India, in the grip of another wave of Covid-19, is currently recording over 250,000 cases daily. In six months' time, the ICC is scheduled to stage the 2021 men's T20 World Cup in the country. How much of an impact will the pandemic have on the tournament Will it be risk-free if it were to be played without crowds within a biosafe environment? What are the risks of having 16 teams travel across the multiple venues proposed by the BCCI? What impact will vaccinations have? Dr Dave Musker, who is in charge of the ICC team looking after biosafety and biosecurity, tries to answer these questions and others.

How much of a challenge is organising a global tournament versus preparing for a bilateral series?
The way I look at that is how many links you've got in the chain. If you have two teams, you've only got two links in the chain in one [biosafe] environment. If you have, for example, eight teams in the IPL - which is not our tournament but we have taken learnings from - you have got a significant additional complexity. So every additional link, every team, every different venue, you are adding a new complexity. None of this is straightforward, but tournament cricket, or franchise leagues, are much more tricky than bilateral series.

Medical advice talks about the risks of people moving around in effect. Let us take the West Indies tour of England at the beginning of the pandemic in 2020. The ECB did a phenomenal job then in Southampton in securing one environment, bringing one touring team in at a time - to qualify for biosafety, reach a point where we can be pretty sure that there is no risk of infection, and then complete what you are doing in Southampton. And then moving on, repeating that [for the next two Tests] in Manchester. If you compare that to eight, ten, 16 teams across multiple venues, it is the number of movements and the changes of environment that really create the risk rather than the actual environment itself.

In addition to bilateral series, there have also been T20 leagues like the IPL, BBL, CPL, PSL, LPL that have been conducted over the year. What are the key learnings from them been?
It is probably helpful to say what the two real marks of a successful biosafety plan are. One is education - that everybody buys into the concept, understands what they are trying to achieve. It cannot be an external stricture. And the second one is discipline. They go hand in glove - people understand what's going on, and they comply with directions to keep themselves and all participants safe. If you get those two things right, then you are likely to be in a safe environment. Where one or the other fails, that's when you tend to have breaches and it becomes extremely tricky.

Most of the biosecure bubbles look pretty similar. You wrap people around, you clean them on arrival, you test regularly, and you make sure they don't put themselves in a position where they could be infected.

There were multiple breaches of protocol during the PSL. Is there anything from there that you'll be mindful of in organising the T20 World Cup?
I'm fascinated to see how the IPL works in India over the coming weeks. We will be travelling to India on April 26 to see the arrangements there and are in touch with the BCCI on this. It is on top of our list of priorities. Some of our teams have already travelled to Delhi in the past and gathered significant learnings from there.

So I don't think we'll be in position to really tie down what we are going to do in the autumn until we see how the IPL goes. There is a robust plan, which I've looked at. I'm looking forward to the way that that is put in place. But it will be foolish to make those prognostications now rather than waiting to see what happens in India in April and May.

In June the ICC will host the World Test Championship final, in Southampton. Last year most cricket was played behind closed doors. What are the chances of the WTC final being opened up to the public subject to government permission? And what are the risks?
I was in the UK last year and I was very impressed by the rigour and the compliance around the biosecure bubble as it was then at the Ageas bowl and at Old Trafford. And it will be fair to say that the ECB have got a track record and experience of running biosafe environments for cricket.

We are still in the process of negotiating what the biosafety will look like [for the WTC], which will be dependent on what is governmental policy in June. That requires a degree of prognostication because of all the [factors] around opening up a society, what happens with crowds at venues, and the pandemic situation in the UK. It is a dynamic situation. We have to be fleet of foot, have contingencies in place.

How much do the case numbers in a country affect the planning? Does it have any impact at all, considering teams operate out of a bubble?
Most of the time we are planning three to four months in advance. So what it's like in the UK at the moment is interesting, but I'm speaking to the ECB about our predictions for June. That's the first thing: what you see at the moment isn't necessarily what you are planning against - you are looking at the future.

