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Old 09-16-2020, 06:20 PM   #6601
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This morning the Big Ten conference announced plans to resume its football schedule in late-October. What is newsworthy about this announcement (and, qualifies it for consideration here) are the protocols being established:

All athletes are to be tested daily, using the rapid antigen testing capabilities recently introduced to the market
Any athlete testing positive will then be required to take a PCR test
Anyone testing positive will undergo comprehensive cardiac screening, including labs and biomarkers, ECG, echocardiogram and cardiac MRI; Clearance from a cardiologist will be required before being allowed to return to practice or play
The earliest an athlete can turn to practice will be 21 days after a positive diagnosis
I would think that breathing hard through an open mouth in a football huddle would spread virus pretty well.

Subject to some debate, but it appears a significant number of Covid patients have some evidence of myocarditis, based mostly on cardiac enzymes leaking from damaged heart cells and Cardiac MRI's. Myocarditis is inflammation of heart muscle. The inflamed and irritable tissue can be the origin of a lethal V-fib or V-tach electrical event. The inflamed area also does not contract as well, and a large affected area could easily cause a five or ten percent reduction in cardiac stroke volume, and an elite athlete might suffer a detectable reduction in oxygen delivery and performance. The treatment, like Beta blockers, would further reduce cardiac output, and might be recommended for years. That's all a dream breaker for an athlete.

This sort of damage could very well repair itself over a period of months, or a year or two, but myocarditis can also lead to scarring and permanent damage. Viral myocarditis, often from Coxsackie virus infection, very infrequently will take a young healthy person and put them on the transplant list. The heart is basically a modified artery. It has some funky circulation and is richly supplied with ACE2 receptors.

https://www.medpagetoday.com/infecti.../covid19/88487

https://jamanetwork.com/journals/jam...rticle/2768916


You might minimize this if you were in to College Football

https://247sports.com/Article/Myocar...led-151036977/
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Old 09-16-2020, 06:49 PM   #6602
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Yeah, I think it's shit.

BUT would these students regress to poor performance due to inability to workout?



(short term goals over long term health #Murica)
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Old 09-16-2020, 08:15 PM   #6603
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Old 09-17-2020, 09:44 AM   #6604
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  • Vaccines will be distributed immediately upon receiving Emergency Use Authorization (EUA)
  • Distribution will be administered centrally via a contract inked on August 14 with McKesson. Some vaccine may require ultra-cold storage, and may be shipped directly from manufacturer to administration sites; If necessary, the McKesson contract can provide rapid distribution of refrigerated (2-8o Celsius) and frozen (-20o Celsius) vaccines
  • McKesson previously distributed vaccine during 2009 H1N1 flu pandemic
  • The Department of Defense will provide logistical support
  • Vaccines will be distributed in phases, based on dose availability. Initially, it will be offered to healthcare workers in high-risk settings, then to other essential workers and those at higher risk of severe disease, such as people age 65 and older
  • The United States is beginning to see the impact of the Labor Day holiday on reported new cases. At this point, it is not clear yet how much of this impact is due to reporting delays in and around the holiday, and how much reflects an increase in infections
  • New cases reported on both Labor Day and the following Tuesday were usually low - a probable artifact of the nature of state health agency hours and reporting practices. This likely resulted in delays in reporting cases and inflated case counts later in the week. It would thereby distort week-over-week comparisons, until such time as the impact of the delays "flush-through" the data - likely by this weekend
  • To illustrate this further, if we use a 14-day average instead of the commonly-used 7-day average, this new infection rate continues to indicate a downward trend throughout this past week
  • Nonetheless, we are seeing other indications that the easing of new infections we have seen since late-July may be beginning to reverse:
  • The 7-day average test-positive rate, which had been trending down since July 22, has now increased for the past several days; it remains significantly lower, however, than it was in both March/April and June/July when we experienced surging new infections
  • Inpatient and ICU census of COVID-19 patients, which also had been steadily declining since July, have been essentially flat for the past four days
  • Thirteen states reported test-positive rates higher than the CDC target for Phase 3 re-opening. The two states with the highest rates, North Dakota and Idaho, as well as Mississippi, Wisconsin and Florida saw these rates decline from where they were two weeks ago. Conversely, Alabama, Kansas, Iowa, South Carolina, Missouri, Nebraska and Georgia's rates increased from two weeks ago
  • New cases reported on Wednesday were higher than one week ago but, lower than for any other Wednesday in the past twelve weeks
  • There are nine states that experienced new infections rates > 200 per day per million population during the past 7 days. Of these, seven saw these rates increase relative to two weeks ago: North Dakota, Arkansas, Missouri, Wisconsin, Oklahoma, Tennessee and South Carolina; Only South Dakota and Iowa, among these nine states saw rates declining from two weeks ago
  • Arkansas posted a new high in its rate of new daily infections per capita; its previous high was set 49 days ago; Montana set a new high 12 days after its previous high; and, West Virginia set a new high 9 days after its previous high
  • Despite the plateauing recently of inpatient and ICU use, ventilator use continues to decline. Additionally the % of ER visits for COVID-19-like illness, pneumonia and shortness-of-breath also continue to decline. Flu visits to the ER have not yet begun to be in evidence
  • On the world stage, Aruba continues to report the highest 7-day average in new cases per capita, followed by Israel, Bahrain and Guadeloupe. Argentina ranks 8th; Costa Rica, 9th; Spain, 10th; and Peru, 11th (Countries 5th-7th each have populations < 1 million). The United Sates ranks 25th
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Old 09-18-2020, 07:27 AM   #6605
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New antigen test isn't being reported. So test positivity rates are coming down all the while hospitalizations are creeping up.

