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Covid 19 virus inpacts sports, NHL,Season Tix other impacts

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If we are to believe the latest info, spread from asymptomatic people is very rare. Also both people are now testing negative and good to go. But it is an indication that this can't go forward if zero positives is the rule. (It isn't). 

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39 minutes ago, remkin said:

If we are to believe the latest info,

I absolutely believe the latest info!  It is all accurate.  Spot on.  We have a handle on this crisis and fully understand it.  I believe everything.  </sarcasm>

 

I'm just venting.  Really, we still don't know enough, so they have to use "an abundance of caution."

 

The whole flip-flop on transmissible (January-"Only spread from contact at wet markets" to May-"There appear to be asymptomatic super spreaders!" to this week-"Asymptomatic rarely spread"), and flip flop on mask wearing is frustrating to all.  I get it.  We're learning.   Still understanding.  And unfortunately, until fully understood, I think you'll see a lot of caution.

 

Something is going on with asymptomatic people.  It wasn't too widely reported, but a few weeks ago they went through one of the meat packing plants in our state and about 25% of the staff were infected, with most saying they had no symptoms.  So either a few symptomatic super spreaders were at work, or some kind of asymptomatic transmission is occurring.  Source: Tyson Wilksboro plant, May 21.

 

I wish there was a follow up on that situation and if they found the source.  Since the state was short on contract tracers, I presume they don't know.

 

 

Edited by wxray1
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4 hours ago, remkin said:

If we are to believe the latest info, spread from asymptomatic people is very rare.

 

Source? Because if you're referencing Monday's comment by the WHO's Maria Van Kerkhove, she corrected it at a special news conference less than 24 hours later:

 

Quote

Van Kerkhove acknowledged Tuesday that her use of the phrase “very rare” had been a miscommunication. She said she had based that phrasing on findings from a small number of studies that followed asymptomatic cases and tracked how many of their contacts became infected. She said she did not mean to imply that “asymptomatic transmission globally” was happening rarely, because that has not been determined yet.

 

That same day, her boss clarified further

 

Quote

Michael Ryan, an Irish epidemiologist and a veteran of two Ebola epidemics and the campaign to eradicate polio, who is leading the W.H.O.’s response to covid-19, said on Tuesday, “It’s clear that both symptomatic and asymptomatic individuals are part of the transmission cycle.”

 

Still more, from the previously linked Stat story:

Quote

“The WHO created confusion yesterday when it reported that asymptomatic patients rarely spread the disease,” an email from the Harvard Global Health Institute said Tuesday. “All of the best evidence suggests that people without symptoms can and do readily spread SARS-CoV-2, the virus that causes Covid-19. In fact, some evidence suggests that people may be most infectious in the days before they become symptomatic — that is, in the presymptomatic phase when they feel well, have no symptoms, but may be shedding substantial amounts of virus.”

 

But yeah, let's play hockey! /sarcasm

Edited by top-shelf-1

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5 hours ago, caneswincup said:

Bruins player and Coyotes staffer, both asymptotic:

 

https://www.nhl.com/bruins/news/bruins-statement-on-covid-19-testing/c-317150538

 

BOSTON - Phase 2 of the NHL's Return to Play Plan requires all players to be tested for COVID-19 prior to using the team's facilities. As part of this process the Bruins were advised that a player tested positive for the COVID-19 virus. The player underwent two subsequent tests, and both returned negative. 

 

For the Bruins player it had to be that either the first test was a false positive OR the second two tests were false negatives OR the player did have the virus but the second two tests came after he was over it. They don't mention antibody testing, which would seem to be needed to know which one for sure, but to me the most likely seems to be a false positive? 

 

Note: I find this an interesting side note; my post isn't meant as a comment on the "politics" of an NHL playoff in either direction.

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18 minutes ago, LakeLivin said:

For the Bruins player it had to be that either the first test was a false positive OR the second two tests were false negatives OR the player did have the virus but the second two tests came after he was over it. They don't mention antibody testing, which would seem to be needed to know which one for sure, but to me the most likely seems to be a false positive? 

 

Note: I find this an interesting side note; my post isn't meant as a comment on the "politics" of an NHL playoff in either direction.

I agree.  It is interesting.  Those in the know can probably expand, but from what I've heard, it is difficult to properly get a good sample.  People who have had the test say the swab feels like it is headed to their brain.  My cousin had "elective" surgery.  (Not really, it was badly needed valve surgery, delayed 2 months.)  He hated the tests he got.  They were required anytime he went to the hospital for testing and then surgery.

 

Who is administering these tests for the team?  What is their training?

