reveals infections before people realize they're sick. A person's viral load might be too low to register a positive test when he's in the dangerous presymptomatic phase of infection. But the ring can perceive slight deviations in temperature, heart rate and respiratory rate that signal an immune response. And that could help save the NBA season.

There are few returning workforces that will be subject to such thorough screening in such a peculiar office setting as NBA players when they return to their jobs. The league is attempting to finish the regular season and playoffs on a restricted Walt Disney World campus in a part of central Florida quickly becoming a coronavirus hot spot. What they're trying to pull off is perhaps the craziest experiment in the history of sports.

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But the almost unfathomably complex return of basketball is not simply dependent on testing and tracing. It's also built on technology like the Oura ring.

It doesn't take much imagination to see how this would be useful to the NBA -- or why NBA players might have second thoughts about wearing it.

Since the citizens of the bubble won't be tested every day in Orlando, where cases and positive test rates are climbing, there is a window for the virus to spread if it gets inside. The real-time physiological data from the rings is a safeguard against a potential outbreak. If someone's illness probability score is alarming, he might decide to get another test or eat by himself instead of going to dinner with teammates. Those behavioral tweaks could be enough to prevent a trail of silent transmission, and NBA executives believe every bit of risk mitigation matters with so much at stake.

But the rings are optional for NBA players in Disney. And it's not clear how many plan to wear them.

NBA officials say there are strict regulations in place to protect their privacy. They point to years of experience working closely with the NBPA to navigate the ethical minefields of wearable devices, and they have promised that personal data will be deleted when the season is over and won't be used against them. The league's 113 pages of health and safety protocols indicate teams won't have access to their illness probability scores -- which are generated by an Oura algorithm that accounts for changes in heart rate, heart rate variability, respiratory rate and temperature -- but they would be informed when the numbers suggest heightened risk or the early signs of illness.

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The players are likely to be skeptical despite the league's assurances. Los Angeles Lakers forward Kyle Kuzma was the first to voice his concerns when he said last week the ring looked like "a tracking device" and punctuated his tweet with an emoji of a detective spying through a magnifying glass.

The idea of a ring detecting infection might sound like science fiction. It's not. In fact it's already happened.

On the morning of March 12, hours after the NBA season was suspended, a Finnish entrepreneur named Petri Hollmén says he woke up and checked the app that he uses to monitor his sleeping habits. It showed that his "readiness score" was low because his body temperature was high. But he felt perfectly fine.

He was curious enough to call local authorities with news of his mild temperature, and they advised him to get tested because he'd recently traveled from a hot spot. As it turned out, he had the virus. Hollmén was surprised -- and surprisingly intrigued. He realized that he only suspected he was sick because of the Oura ring on his finger.

A similar turn of events unfolded in sports last weekend. Nick Watney withdrew from a PGA Tour event after he tested positive for the virus on Friday, and he told golfers he only got tested because his Whoop wristband fitness tracker alerted him to an unusually elevated respiratory rate.

A few months before Watney's test and a few thousand miles from Hollmén's bed, University of California, San Francisco researchers were running an unrelated study using Oura rings. They decided to pause that research and pivot to coronavirus.

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Their ongoing TemPredict study attempts to identify patterns in physiological data from the Oura rings, and their subjects include 40,000 volunteers around the world, more than 3,000 health-care workers in the Bay Area and, perhaps, NBA players in Disney World. This closed environment with a frequently tested population is a dream for researchers who are trying to make progress understanding the novel virus.

"The NBA can show the world how this kind of smart, public health infrastructure could be done," said Benjamin Smarr, a University of California, San Diego data scientist involved with the study.

The NBA was consulting with other sports leagues, corporations and the military on health and safety practices when it came across the TemPredict study and made contact with Oura.

They are likely to get more participation from team staffers and league employees than players. There are some who already wear the rings for sleep tracking. There are even some who have invested in the company. But it's difficult to get hundreds of NBA players to do anything -- let alone something that makes some feel like they're being watched.

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Harpreet Rai, the CEO of Oura, says that if players asked why they should wear the company's product, he would offer three reasons: accuracy, convenience and trust. He would also tell them health-care workers have reported that wearing the smart rings gave them peace of mind in an otherwise stressful environment. "More data helps us feel more secure," Rai said.

Oura has financial backing from current and retired NBA players, but even Rai says he never expected his company to strike a deal with the league because of its application in a pandemic.

"I would've thought it would be about player health, recovery and sleep, " Rai said. "But the world has changed. So have we. And so has the NBA."