(11-30-2020 07:02 PM)ruowls Wrote:  Well, it is actually an opinion of a licensed medical provider. I guess your medical cohort are more learned than my cohort of providers.

I'm not saying that either of our medical cohorts are more learned, just pointing out that folks should not give too much weight to individual data points (wherever that data point may fall along the spectrum).

That said, when I look at the bios of my 2 former roommates, I feel like they have achieved a bit more than me since our Rice days!

An interesting wrinkle.
Would appear that all of the game day rapid tests were quite likely false positives.

https://www.ktsm.com/sports/college-spor...ball-team/

(12-01-2020 03:41 PM)OwlSquared Wrote:  An interesting wrinkle.
Would appear that all of the game day rapid tests were quite likely false positives.

https://www.ktsm.com/sports/college-spor...ball-team/

The gracious host in me thinks that Rice should reimburse UTEP for its travel costs, since it was our testing errors that caused the game to be cancelled. Or at the least pay for the bus that those poor kids had to take all the way back to El Paso.

(12-01-2020 03:41 PM)OwlSquared Wrote:  An interesting wrinkle.
Would appear that all of the game day rapid tests were quite likely false positives.

https://www.ktsm.com/sports/college-spor...ball-team/

I know multiple people who have received positives on the rapid tests and a negative the next day on PCRs. The rapid tests seem to throw an awful lot of errors and I’d be interested to see how those get recorded in the nationwide data.

(11-30-2020 06:25 PM)mrbig Wrote:  Anecdotes are fun!

My OBGYN wife, my Adult Congenital Heart Disease cardiologist former Rice roommate, my pediatric solid tumor oncologist former Rice roommate, another oncologist that I knew at Rice, my father-in-law pathologist, an allergist/immunologist who is a friend, and many others disagree with the “we have lost our minds over Covid” take. In fact, one of the oncologist has posted a few videos begging people to take it more seriously because he had multiple immunity-compromised patients get sick and die from Covid from others who did not wear masks.

LET THE ANECTDOTES RAIN DOWN UPON US LIKE FIRE!

Actually the part I find interesting about this is that the people who mostly have to deal with the 192mm administered tests and 13.6 million positives think its overblown, but the people who have to deal with the 260,000 deaths do not.

That makes perfect sense to me, especially when you consider that COVID to someone dealing quite often with end-stage diseases (the oncologist) would be especially passionate about every 'avoidable' death. Its worth noting also that the ones delivering the mostly negative tests are significantly measured by 'patient satisfaction' in terms of reimbursement while the oncologist is significantly measured by 'mortality rate'. I'm not AT ALL saying that these are drivers of their opinions, but I am saying that the reasons for the ties to reimbursement are also part of their overall outlook. The PCP/GP is more likely to focus on the patient experience... smiling and being happy/bubbly while seeing 50 MOSTLY HEALTHY patients in a day with a burned out staff etc etc can be a struggle while the oncologist and his staff has to deal with death every day. You don't usually ask someone whose father just died if the provider sat and smiled while he explained to you that he was dead.

Imagine how frustrating it would be to cure someone of Cancer and have them die of COVID during their depleted state because someone in the family didn't wear a mask.... but that doesn't apply to that many people.... but for those people its really tragic. Does this mean that the solution to this is to have millions more people do much more, or does it mean that the hand-full of people exposed to that person need to go WAY overboard in their actions?

Your OB/GYN wife is a hybrid... She doesn't see a lot of death but she probably sees some... but despite having some PCP duties, she also likely sends the covid testing elsewhere like to Urgent Care or a testing sight, who is more likely to contract with a GP/PCP to supervise it... to protect her other patients.

(12-01-2020 03:59 PM)cr11owl Wrote:  I know multiple people who have received positives on the rapid tests and a negative the next day on PCRs. The rapid tests seem to throw an awful lot of errors and I’d be interested to see how those get recorded in the nationwide data.

Because they are reported daily, each test is reported to the CDC. They are adjusted later in some but not all cases.

(12-01-2020 03:59 PM)cr11owl Wrote:  

(12-01-2020 03:41 PM)OwlSquared Wrote:  An interesting wrinkle.
Would appear that all of the game day rapid tests were quite likely false positives.

https://www.ktsm.com/sports/college-spor...ball-team/

I know multiple people who have received positives on the rapid tests and a negative the next day on PCRs. The rapid tests seem to throw an awful lot of errors and I’d be interested to see how those get recorded in the nationwide data.

