Rugby union’s governing body has taken steps to ensure that players who suffer suspected concussion during a match in the World Cup are substituted. This follows Wales’s decision to allow George North to play on against England on Friday night, after the wing appeared to have been temporarily knocked out, causing widespread consternation.
The match at the Millennium Stadium attracted a television audience of 8.8m and a number, including former internationals such as Will Carling, Lewis Moody and Rory Lamont, who suffered a number of concussions during his career, expressed concern that North, who suffered concussion in November, was not replaced 19 minutes from the end after suffering a second blow to the head having earlier sustained an accidental kick to the face from England’s Dave Attwood.
World Rugby is investigating why North, who is undergoing concussion protocols this weekend, was not taken off. Wales’s medical staff did not have access to television replays, a facility that will be in place for every World Cup match, along with an independent doctor who will have the final say on whether a player returns to the pitch, and were unaware that the wing had suffered another blow to the head.
“George North knocked out twice in one game and still on the pitch,” tweeted Lamont, the former Scotland back. “How is this still happening? Concussion protocols are still a joke. We need independent medics making the decisions. Team medics are under too much pressure.” The former England captain Moody asked: “Why was George North not taken off terrible decision by the medics. Out cold.”
Research has found that a team doctor is more likely to block a player who has suffered a head injury returning to the field than an independent medical officer, not least because they know the individual’s history, but independents are not employed in tournaments not run by World Rugby because of the cost. Television feeds for medical teams depend on the host broadcaster.
World Rugby has made concussion its priority and with television audiences for some matches during the World Cup, mainly those involving England, likely to exceed Friday’s, the governing body is anxious to avoid the bad publicity generated when what appears to be appropriate action is not taken after a player suffers a head injury.
There was a furore during the third Test between the Lions and Australia in 2013 when the Wallabies flanker George Smith left the field jelly-legged after suffering a blow to the head only to return a few minutes later. The Australian Rugby Union has since hired a concussion expert who is on hand for every Test, but the lack of a uniform approach outside the World Cup means there are anomalies.
“Addressing concussion is not about sanitising rugby or stopping people from playing the game, it is simply about education and informed consent,” said Lamont last year. “We are talking about human welfare.
“There is a duty to ensure that every person who decides to participate has an understanding of the possible lasting effects of concussion. I never had informed consent when I played the game. If I had known the possible long-term health risks associated with concussion at the start of my career I may have retired from rugby after my 2008 concussion.”
The Welsh Rugby Union, which issued a statement on North after World Rugby had asked for a report, said that the player showed no signs or symptoms of concussion after he was examined in the dressing room at the end of the match. “While George is currently symptom-free, retrospective video review of the second incident identified the mechanism of injury which was previously unsighted on the field of play,” it said in a statement. “This review has warranted the medical team to manage the player as concussed although the player currently has no signs and symptoms. He will now undertake a graduated return to play protocol with multiple follow-up cognitive and physical tests.”
In order to be available for selection to face Scotland at Murrayfield next Sunday, North must be symptom-free six days before the match. That will also apply to the Wales prop Samson Lee, who left the field 10 minutes from the end and was diagnosed with concussion. The Ireland fly-half Jonathan Sexton has not played for 12 weeks after suffering repeated head injuries last year and Wales will be under pressure to rest North.
