Across the NBA, team officials tasked with enforcing and managing the league's day-to-day health and safety protocols say they're exhausted and struggling to balance those roles along with their typical team duties, many of which are focused on player health.

Further, several of these officials say they have found themselves so busy with protocols that their ability to work with individual players on a hands-on basis -- in areas that include treatment, recovery, training -- has been sacrificed, leading to concerns about reduced care for players.

"I've actually told my peers on these trips that we've been on -- it's very, very difficult for me to get my hands on [players]," said one Western Conference head athletic trainer, who, like others, spoke on the condition of anonymity because they aren't authorized to speak publicly. One Eastern Conference head athletic trainer independently echoed this point and said it's shared league-wide among peers.

One league health official who is close to the matter added, "What scares me -- and I know it's happening -- is that their normal job of doing health care on players [is impaired]. I've had some trainers tell me, 'I haven't touched a player in two weeks because I've been so busy doing all this logistics and testing and all that.' That's concerning. That's definitely what I don't want to happen."

A second Western Conference head athletic trainer agreed with the above sentiment.

"There will be some decline in player health care," that head athletic trainer said. "But I think the larger part will be the overload of the care providers."

As the NBA tries to hold a season outside a bubble during the coronavirus pandemic, team health officials and others filling protocol roles are essentially the NBA's front-line workers. Roles that have been largely delegated to team health officials, as outlined in the NBA's 158-page protocols, include testing officer, contact tracing officer, facemask enforcement officer, facility hygiene officer, health education and awareness officer and travel safety officer, among others. Some team health officials hold more than one of those roles, along with their original roles.

"We're responsible for the logistics of all of the staff, PCR testing, and all of the player rapid testing, and the compliance with the timelines that go into that every day, whether it's an off day, whether it's a game day," said the second Western Conference head athletic trainer. "So the workload has increased dramatically. [And] there's not been a decrease in any of the other workload."

Said one Eastern Conference basketball operations official who is working to handle their team's contract tracing program, "It's just frustrating because with all these things they are making us do it's been hard to find time to do our actual jobs. People are going to be exhausted and sick after this year with everything we are forced to do."

For all their duties, no team official who spoke with ESPN blamed the NBA or its protocols. Rather, there was an understanding that this is an extraordinary situation with understandably high demands. There is hope that staffers can find a rhythm as the season goes on, but several team health officials also noted that the situation continually evolves, with more memos and conference calls from the league in which new protocols are introduced or changes are made. There are also continually evolving city and state restrictions that affect team markets differently.

"Emails are coming fast and furious at all times," said the Eastern Conference head athletic trainer. "And they're not a one-page memo; these are 15 pages, sometimes. They come through daily almost. And so, yeah, we have an obligation to stay current on stuff and it's time-consuming."

A Western Conference GM added, "There's just not enough hours in the day to read the memos, the nuances, compliance, testing, the things that quickly change." The Western Conference GM continued, "You have constant scenarios happening where the memos don't cover that particular situation...That's no one's fault. It's just where we're at."

If their own physical and mental health is failing under the weight of added duties, as several team officials independently say is already happening, then what about the health of players? Several of these officials voiced concerns about not only a decline in players' health care but in the fragility of a non-bubble season, given the constant potential for outbreaks if there's slippage in protocols, vigilance, diligence or compliance.

"Normally, if you can get a 90% compliance rate in a lot of things, that's really good," said the second Western Conference head athletic trainer. "In some ways, a 90% compliance rate here might as well be zero."

Some team health officials reported weeks ago, as training camp was gearing up in early December, that they were already far busier than they had ever been in their careers, with the Western Conference head athletic trainer saying that the workload was at least double if not three times what it was before. For some, looking ahead to the coming months is daunting.

"Every waking hour seems to be committed to [the protocols]," said the Eastern Conference head athletic training official. "But you look down the pike here, and... you wonder, 'God, I barely got through today, how am I going to do this another 100-something times?'"

Said one Eastern Conference general manager, "There's a lot of people that are exhausted. I think their mental weight is as heavy as the physical weight. It wears on you, especially when you're traveling, especially on the road. There's so many moving parts."

Sleep loss is another factor in a league that has struggled with that very issue for years.

"It's extremely difficult," said the first Western Conference head athletic trainer. "The days become longer when you thought they were as long as they could be. If you get a phone call at 2 or 3 in the morning about a possible positive [test] that ends up being a false positive, you're trying to deal with that up until the team is starting to come in the facility at 8 or 9 just to make sure you're complying with everything and then go through your shootaround and then you have a game [and if you] get to bed at midnight, you're lucky to get three or four hours."

The Western Conference GM said his team's health and athletic training staff is robust but still struggling.

"The reality is, these people are really working hard to keep us all safe," said the Western Conference GM. "And like the front-line health care workers, we probably haven't put enough time and thought into their physical and emotional state."

That GM added, "I can't say thank you enough to my guys because you can feel it on them. It's really emotionally exhausting the health performance staff."

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NBA team health officials find balance tough with new COVID-19 protocols - ESPN