Seems like the wrong test on a % false positive basis to use for an incoming party of 100 and hope you don't get a false positive. But good Covid protocol is important (never you mind the unleashing 6,000 thanksgiving travelers).

I am not sure whether Rice is being too strict on its covid protocols or not. I'm happy that Rice hasn't had to cancel any games because of covid issues on our side of the ball. I agree that it felt like the school/team waited longer than necessary before starting practices and games.

There is no way to no the perfect approach in advance, and it is easy to criticize a school/team for being either too lenient or too strict about things in retrospect. I don't know enough to be overly critical of Rice, a global pandemic hasn't happened in ... quite a while. Tulane has done well, but New Orleans didn't have a problem with the 2nd wave in July/August while Houston obviously had a lot of cases during that time, right when practices would be in full swing.

(12-01-2020 04:25 PM)Hambone10 Wrote:  Actually the part I find interesting about this is that the people who mostly have to deal with the 192mm administered tests and 13.6 million positives think its overblown, but the people who have to deal with the 260,000 deaths do not.

That makes perfect sense to me, especially when you consider that COVID to someone dealing quite often with end-stage diseases (the oncologist) would be especially passionate about every 'avoidable' death. Its worth noting also that the ones delivering the mostly negative tests are significantly measured by 'patient satisfaction' in terms of reimbursement while the oncologist is significantly measured by 'mortality rate'.

I hadn't thought of it that way, and the reasoning does make some sense to me.

That said, I am not sure I agree. At least in New Orleans, there are a million places doing testing (free testing by the city/state, many chain drug stores, many urgent cares, all ER's). Obviously the ER's also have to deal with some segment of the very sick covid patients as well.

Most of the people that I cited (other than the oncologist) haven't dealt with either the testing side or the treatment side. So their opinions are formed based on their medical training and knowledge, not their 1st-hand exposure to covid testing or covid patients.

(12-01-2020 04:25 PM)Hambone10 Wrote:  Your OB/GYN wife is a hybrid... She doesn't see a lot of death but she probably sees some... but despite having some PCP duties, she also likely sends the covid testing elsewhere like to Urgent Care or a testing sight, who is more likely to contract with a GP/PCP to supervise it... to protect her other patients.

I don't think her clinic does covid testing. She has found out 5 or 6 times that a patient she saw was diagnosed with covid a few days afterward (which is why my wife has been tested 8 times!). But she doesn't test or treat for covid herself and as far as I know, none of her patients have had severe cases. She just values mask-wearing, social distancing, and certain limitations on gatherings and businesses to help prevent the spread of covid.

(12-02-2020 11:48 AM)mrbig Wrote:  I am not sure whether Rice is being too strict on its covid protocols or not. I'm happy that Rice hasn't had to cancel any games because of covid issues on our side of the ball. I agree that it felt like the school/team waited longer than necessary before starting practices and games.

There is no way to no the perfect approach in advance, and it is easy to criticize a school/team for being either too lenient or too strict about things in retrospect. I don't know enough to be overly critical of Rice, a global pandemic hasn't happened in ... quite a while. Tulane has done well, but New Orleans didn't have a problem with the 2nd wave in July/August while Houston obviously had a lot of cases during that time, right when practices would be in full swing.

(12-01-2020 04:25 PM)Hambone10 Wrote:  Actually the part I find interesting about this is that the people who mostly have to deal with the 192mm administered tests and 13.6 million positives think its overblown, but the people who have to deal with the 260,000 deaths do not.

That makes perfect sense to me, especially when you consider that COVID to someone dealing quite often with end-stage diseases (the oncologist) would be especially passionate about every 'avoidable' death. Its worth noting also that the ones delivering the mostly negative tests are significantly measured by 'patient satisfaction' in terms of reimbursement while the oncologist is significantly measured by 'mortality rate'.

I hadn't thought of it that way, and the reasoning does make some sense to me.

That said, I am not sure I agree. At least in New Orleans, there are a million places doing testing (free testing by the city/state, many chain drug stores, many urgent cares, all ER's). Obviously the ER's also have to deal with some segment of the very sick covid patients as well.

Most of the people that I cited (other than the oncologist) haven't dealt with either the testing side or the treatment side. So their opinions are formed based on their medical training and knowledge, not their 1st-hand exposure to covid testing or covid patients.

(12-01-2020 04:25 PM)Hambone10 Wrote:  Your OB/GYN wife is a hybrid... She doesn't see a lot of death but she probably sees some... but despite having some PCP duties, she also likely sends the covid testing elsewhere like to Urgent Care or a testing sight, who is more likely to contract with a GP/PCP to supervise it... to protect her other patients.

