Updated with more information at 9:20 p.m. on Oct. 8, 2020.
NASHVILLE — The NFL has been forced to shuffle its schedule for the second straight week as the Tennessee Titans' COVID-19 outbreak continues to grow and the New England Patriots deal with their own challenges related to the coronavirus.
The NFL announced Thursday night that Tennessee's Week 5 game against the Buffalo Bills has been moved from Sunday to 7 p.m. EDT Tuesday on CBS, provided the Titans have no more positive tests for COVID-19 before then.
The league also postponed the Patriots' home game against the Denver Broncos, moving it from Sunday to 5 p.m. EDT Monday, giving ESPN a doubleheader with the late game between the Los Angeles Chargers and the New Orleans Saints.
The fallout from those moves has the Bills' Week 6 home game against the Kansas City Chiefs moving from next Thursday to the following weekend — if the Buffalo-Tennessee game is actually played on Tuesday — but no specific day or time has been determined.
"These scheduling decisions were made to ensure the health and safety of players, coaches and game day personnel and in consultation with medical experts," the NFL said in a statement released Thursday night.
Four games now have been postponed due to the pandemic. In Week 4, the Titans' home game against the Pittsburgh Steelers was set to be played a day or two later than planned before ultimately being moved to Oct. 25 in Week 7. The Patriots were set to play at Kansas City last Sunday afternoon, but after a player for each team tested positive for COVID-19, it was moved to Monday night.
Hours earlier, the Bills (4-0) had been preparing as if the NFL's first COVID-19 outbreak wouldn't affect a showdown between two of the league's six remaining undefeated teams. And get this: Any updates the Bills were receiving on the Titans' outbreak were coming through the media.
"It's really up in the air," Buffalo center Mitch Morse said earlier Thursday. "I think it's an ongoing, evolving situation that all parties involved are trying to do the right thing. I think player safety is No. 1, and then trying to get this game going is the utmost importance for a lot of people, but not at the cost of players' health."
The Titans' outbreak increased to 23 people Thursday with tight end MyCole Pruitt and a defensive back from the practice squad put on the COVID-19 reserve list that afternoon. Tennessee's facility remains closed with the team still prohibited from any in-person activities.
The Titans (3-0) have had 21 positive tests returned since Sept. 29, and 13 players are on the COVID-19 reserve list, including four starters and a long snapper.
Also earlier, Buffalo safety Micah Hyde said he didn't want to postpone or cancel anything.
"We're not really sure what's going on," Hyde said. "Honestly, we're clueless (about) the situation coming up. So all we can do is practice and prepare like we're going to play on Sunday, and I think everybody in this building wants to play."
Titans coach Mike Vrabel has talked with reporters only once this week, and he said Tuesday that he stood by the franchise following the league's coronavirus protocol. However, the investigation by the NFL and the players' association into how the league's first COVID-19 outbreak occurred found "several specific incidents" of the Titans possibly breaking that protocol, a person with knowledge of the inquiry told The Associated Press on Wednesday.
Also, Tennessee was told players could not gather together for any in-person activities either at the club's facility or elsewhere a day before several Titans worked out at a private school, a person familiar with the situation told the AP on Thursday.
The NFL closed the facilities of both the Titans and the Minnesota Vikings on Sept. 29 after eight positive test results for Tennessee, which had won at Minnesota the weekend before. A group of Titans, which included quarterback Ryan Tannehill, worked out at Montgomery Bell Academy in Nashville on Sept. 30 after getting permission from coaches at the school.
There wasn't language in the collective bargaining agreement or COVID-19 protocol related to working out after being told not to or in case of an outbreak at a team's facility.
Commissioner Roger Goodell warned all 32 teams Monday that following the protocol is mandatory and that violations forcing changes in the schedule could lead to being stripped of draft choices or forfeiting games. The NFL also updated its COVID-19 protocol on Oct. 2.
Dr. Allen Sills, the NFL's chief medical officer, said Wednesday that the investigation included video inside the Titans' facility, interviewing everyone involved and even studying seating charts on buses and planes. Sills noted investigators wanted to learn how to improve, and the NFL already has made a number of changes.
The Patriots missed a second straight day of practice Thursday after reigning NFL defensive player of the year Stephon Gilmore joined quarterback Cam Newton on the COVID-19 reserve list Wednesday. New England also has a defensive tackle from the practice squad on the list.
Patriots coach Bill Belichick said Thursday the team closed its facility for the health and safety of the club and was continuing to prepare virtually for the game against the Broncos. When the Patriots return to their facility will be a medical decision rather than a football one, Belichick said.
"Things are changing very quickly or could change very quickly. Sometimes they do, sometimes they don't," Belichick said. "We knew that at the beginning of the season, that there were going to be challenges. There have been. And we're ready to work through them. And that's what we're doing."
On Oct. 1, the NFL sent new regulations to all 32 teams detailing additional steps, including a second daily test when dealing with an outbreak or having been exposed to an outbreak. That also included teams and players being barred from holding any gatherings or group activities away from their facilities.
Miami Dolphins coach Brian Flores said all coaches and players can control is how they practice and follow the protocol, not whether games are played or postponed.
"Do you start to think about, 'OK, if we start canceling more games or postponing more games, what's that going to look like for the rest of the season?' Yeah, but I try not to look that far down the road," Flores said. "I think the league will handle those things, and if we end up being affected, then so be it."
The Titans also announced that tight end Tommy Hudson, a practice squad member currently on the COVID-19 reserve list, has been suspended without pay for six games for violating the NFL's policy on performance-enhancing substances.