 

 

Edited by wxray1
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5 hours ago, wxray1 said:

I agree.  It is interesting.  Those in the know can probably expand, but from what I've heard, it is difficult to properly get a good sample.  People who have had the test say the swab feels like it is headed to their brain.  My cousin had "elective" surgery.  (Not really, it was badly needed valve surgery, delayed 2 months.)  He hated the tests he got.  They were required anytime he went to the hospital for testing and then surgery.

 

Who is administering these tests for the team?  What is their training?

 

 

Very astute wxray and Lake alike. So, for what it's worth:

 

I'm assuming that the tests being bandied about by the League, and at present, the test most rapid and reliable is the RT-PCR. Viral growth on cell media is much too slow, but much more specific AND does indicate an INFECTIOUS VIRION, which the PCR test does not, but that's a story for another discussion. So, a couple of thoughts on the PCR test. 1st, it's hard for me to envision a false positive with it although I suppose a Corona virus close to it's genetic makeup could result in a false positive. Since the test relies on amplification of a genomic signal, a false reading in that is amplified hugely allowing for misidentification. In fact, the opposite is of concern, in that if this virus has some genetic shift, or more concerning, actual mutation, that could render the current PCR tests inaccurate? Of course, the latter would depend on what domain of the SARS-CoV-2 virus that the test is based upon(i.e. it's not testing the complete outer surface of the virus, but certain specific regions). 

 

Now, as for the actual procurement of the sample, YES, there is sampling error. As you point out wxray, the actual sampling is not for the faint of heart, if the sample is nasopharyngeal. Thus, get a neophyte tech, afraid of hurting the patient, and the appropriate site of sampling may not be reached? Saying that though, I personally had a body with very suspicious clinical history, and I was very aggressive, but the test returned negative. This brings up another point being hinted at, but I've not seen conclusively confirmed(perhaps you have rem). Some articles I've read appear to suggest that the virus lurks about in different areas of the respiratory tract, in different numbers? Thus, I've wondered if sampling at different stages of the disease would result in different results. I thought there had been some suggestion that as the disease progressed, the virus was more abundant further down the respiratory tract. This seems logical for 2 reasons, 1st that both asymptomatic and pre-symptomatic shedders would expectorate more abundant virions as the virus is located in upper respiratory tract early on. Also, as one "swallows" sputum, and we all do, than the virus is transported into lower respiratory tract where it does it's thing in the lungs(alveoli). However, both tech sampling error as well as perhaps reduced virus in area sampled would result in FALSE NEGATIVE results. 

 

Bottom line, I agree this sounds like FALSE POSITIVE. There's one additional thought I'll add, There is a phenomenon observed with viruses that also must be considered, and that I'll refer to as "threshold" of viral particles needed to initiate disease. Again, think of the amplification of the PCR process, and the test does not indicate the viral load so to speak, therefore cannot distinguish if the virus exceeds that threshold in that particular subject, and it is unique for each person, to result in disease, or not.Therefore, in this scenario, pick up a handful of viruses, and amplify, voila, a positive test, but insufficient to break thru the subject's immune system so no disease. Thus, in a sense, that is another FALSE POSITIVE. 

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My guess is that asymptomatic patients rarely spread the disease with moderately casual contact. This is a guess on my part, so no source. My guess is that asymptomatic patients still spread the disease to close contacts. The virus is spread by droplet. It has to be projected into the air. The main way that happens is a cough or sneeze. If you are asymptomatic you are not coughing or sneezing much at all since those are symptoms. There is data that a simple surgical mask on a symptomatic patient largely stops the spread. In our ED, no one has contacted Covid from a patient and we use surgical masks even with symptomatic patients. Many many patients take their masks off in the room also.

 

That said, the WHO statement was the source, but it was a bit tongue in cheek about the "latest" since the latest turns out to be wrong so often. How ironic that this one was walked back in less than a day. In this case, apparently she was trying to distinguish between people who never get symptoms and people in the incubation period who will get symptoms, claiming that those who never get symptoms rarely spread it. But then it says 15%, which is not really rare. But this is part of the problem with this whole thing. We don't really even have a handle on the number of patients who get few if any symptoms. Then then biases kick in and who knows? Not WHO.

 

But in terms of the NHL there is the added factors of pre quarantine and daily testing to catch asymptomatic people.