https://khn.org/news/lack-of-antigen...-the-pandemic/
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Old 09-18-2020, 08:00 AM   #6606
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Originally Posted by Yakoo752 View Post
New antigen test isn't being reported. So test positivity rates are coming down all the while hospitalizations are creeping up.

https://khn.org/news/lack-of-antigen...-the-pandemic/
I thought there were issues with antigen test result accuracy? Is that not the case?
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Old 09-18-2020, 09:15 AM   #6607
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It is less accurate then a PCR but it's rapid with results in minutes not days and inexpensive.

The idea is you test more often to wash out the accuracy.

10s of millions of the antigen test have been shipped since approved a few weeks back.

If you want to open up, we need to understand how many people are infected. Not reporting antigen test, when there are millions in the system, is grossly inappropriate.
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Old 09-18-2020, 11:34 AM   #6608
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I would think that breathing hard through an open mouth in a football huddle would spread virus pretty well.

You might minimize this if you were in to College Football

https://247sports.com/Article/Myocar...led-151036977/
Zero positives after testing both teams that played in the first NFL game. Zero positives reported so far from any of the college football games played so far. The positive test rate of Division I athletes so far have been lower than the broader population at large and lower than the general populations of the schools that have on campus classes going on. To say that the athletes are at greater risk than the general population or their non-athlete classmates isn't supported by any facts at this point. And the schools are doing a very good job of cancelling games if there are any issues, erring on the side of supreme caution. Baylor cancelled its game with Houston today due to Covid, but it supposedly wasn't over a positive test, it was the result of contract tracing that impacted one small group of players. Really sounds like the schools aren't serving up their athletes at the altar of money.

And the myocarditis thing. Aside from the question about whether they were really actually diagnosed with Covid caused MCD, why would they be any different if they caught Covid outside of football? So unless there is a higher risk of Covid by playing, why is this even an issue?