The second thing is that it's an amalgam. So regardless of whether you are in a [highly] Covid-19 affected country and you have people from a low-risk country coming in, what you are managing is travel across borders and what you do to protect people in that environment. You secure them in a bubble, ensure they are safe from any risk of infection when they are playing. It is all about prediction and also understanding the environment of where the teams come from and where they are going. Not as simple as high Covid equals high security.

As far as the T20 World Cup is concerned, what would you say is the one thing you want teams and member boards to keep uppermost in mind?
Two things, really. Absolutely critically, it is about understanding your players and who you are playing with. Because one thing we do know is that playing in biosecure environments takes a toll on everyone's well-being. So my first key message will be to look after each other. Because these people are living and working together, they know each other well and they will know if somebody is struggling or they need some support. The second thing is, if you are unsure or you have any questions, ask, test us, make sure that our plans are robust.

Would it not be safer to have a World Cup restricted to fewer venues rather than multiple cities?
Could be, might not be. The way the IPL is managed, they only have two venues engaged at one time. You haven't got eight venues at one time. One of the reasons for going to India is to take the cricket across a cricket-loving country so everybody can see their heroes live. There is a tension between doing that and staging the event in a way that is as secure as possible for everybody, that's why we haven't published or really got into the detail of the staging venues. If the IPL works with this two-venue caravan model, then it is clearly a good starting point for us to understand how we may stage the men's T20 World Cup.

What if there are Covid cases in a team or within a bubble during the tournament?
You strive not to have cases in the bubble, because you look at cleansing and sanitising pre-travel [before joining the bubble], managed isolation with testing, good social distancing, and the use of health mitigation measures on travel. And then on arrival, a period of time where there is strict isolation inside hotel rooms, along with testing. So you should clear people before they enter into the team environment. And that has proved successful: look at the IPL last year, look at India's tour of Australia, look at England's series at home last summer, to cite a few examples.

So it is perfectly reasonable that you can put measures in place to ensure the chances of somebody testing positive is significantly reduced. Having said that, if somebody does test positive, which has also happened, then we are looking at isolation in-room or at a medical facility, and then retesting to make sure it is not a false positive, and then putting in the appropriate medical care around that person.

The other thing that's going to come into play is understanding what the vaccination status is.

Will there be a different level of risk acceptance as many more people are vaccinated by the time of the T20 World Cup?
One of our medical advisory groups is involved in international basketball. They had a team that was fully vaccinated and somebody came down with Covid-19. It was treated like severe flu because they had been vaccinated - they were put in their rooms and they recovered and were allowed back into the tournament. We have detailed protocols to deal with positive cases. But the key issue is to make sure that when you are actually setting up the bio-bubble, it is effective and people are safe within.

So the medical advisory committee and academic research suggest that if you are vaccinated, you can still get Covid-19, although it is much less likely, and if you do become sick, you are much, much less sick. The vaccination status of participants will be a significant mitigation in understanding the risk to all the participants.

What about all the Covid-19 variants and mutations globally - do they have an impact?
At some point there will be a phenomenon called "vaccine escape" - the virus will mutate to a position where the current crop of vaccines will have limited impact upon transmission or effectiveness. That will happen, but that's why you are seeing so much about second- generation vaccination. All the vaccines have a wide spread of efficacy against various mutations, but all of them do offer significant mitigation, in that you are unlikely to get very sick if you are vaccinated, regardless of mutations and variants.

Will the ICC have a role similar to the bubble integrity manager to ensure all participants are complying with biosafety rules?
Yes. And we will recommend, I suppose, a Covid scientific advisory committee with a qualified medical epidemiologist and probably me as the chief Covid compliance officer to make sure we have the right scientific advice during the tournament.

What about crowds being allowed at the T20 World Cup?
It's too far away. The key thing to me is that we keep learning and we keep listening. We are stronger working together with the other boards and people and our colleagues in the BCCI. The critical thing is, we work together as a cricketing community, so we can put the game on. We are fans as well. I don't want to cancel tournaments. I want to see live cricket. We are passionate about cricket. And we are passionate about putting on tournaments, we just want to do it safely.