I don't think her clinic does covid testing. She has found out 5 or 6 times that a patient she saw was diagnosed with covid a few days afterward (which is why my wife has been tested 8 times!). But she doesn't test or treat for covid herself and as far as I know, none of her patients have had severe cases. She just values mask-wearing, social distancing, and certain limitations on gatherings and businesses to help prevent the spread of covid.

I am for taking appropriate measures to reduce risk. Obviously, I want to promote wellness and good health.
I have seen cases of false positives with the rapid test. It goes back to what I was taught as a resident. Treat the patient and not some number. In other words, if you have an asymptomatic person and a do a COVID test and the results do not match the clinical picture of the patient, then a confirmatory PCR test is performed. Rice should know this. It seems pretty clear that the protocol Rice followed in this case is flawed and doesn't account for this happening, which it did and is likely to happen. We had a talk this morning about testing. In our case, it was using a rapid test for a patient that had already tested positive as a means to clear their return to work based on their employers demands. The employer is being irrational and not following the CDC guidelines to return to work after a case of COVID. After thinking about the tests and this situation, there is a difference in what the tests test for. The rapid test looks for a protein while the PCR looks for DNA/RNA. DNA and RNA degrade quickly and aren't present if replicating viruses aren't present. So, it is a much better test to test for active infection. The rapid test tests for a protein that may not degrade as quickly. As such, it will hang around after an infection and may not accurately reflect the state of an infection. These are probably things not every doctor thinks about and how these results alter the numbers without accurately capturing the true picture of the clinical disease. Then, throw on top of this the attribution of cause of death and the numbers may not tell the true story but it is the story pushed by the media and or experts who look only at the numbers instead of the clinical condition of actual patients.
So, what Hambone said, again.

(12-02-2020 12:18 PM)ruowls Wrote:  I am for taking appropriate measures to reduce risk. Obviously, I want to promote wellness and good health.
I have seen cases of false positives with the rapid test. It goes back to what I was taught as a resident. Treat the patient and not some number. In other words, if you have an asymptomatic person and a do a COVID test and the results do not match the clinical picture of the patient, then a confirmatory PCR test is performed. Rice should know this. It seems pretty clear that the protocol Rice followed in this case is flawed and doesn't account for this happening, which it did and is likely to happen. We had a talk this morning about testing. In our case, it was using a rapid test for a patient that had already tested positive as a means to clear their return to work based on their employers demands. The employer is being irrational and not following the CDC guidelines to return to work after a case of COVID. After thinking about the tests and this situation, there is a difference in what the tests test for. The rapid test looks for a protein while the PCR looks for DNA/RNA. DNA and RNA degrade quickly and aren't present if replicating viruses aren't present. So, it is a much better test to test for active infection. The rapid test tests for a protein that may not degrade as quickly. As such, it will hang around after an infection and may not accurately reflect the state of an infection. These are probably things not every doctor thinks about and how these results alter the numbers without accurately capturing the true picture of the clinical disease. Then, throw on top of this the attribution of cause of death and the numbers may not tell the true story but it is the story pushed by the media and or experts who look only at the numbers instead of the clinical condition of actual patients.
So, what Hambone said, again.

Just imagine if we had a physician involved in making decisions regarding Rice football?

(12-02-2020 12:32 PM)Tomball Owl Wrote:  

(12-02-2020 12:18 PM)ruowls Wrote:  I am for taking appropriate measures to reduce risk. Obviously, I want to promote wellness and good health.
I have seen cases of false positives with the rapid test. It goes back to what I was taught as a resident. Treat the patient and not some number. In other words, if you have an asymptomatic person and a do a COVID test and the results do not match the clinical picture of the patient, then a confirmatory PCR test is performed. Rice should know this. It seems pretty clear that the protocol Rice followed in this case is flawed and doesn't account for this happening, which it did and is likely to happen. We had a talk this morning about testing. In our case, it was using a rapid test for a patient that had already tested positive as a means to clear their return to work based on their employers demands. The employer is being irrational and not following the CDC guidelines to return to work after a case of COVID. After thinking about the tests and this situation, there is a difference in what the tests test for. The rapid test looks for a protein while the PCR looks for DNA/RNA. DNA and RNA degrade quickly and aren't present if replicating viruses aren't present. So, it is a much better test to test for active infection. The rapid test tests for a protein that may not degrade as quickly. As such, it will hang around after an infection and may not accurately reflect the state of an infection. These are probably things not every doctor thinks about and how these results alter the numbers without accurately capturing the true picture of the clinical disease. Then, throw on top of this the attribution of cause of death and the numbers may not tell the true story but it is the story pushed by the media and or experts who look only at the numbers instead of the clinical condition of actual patients.
So, what Hambone said, again.