Last edited by Archimedes; 09-18-2020 at 12:22 PM..
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Old 09-18-2020, 12:35 PM   #6609
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Zero positives after testing both teams that played in the first NFL game. Zero positives reported so far from any of the college football games played so far. The positive test rate of Division I athletes so far have been lower than the broader population at large and lower than the general populations of the schools that have on campus classes going on. To say that the athletes are at greater risk than the general population or their non-athlete classmates isn't supported by any facts at this point. And the schools are doing a very good job of cancelling games if there are any issues, erring on the side of supreme caution. Baylor cancelled its game with Houston today due to Covid, but it supposedly wasn't over a positive test, it was the result of contract tracing that impacted one small group of players. Really sounds like the schools aren't serving up their athletes at the altar of money.

And the myocarditis thing. Aside from the question about whether they were really actually diagnosed with Covid caused MCD, why would they be any different if they caught Covid outside of football? So unless there is a higher risk of Covid by playing, why is this even an issue?
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In response to a series of questions from ESPN about their COVID-19 testing protocols, almost half of the 65 schools in the Power 5 conferences declined to share data about how many positive tests their programs have had to date.

Nearly a third of the schools overall declined to provide information about protocols in addition to withholding the number of athletes who have tested positive.

Twenty-one schools that declined to provide data are in the conferences that plan to play college sports this fall: the ACC, Big 12 and SEC.
https://www.espn.com/college-sports/...d-19-test-data
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Old 09-18-2020, 01:03 PM   #6610
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https://www.nytimes.com/interactive/...s-tracker.html
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Old 09-18-2020, 02:21 PM   #6611
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Originally Posted by Yakoo752 View Post
It is less accurate then a PCR but it's rapid with results in minutes not days and inexpensive.

The idea is you test more often to wash out the accuracy.

10s of millions of the antigen test have been shipped since approved a few weeks back.

If you want to open up, we need to understand how many people are infected. Not reporting antigen test, when there are millions in the system, is grossly inappropriate.
I understand the necessity of testing, my comment was specifically addressing the accuracy. How accurate are they and do the resulting errors wind up being more positive or more negative, or is it an even split?

Also, are the results tracked granularity enough so that multiple tests of the same person are correctly accounted for?

I’m an engineer, you’ll have to excuse my wanting to dig into the nerdy specifics. LOL
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Old 09-18-2020, 02:35 PM   #6612
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It is less accurate then a PCR but it's rapid with results in minutes not days and inexpensive.

The idea is you test more often to wash out the accuracy.

10s of millions of the antigen test have been shipped since approved a few weeks back.

If you want to open up, we need to understand how many people are infected. Not reporting antigen test, when there are millions in the system, is grossly inappropriate.
I found more info on my KHN feed. I think there’s some terminology issues.

All tests are antigen tests, though the article appears to distinguish PCR performed in full-scale diagnostic equipment labs from all other tests.

Rapid tests are also called “point-of-care” tests and refer to the rapid strep and flu tests performed in doctors offices and urgent cares. This would include Abbot Labs ID now, which is a desktop PCR test for COVID. With all PCR tests, the Antigen is viral RNA. In the Point of Care role, the industry calls these “molecular tests” because that little desk top machine uses chemical techniques to denature RNA and do PCR right in that little breadbox. These represent a small percentage of total tests performed so far.

Point of Care tests would also include “Lateral Flow” tests, much less high tech than even desktop PCR. This tech is used in home pregnancy tests. So far, almost all lateral flow tests actually measure ANTIBODIES to COVID. However, Abbot now is producing a lateral flow COVID 19 ANTIGEN test, just released. It’s called Abbot BiNaxNow, and includes an app. The article seems to consider all Point of Care tests “Antigen tests”. One is actually PCR, one is lateral flow, and all the rapid tests for COVID antibody are lateral flow.

Point of Care tests are”CLIA-waived”, meaning exempt from most federal lab compliance standards.

Confused? So was the author.

Her point is well taken though.

Are lateral flow studies measuring antibodies in recuperating patients being reported to state health departments per law? Probably not. The patient may have already had a positive Covid Antigen test, so don’t want to double count.
also, what’s the point? You don’t quarantine recovered people with antibody. The specificity and correlation of Ab to active infection isn’t well known either.

