In Thursday night’s NFL game between the Miami Dolphins and Buffalo Bills, Miami’s $212m quarterback Tua Tagovailoa suffered his fourth documented concussion, and third since joining the NFL, after colliding with defensive back Damar Hamlin, who himself nearly died in a game less than two years ago. The reactions from inside the football world were immediate and telling.

• Dez Bryant, longtime Dallas Cowboys wide receiver: “That’s it … NFL go ahead and do the right thing. Tua has had entirely way too many concussions. He need to retire for his longevity health concerns.”

• Shannon Sharpe: three-time Super Bowl champion turned pundit: “Really hope Tua is ok, but he’s gotta seriously think about shutting it [down]. I [hate] saying this. His concussions are getting worse and worse and he’s a young man with his entire life ahead of him.”

• Antonio Bryant, former All-Pro wide receiver: “In all seriousness Tua may want to rethink playing football in the future depending on severity. Concussions not something to mess with.”

• Robert Griffin III, Heisman trophy winner: “Really just praying for Tua’s long term health. Another concussion puts him at 3 officially and countless other scares. Think of the person not just the player.”

But as well-intentioned as those pleas are, they should not be the predominant takeaway from this event.

The fact we all need to confront in the aftermath of yet another spectacle of egregious harm is that this sport is profoundly and irredeemably unsafe. It has already killed or transformed the lives of far too many participants. There is no plausible deniability about the consequences. This is not the time to deploy personal responsibility narratives around what the right ‘choice’ is for Tua Tagovailoa, who seven weeks ago signed a team-record contract extension. He is currently simply the most visible representation of the harm this sport inflicts on everyone who participates.

Every 2.6 years of participation in tackle football doubles the chances of contracting CTE and kids start playing this sport at five years old. Concussions are the most extreme manifestation of the problem, but they are not the only one. For members of the offensive and defensive lines especially, constant head contact is an inextricable part of the game as it is currently conceived, and it is that contact that leads to brain deterioration.

Former John ‘Jabo’ Burrow was once in exactly this position as a power five college football player who suffered traumatic head injury in the sport that he couldn’t shake. Like others who would more famously follow in his footsteps, like Chris Borland and Andrew Luck, Burrow made the difficult decision to retire from a sport he loved.

“My opinion is the sport is specifically designed for these sorts of things to happen,” Burrow told us in response to Tagovailoa’s injury. “Violence and inflicting physical trauma is a necessary step to successfully move the ball further down the field or to keep the other team from doing so. We have accepted that. It is bare-knuckle boxing that is socially acceptable for children to participate in. I see videos of seven-year-olds taking and delivering similar hits being lauded, but if they were fist fighting in an organized bare-knuckle organization at the same age people would be arrested. I don’t see much difference between the two sports anymore.”

He added: “Violence and trauma is necessary for participating in the game, but the natural outcome of those things is brain trauma and risk of death. I just hope Tua can be ok. It makes me very sad for him. Dtamar Hamlin had some comments I read on using counseling to help process his trauma in order to get back to a place where he feels safe being on the field. That makes me sad too, but for different reasons.

“The game is traumatic.”

Similarly, in research for our forthcoming book The End of College Football: On the Human Costs of an All-American Game, we spoke to 25 former big-time college football players anonymously about their experiences in the sport. Traumatic head injury was a persistent theme in those discussions.

Although formally diagnosed concussions are often the focus of the discourse around the problem in the sport, the truth is that most of the traumatic brain injury, concussive or subconcussive, that occurs in tackle football is never formally reported.

One former player told us, “We had maybe 30-ish padded practices in 28 days … you hit your head in those four weeks, thousands of times at a G-force of at least 20 Gs. You know it experientially, but you don’t know the science behind it. So like, ‘camp fog’ or ‘camp brain’ was something we’d discuss. And it was just so normal. I was never diagnosed with a concussion. There’s a handful of times where I was concussed. And my sophomore year, I was … throwing up on the sidelines. And [linebackers’ coach] looked at me, and said, ‘You good?’ And he wasn’t asking, he was telling me.”

As that example reveals, a huge part of the problem is that head injury continues not to be taken sufficiently seriously by those in positions of authority in the sport on the coaching side.

Another player explained, “They scare you into not reporting your injuries, especially concussions, because they treat you even worse as a person, because they just think you’re faking it.” Still a third said, “It was light bullying … snarky comments. Like, ‘Oh, it looks like you’re fine. You’re moving fine, you could get out there.’ Or, ‘You’re not practicing today?’ alluding towards, like, ‘You need to get your ass out there.’”

It is the players who must live with the consequences, not the coaches. One explained that the scariest part for him is that he does not even “know [the] price that I paid in terms of cognitive ability, in terms of how many concussions did I play through, how many times did I have a concussion and didn’t report it?” Another says he suffers “from panic disorder related to probably all the subconcussive blows.”

The fact that people are worried about the health and wellbeing of Tua Tagovailoa is only a good thing. We need to be humane towards the athletes whose sacrificial labor sustains our emotional investments in sports fandom, and expressing fear on his behalf – much as people did after watching Damar Hamilin lie on the field after his heart stopped – is precisely the appropriate response.

But we cannot fool ourselves into thinking Tagovailoa or Hamlin are and tragic rare exceptions. They are simply the visible consequences of the toll that tackle football takes on all who participate.

“I feel like there’s a good chance that I will have CTE,” a player told us. “Especially if I kept playing, it’ll probably be guaranteed.

“But I won’t find out until I die, which isn’t comforting at all.”

Nor should it be, for any of us.