Just imagine if we had a physician involved in making decisions regarding Rice football?

Things may not have been different in this case, but it certainly would help to have a voice of reason based on clinical management in the discussion with administration.
And as a bonus, Rice would sure have a QB and an offense others would envy.

(12-02-2020 11:48 AM)mrbig Wrote:  That said, I am not sure I agree. At least in New Orleans, there are a million places doing testing (free testing by the city/state, many chain drug stores, many urgent cares, all ER's). Obviously the ER's also have to deal with some segment of the very sick covid patients as well.

Most of the people that I cited (other than the oncologist) haven't dealt with either the testing side or the treatment side. So their opinions are formed based on their medical training and knowledge, not their 1st-hand exposure to covid testing or covid patients.

Edited for brevity, but your comments about your wife also apply.... This is what I'm speaking about. I'm not really sure what you're not agreeing with. Perhaps I said something poorly?

Your wife's staff may or may not be also helping out at these other places, but the hospital and GP and UC staffs mostly are... and they are more likely to be operating under the license of a GP/FP/IM rather than an oncologist or OB/GYN... so docs like RU and other FPs are seeing/being impacted by (in terms of oversight and stressed staff) a lot more of the hysteria, while others like your wife and the oncologist are seeing much less of it. They are seeing REAL cases, if any.
[quote = 'ruowls'] It goes back to what I was taught as a resident. Treat the patient and not some number.
[/quote]
and what you made sure I knew, lol.... and what increases the effort and 'hysteria', especially at the broader levels of care like GP/FP/IM over a symptomatic positive result which specialists more often see... either because they are treating the symptoms, or because despite being symptomatic, their care for their other issues cannot wait. An OB/GYN might need to provide care for a COVID positive pregnant mom, but their well-check will be postponed which is why I listed her as a hybrid. The Oncologist doesn't likely have as much flexibility, at least in my vision of their practice. Not a lot of experience with them... other than for critical care. The GP (or their staff) is more likely involved in the testing.

On the conference board it's being reported that all the UTEP players in question we're retested when they arrived in El Paso. All the tests came back negative for COVID.

(12-03-2020 01:58 AM)Ourland Wrote:  On the conference board it's being reported that all the UTEP players in question we're retested when they arrived in El Paso. All the tests came back negative for COVID.

Sounds like Rice made a mistake with regards to the type of rapid test (there are PCR tests with a quick turnaround).

I understand the decision based on the results - if these results had turned out to be real positives, this could have resulted in a spreading event within the UTEP team and to the Rice team. All of a sudden you have viral spread between schools and potentially to any support staff, and Rice has clearly been extra conservative when it comes to COVID spread.

If only Rice had built in more flexibility, which would have allowed for the use of a more accurate quick turnaround test. Maybe Rice will change their process.

(12-03-2020 07:42 AM)RiceLad15 Wrote:  

(12-03-2020 01:58 AM)Ourland Wrote:  On the conference board it's being reported that all the UTEP players in question we're retested when they arrived in El Paso. All the tests came back negative for COVID.

Sounds like Rice made a mistake with regards to the type of rapid test (there are PCR tests with a quick turnaround).

I understand the decision based on the results - if these results had turned out to be real positives, this could have resulted in a spreading event within the UTEP team and to the Rice team. All of a sudden you have viral spread between schools and potentially to any support staff, and Rice has clearly been extra conservative when it comes to COVID spread.

If only Rice had built in more flexibility, which would have allowed for the use of a more accurate quick turnaround test. Maybe Rice will change their process.

FIFY. There is no rational basis for believing in the possibility of communicability between teams during a football game. But of course the pregame testing and decision making process (which certainly isn't unique to Rice, it must be said) is essentially divorced from any real probabilistic analysis and instead basically functions for appearances' sake.

This is what people mean when they say "we've lost our minds over COVID" . . . not that the disease isn't real or doesn't deserve precautionary measures, but that the precautions that do get put in place are often irrationally overbroad -- and that any questioning of them results in being hysterically accused of mass murder.