Is the desktop PCR test for acute infection being reported if positive? It should be. The same for the just released lateral test for acute infection. But POC tests are performed in small settings and purchased in small lots. Some may not get reported. Big labs report directly from the lab. Mom and Pop clinics have to fill out a Confidential M&M and fax to their County Health Department.

The author also seems to want to know not only how many tests are positive, but also how many are negative, and how many are even being purchased.

As rapid POC testing becomes more common, we’ll have to grapple with that.


Edit

I must correct myself, having made my own terminology mistake. An Antigen is something that binds to an Antibody. PCR tests do not involve an antibody. I’m not sure what the common use name for the actual DNA or RNA fragment they search for. “Nucleic acid fragment homolog thingie?” Dr SLO?

Last edited by Snaggy; 09-19-2020 at 11:11 AM..
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Old 09-18-2020, 02:44 PM   #6613
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I found more info on my KHN feed. I think there’s some terminology issues.

All tests are antigen tests, though the article appears to distinguish PCR performed in full-scale diagnostic equipment labs from all other tests.

Rapid tests are also called “point-of-care” tests and refer to the rapid strep and flu tests performed in doctors offices and urgent cares. This would include Abbot Labs ID now, which is a desktop PCR test for COVID. With all PCR tests, the Antigen is viral RNA. In the Point of Care role, the industry calls these “molecular tests” because that little desk top machine uses chemical techniques to denature RNA and do PCR right in that little breadbox. These represent a small percentage of total tests performed so far.

Point of Care tests would also include “Lateral Flow” tests, much less high tech than even desktop PCR. This tech is used in home pregnancy tests. So far, almost all lateral flow tests actually measure ANTIBODIES to COVID. However, Abbot now is producing a lateral flow COVID 19 ANTIGEN test, just released. It’s called Abbot BiNaxNow, and includes an app. The article seems to consider all Point of Care tests “Antigen tests”. One is actually PCR, one is lateral flow, and all the rapid tests for COVID antibody are lateral flow.

Point of Care tests are”CLIA-waived”, meaning exempt from most federal lab compliance standards.

Confused? So was the author.

Her point is well taken though.

Are lateral flow studies measuring antibodies in recuperating patients being reported to state health departments per law? Probably not. The patient may have already had a positive Covid Antigen test, so don’t want to double count.
also, what’s the point? You don’t quarantine recovered people with antibody. The specificity and correlation of Ab to active infection isn’t well known either.

Is the desktop PCR test for acute infection being reported if positive? It should be. The same for the just released lateral test for acute infection. But POC tests are performed in small settings and purchased in small lots. Some may not get reported. Big labs report directly from the lab. Mom and Pop clinics have to fill out a Confidential M&M and fax to their County Health Department.

The author also seems to want to know not only how many tests are positive, but also how many are negative, and how many are even being purchased.

As rapid POC testing becomes more common, we’ll have to grapple with that.
And on top of all that, where do we stand on serology testing now?
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Old 09-19-2020, 07:05 AM   #6614
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Well, I don't watch these guys any more but I might watch this one.

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Old 09-19-2020, 10:58 AM   #6615
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And on top of all that, where do we stand on serology testing now?
So, serological testing determines if the body has produced antibodies to an infection.

In clinical speak, conversion means they’re present, comparative IgM and IgG concentrations help determine if the infection is pretty new, and titers estimate the quantitative vigor of the response.

The rapid lateral flow assays will be binary yes/no for antibodies, no real ability to determine anything else. Titers can be measured in a clinical lab, for instance, when using convalescent plasma, to make sure the material has a useful number of antibodies. Not much value otherwise at this time in patient care. Currently, comparative IgG and IgM assays are a research tool.

Rapid tests for antibody probably have had disappointing specificity, meaning a positive test doesn’t really prove an infection has occurred. If a lateral flow test is developed with a highly specific monoclonal antibody that does not react to previous corona infections, that will improve. I do not know when those will appear, or have yet.
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