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Interestingly, just started to go thru my daily it seems COVID-19 and saw an article that sheds similar light of the issue of "false positives", as I lamely attempted to do. Its an article from NPR which is related to a study that a wildlife biologist did apparently in California testing for a non-native mussel (so-called zebra mussel), showing up in their waters and causing havoc. Dr Andrew Cohen et al were using a PCR test of waters looking for genetic evidence of spread and noted a lot of false positives!! Y'all recall that I wrote on Disease Prevalence as relates to accuracy, well that seems to be the problem there, and could be the issue with that false positive it would seem in the hockey player. That and the extreme sensitivity to minute contamination by the smallest of genetic substance almost mandate repeating the test, WHEN CLINICALLY IT'S RESULTS DO NOT FIT, i.e. the subject is symptom free? 

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12 hours ago, remkin said:

My guess is that asymptomatic patients rarely spread the disease with moderately casual contact. This is a guess on my part, so no source. My guess is that asymptomatic patients still spread the disease to close contacts. The virus is spread by droplet. It has to be projected into the air. The main way that happens is a cough or sneeze. If you are asymptomatic you are not coughing or sneezing much at all since those are symptoms. There is data that a simple surgical mask on a symptomatic patient largely stops the spread. In our ED, no one has contacted Covid from a patient and we use surgical masks even with symptomatic patients. Many many patients take their masks off in the room also.

 

That said, the WHO statement was the source, but it was a bit tongue in cheek about the "latest" since the latest turns out to be wrong so often.

Rem, I can't help noticing that your stuff tends to become "tongue-in-cheek" when someone calls you on it. You could have found the walk-back just as easily as I did--easier I would think, being in the biz.

 

As for the bolded line, I'm sorry, but no. You surely are aware that perspiration, excrement, urine--all are at minimum suspected as possibly spreading the virus. The fact is that, like so much else with this thing, we just don't know. And I surely hope that, as a physician, you subscribe to the maxim, scientifically proved again and again throughout history, that what we don't know CAN hurt us, yes? Because there is not one thing "biased" about that.

 

In other news, talk about burying the lede:

Quote

NEW YORK (AP) — Baseball Commissioner Rob Manfred says there might be no major league games this year after a breakdown in talks between teams and the players’ union on how to split up money in a season delayed by the coronavirus pandemic.

 

The league also revealed several players on big league rosters have tested positive for COVID-19.

 

Two days after union head Tony Clark declared additional negotiations futile, Manfred reversed his position of last week when he said he was “100%” certain the 2020 season would start.

 

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I watched golf this weekend with no fans, and it was ok. I've watched a bit of NASCAR with no fans, and that was ok, too. Korean baseball with no fans is a bit weird, but I'd be ok with MLB coming back with no fans. Playoff hockey and NBA,in my opinion, needs fans. Everything about the playoffs is more intense than the regular season, and I can't imagine watching without 19,000 Caniacs going nuts. I wish they would just wait until it's safe before they come back. 

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The tongue and cheek thing was about something being the latest thing, which is something I've mentioned previously more than once. There are so many latest things that turn out not to be true that one has to be cautious of the newest things. It's pretty ironic that the thing I didn't catch was someone admitting that they put out something wrong. One notes the hydroxychloroquine study that the Lancet had to retract. That doesn't happen very often. The latest is not always the greatest. WHO has specialized in proving that. 

 

I really don't have much trouble admitting if I get something wrong. Though in this case we really we don't know if it's wrong, we just can't say for sure if it's right. 

 

In the case of how this is transmitted, that data has changed too. At first it was thought to be all over surfaces and spread that was, there was all of this data about how long the virus persisted on surfaces. Now (I think, maybe they've switched back) it is thought not to be a major fomite, and surfaces aren't that huge of a deal. 

 

Anyways, details and 'facts' are pretty fluid. It is very hard to keep up with things unless one spends a ton of time on it. Personally I'm mainly trying to keep up with major treatment changes at this point. Just saw that dexamethazone is good at least in hospitalized patients. Steroids were thought to be not good earlier. And so it goes. 

 

This is why I swore off trying to debate this point by point. The points keep changing. But then almost every member of this board is able to carry this discussion on in a non personal, non political manner, so the discussion is enjoyable and informative.

 

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23 hours ago, cc said:

It will never be "safe" again.  It never was before. Any association with groups carries with it the increased possibility of an infectious disease transmission.  We just never had this level of reaction before.  For many reasons.

 

 

I'm sure some uninformed parents worried about their kids contracting polio were as certain as you that it "would never be safe again." And they were wrong, too. 

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1 hour ago, remkin said:

It's pretty ironic that the thing I didn't catch was someone admitting that they put out something wrong.

It's not ironic, Rem. It's lazy on your part. It was all over the news--at least the news that's done by actual journalists.

