How Chris Sale was able to have Tommy John surgery amid coronavirus shutdown

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In a vacuum, it was a standard announcement from the Boston Red Sox on Monday.

"Left-handed pitcher Chris Sale today underwent successful left UCL reconstruction ('Tommy John surgery,')" the team's statement read. "The procedure was performed by Dr. Neal ElAttrache at the Kerlan-Jobe Institute in Los Angeles, CA."

But when you consider the circumstances -- that California is under a state-wide shelter-in-place order amid the global coronavirus pandemic -- it's pretty remarkable that Sale walked into a medical facility to undergo a non-essential operation.

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So, how did Sale and the Red Sox pull this off?

According to Chief Baseball Officer Chaim Bloom, the team had plenty of internal debate before Sale flew to California on Monday.

"It was important to all of us to do this in a way that would not place any undue burden on anyone suffering due to coronavirus,” Bloom said Monday night in a conference call, via MassLive.com's Chris Cotillo.

"I spoke to Dr. ElAttrache personally to make sure that was the case here and he is just as mindful of the considerations that go along with surgery at a time like this. ... We know this is not life and death and that there are people who are suffering in situations that are life and death."

Los Angeles County (where Sale had his surgery) recently issued a memo recommending all elective surgeries be "limited" until further notice. But the memo didn't explicitly ban such operations, and ElAttrache is of the belief that they're borderline essential for top pitchers like Sale.

"I know that I’m going to get criticized for taking care of these kinds of guys, but it’s essential to their livelihoods," ElAttrache told the San Francisco Chronicle last week. "If you have somebody’s career at stake and they lose two seasons instead of one, I would say that is not a nonessential or unimportant elective procedure."

While ElAttrache's shop is still open, others are already shut down: Orthopedic surgeon Dr. James Andrews recently announced he's suspending all Tommy John surgeries at his Florida clinic amid the pandemic.

The Red Sox revealed Sale would need surgery back on March 19 and didn't provide any updates until after Sale's operation Monday. So, why the delay?

Bloom told the reporters the team was working out logistics and making sure it was safe for Sale to go under the knife.

"I think under normal circumstances, we might have been able to have it happen a little bit sooner,” Bloom said. "Obviously, we’re still talking about a relatively short timetable. There’s usually a lag of a few days at a minimum to get something like this done, even in normal times. It was a little longer in this case just because of all the considerations that I discussed."

Sale faces a 14- to 15-month recovery that should sideline him until at least June 2021. But the 31-year-old likely is grateful he was able to have the operation at all before the pandemic worsens in the United States, which already has the most confirmed coronavirus cases of any country in the world.

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