This big midseason showdown on Thursday night at Arizona provides another fresh, prime-time reminder of all that can still be thrown out of whack by COVID-19.

No Davante Adams? What showdown?

The Green Bay Packers star was placed on the COVID-19 reserve list this week, likely costing Aaron Rodgers the connection with his most lethal target. On top of that, Packers defensive coordinator Joe Barry will miss the game, due to COVID-19, with play-calling duties turned over to Jerry Gray. Another receiver, Allen Lazard, is on the list, per multiple reports, as an unvaccinated “close contact,” just days after having his most productive game of the season.

Go ahead, A-Rod. Try to outduel Kyler Murray and the prolific Cardinals offense without ‘em.

The Cardinals can relate. They’ve won the past two weeks without star linebacker Chandler Jones, including the tilt at Cleveland on Oct. 17 when coach Kliff Kingsbury and GM Steve Keim were also absent due to COVID-19.

Although the NFL season is approaching the halfway mark without the type of widespread outbreaks that occurred last year and without having to reschedule any games, a la 2020, the cases with the Packers and Cardinals underscore the legitimate threat that COVID-19 still presents as an X-factor.

“We know we’re not out of the woods yet,” Allen Sills, the NFL’s chief medical officer, told USA TODAY Sports on Wednesday.

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Green Bay Packers wide receiver Davante Adams (17) salutes the fans after winning in overtime against the Cincinnati Bengals at Paul Brown Stadium.

Green Bay Packers wide receiver Davante Adams (17) salutes the fans after winning in overtime against the Cincinnati Bengals at Paul Brown Stadium.

Sills reiterated that point during his presentation to NFL owners on Tuesday in New York, although it’s doubtful that he needed to make a hard sell as largely isolated cases keep popping up. Although the NFL declares that 100% of the team staffs are vaccinated league-wide (with 94.1% of players vaccinated), the status of Chicago Bears coach Matt Nagy for the game Sunday against the San Francisco 49ers is in jeopardy because of his positive COVID-19 test.

“There’s still a lot of COVID disease in our communities that’s obviously the source of it coming and exposing our teams…potentially getting into our facilities,” Sills said. “So, I think we all have to remain vigilant.”

The NFL’s stringent protocols aimed at mitigation, including daily testing, worked well enough for the league to achieve its objective last year of having a complete season. This year, with the emergence of the vaccine, the games are staged again in full stadiums, and the league and NFL Players Association have scaled back protocols and testing for vaccinated players.

From the opening of training camps this summer through Oct. 16, the league reports that routine monitoring resulted in confirmed positive cases for 83 players and 161 staff personnel. With more than 94,500 tests administered during that period, that’s an incidence rate of roughly .5%.

If the NFL-like results, and particularly vaccination rates, applied across the nation and world at large, it stands to reason that this pandemic would be over. But given the isolated cases and other factors, Sills, mindful that flu season is approaching, is plenty wary about how COVID-19 could potentially alter the remainder of the NFL season.

His two biggest concerns?

“One is just the unpredictability of the global pandemic,” Sills said. “I think we’ve seen multiple times where we think we understand this disease and it takes a sharp turn in a different direction that we didn’t expect. There’s always that element of the unknown.

“And the other one is complacency. Everyone certainly appreciates that we feel we are in a better place this year than last year. That does not mean we can get complacent. … All of us are ready for this to be over, but we’re just not at a point where I think we can take our foot off the gas pedal.”

In the meantime, the continued research adds layers of knowledge. The league is on the verge of launching a voluntary study among staff league-wide to assess patterns with antibodies, which could provide more insight into risk levels and potential need for booster shots.

Also, Sills said that it was striking in assessing the genetic sequencing from the Cardinals cluster that five different strains of the virus were identified from the first seven COVID-19 cases.

“It would have been easy to assume that while there are seven cases clustered on one team, they probably have spread from one person to another,” Sills said. “But it turns out the genetics showed us that was not the case. These were five different exposures where someone contracted the virus outside the facility and then came in and (had) a positive test.”

Sills said the positive cases this year are similar to those from last year (when 262 players tested positive from the start of training camp to the Super Bowl) in that transmission is still largely the result of long periods of exposure to an infected individual, typically in a household or within a small, poorly ventilated room.

“That’s confirming what we saw last year as far as transmission,” Sills said. “I just think that with the delta variant, we see that even more fully played out. The flip side is that we’re not seeing on-field transmission, we’re not seeing people become positive from walking past someone in the hallway or having a transient conversation outside, on the sideline, or something of that nature.”

Even so, the threat is still real. COVID-19 can emerge as an X-factor on any given Sunday. Or any given Thursday. Just ask Rodgers, who was a bit shocked upon learning that Adams, No. 17, had landed on the COVID-19 list.

“We’re maybe slightly more healthy than some of the other teams as far as not having as many cases,” Rodgers told reporters. “There have been cases and we’ve dealt with ‘em. But when I heard (No.) 17, I was hoping that it was going to be one of those false positives.”

No such luck. Just a reminder that COVID-19 strikes again.

Follow USA TODAY Sports’ Jarrett Bell on Twitter @JarrettBell.

This article originally appeared on USA TODAY: NFL not ‘out of the woods’ on COVID-19 as issues pop up

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