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I don't care about the season any more. And the pandemic is over...or at least the precautions are. If state and local governments are going to allow (and condone) tens of thousands of protesters to take to the streets in every major city in America for weeks, I can't take them seriously with their lockdowns and "advice" on precautionary measures for any event. I won't watch sports out of principal. You know why? They shut us down completely. I had two friends who weren't able to attend the births of their children, my dad lost a good friend and couldn't go to his funeral....but the same people telling us to lock ourselves in our house for months are now encouraging us to take to the streets in the name of "justice". We've been taken on the biggest ride in our history. I'm doing it in their honor. Because when it's all said and done, the numbers are completely inflated and now that we know more about this virus and its effects (and who it affects), even the so-called experts won't back off or admit they were wrong. Go live your life. If you are high risk, be careful. The end.       

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14 hours ago, top-shelf-1 said:

s for the bolded line, I'm sorry, but no. You surely are aware that perspiration, excrement, urine--all are at minimum suspected as possibly spreading the virus. The fact is that, like so much else with this thing, we just don't know. And I surely hope that, as a physician, you subscribe to the maxim, scientifically proved again and again throughout history, that what we don't know CAN hurt us, yes? Because there is not one thing "biased" about that.

Source for "spread" thru perspiration, excrement and urine? I have not read that, and am reminded that "recoverability" does not equate to "infectivity"? As I posted above, the RT-PCR test tests for a portion of the virus, and doesn't indicate that the intact virus is either present or that it is viable. Unless the virion is inoculated onto either a cell media of animal testing, and shows viral effects, than I am unaware how we know its ability to cause disease? 

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1 hour ago, Altaholic said:

Go live your life. If you are high risk, be careful. The end. 

 

My cousin did that.  Screw the govt taking over our lives, he said.  Now he's dead.

 

31 years old.

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48 minutes ago, coastal_caniac said:

 

My cousin did that.  Screw the govt taking over our lives, he said.  Now he's dead.

 

31 years old.

Thank you coastal. Just a gentle reminder that this ain't your everyday flu. Yes, there are asymptomatic cases, probably lots. And there are cases with minor problems. But to me, it's almost like Russian Roulette and one never knows in which cylinder the bullet is housed? One just never knows?

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1 hour ago, coastal_caniac said:

 

My cousin did that.  Screw the govt taking over our lives, he said.  Now he's dead.

 

31 years old.

Sorry to hear that

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4 hours ago, coastal_caniac said:

 

My cousin did that.  Screw the govt taking over our lives, he said.  Now he's dead.

 

31 years old.

 

Sending my condolences, too, coastal. Thoughts to his family and yours.

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I've actually read this whole thread.  What an accomplishment.  I really appreciate the insight from Rem and KJUN, thanks to both of you.  Don't care for the politics or the personal insults here and there, and even recently just up a bit, so haven't posted.

 

Take care, hopefully we might have hockey sometime.

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I appreciate KJUN and Rem's perspectives.  They both see a lot of "stuff" in their different fields.  I can't imagine working in either.  I just visited my doc for a minor urgent need which was an emergency for me.  Let's just say my consultation with Dr. Google was bogus.  My real doc nailed the problem.  Thankful for that.  As for KJUN, what a responsibility.  I watched one of those true crime shows, and was shocked at the gruff the DA and cops gave the medical examiner.  That job has a lot of responsibility and pressure.  Thank you both!

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11 hours ago, coastal_caniac said:

I've actually read this whole thread.  What an accomplishment.  I really appreciate the insight from Rem and KJUN, thanks to both of you.  Don't care for the politics or the personal insults here and there, and even recently just up a bit, so haven't posted.

 

Take care, hopefully we might have hockey sometime.

Thanks Coastal. That means a lot to me. I am also very sorry to hear about your cousin. 

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22 hours ago, KJUNKANE said:

Thank you coastal. Just a gentle reminder that this ain't your everyday flu. Yes, there are asymptomatic cases, probably lots. And there are cases with minor problems. But to me, it's almost like Russian Roulette and one never knows in which cylinder the bullet is housed? One just never knows?

 

That's a great analogy, kjun. I can see it working on 2 levels; first, in areas where the disease is active, you might get it but not have major problems. Second, in areas where it hasn't hit hard yet, one might currently be relatively safe from contracting it at all, even without precautions, but if / when it does hit, it could spread before the "alarm" is raised and you start to take precautions.  The principle is the same, the difference being the number of empty chambers alongside the one with the bullet.    

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On 6/16/2020 at 2:57 PM, coastal_caniac said:

 

My cousin did that.  Screw the govt taking over our lives, he said.  Now he's dead.

 

31 years old.

Coastal, I am so sorry. 

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