(12-03-2020 11:17 AM)illiniowl Wrote:  

(12-03-2020 07:42 AM)RiceLad15 Wrote:  

(12-03-2020 01:58 AM)Ourland Wrote:  On the conference board it's being reported that all the UTEP players in question we're retested when they arrived in El Paso. All the tests came back negative for COVID.

Sounds like Rice made a mistake with regards to the type of rapid test (there are PCR tests with a quick turnaround).

I understand the decision based on the results - if these results had turned out to be real positives, this could have resulted in a spreading event within the UTEP team and to the Rice team. All of a sudden you have viral spread between schools and potentially to any support staff, and Rice has clearly been extra conservative when it comes to COVID spread.

If only Rice had built in more flexibility, which would have allowed for the use of a more accurate quick turnaround test. Maybe Rice will change their process.

FIFY. There is no rational basis for believing in the possibility of communicability between teams during a football game. But of course the pregame testing and decision making process (which certainly isn't unique to Rice, it must be said) is essentially divorced from any real probabilistic analysis and instead basically functions for appearances' sake.

This is what people mean when they say "we've lost our minds over COVID" . . . not that the disease isn't real or doesn't deserve precautionary measures, but that the precautions that do get put in place are often irrationally overbroad -- and that any questioning of them results in being hysterically accused of mass murder.

No rational basis? Let’s say a lineman has COVID. How frequently are they in a pile of bodies, breathing heavily, and without a mask on?

A kicker or punter is very unlikely to spread the virus to the other team because of how infrequently they get into close contact with others, but players in the trenches are in each others’ faces very frequently.

I would think that repeated, close quarter exposure, with heavy breathing is not a scenario where spread is impossible.

You have to take into account that El Paso was a hot bed for Covid and the national guard was sent in to help out the aid workers and process the dead.

(12-03-2020 02:51 PM)RiceLad15 Wrote:  

(12-03-2020 11:17 AM)illiniowl Wrote:  

(12-03-2020 07:42 AM)RiceLad15 Wrote:  

(12-03-2020 01:58 AM)Ourland Wrote:  On the conference board it's being reported that all the UTEP players in question we're retested when they arrived in El Paso. All the tests came back negative for COVID.

Sounds like Rice made a mistake with regards to the type of rapid test (there are PCR tests with a quick turnaround).

I understand the decision based on the results - if these results had turned out to be real positives, this could have resulted in a spreading event within the UTEP team and to the Rice team. All of a sudden you have viral spread between schools and potentially to any support staff, and Rice has clearly been extra conservative when it comes to COVID spread.

If only Rice had built in more flexibility, which would have allowed for the use of a more accurate quick turnaround test. Maybe Rice will change their process.

FIFY. There is no rational basis for believing in the possibility of communicability between teams during a football game. But of course the pregame testing and decision making process (which certainly isn't unique to Rice, it must be said) is essentially divorced from any real probabilistic analysis and instead basically functions for appearances' sake.

This is what people mean when they say "we've lost our minds over COVID" . . . not that the disease isn't real or doesn't deserve precautionary measures, but that the precautions that do get put in place are often irrationally overbroad -- and that any questioning of them results in being hysterically accused of mass murder.

No rational basis? Let’s say a lineman has COVID. How frequently are they in a pile of bodies, breathing heavily, and without a mask on?

A kicker or punter is very unlikely to spread the virus to the other team because of how infrequently they get into close contact with others, but players in the trenches are in each others’ faces very frequently.

I would think that repeated, close quarter exposure, with heavy breathing is not a scenario where spread is impossible.

I understand how football is played, thanks. Nevertheless, the fact remains that there has been essentially no proven transmission of the virus in the various fields of play (football, running, etc.). The generally accepted standard for considering oneself "exposed" is spending 15 continuous minutes in close quarters -- indoors, mind you. Is it literally impossible that it could happen in a football game (or a XC race, or a soccer match, etc.)? Perhaps not, but the data show that the probability is not meaningful in any rational, statistical sense. Literal impossibility is an irrational standard to construct policy around, and generally we don't, but with COVID, policymaking has at many times seemed geared more toward appeasing neurotic fears or trying to give the appearance of "doing something, anything" rather than being more soberly and scientifically calibrated.

Santa Clara County's "experts" have decreed in their incontestable wisdom that all contact sports must cease in the name of public health. The 49ers will now play in Arizona for the next 2 weeks. To my knowledge, football isn't played any differently in Arizona. So the Niners are quite literally flaunting "expert" advice, are openly and notoriously practicing activity officially deemed an unacceptable threat to the public health, and then they expect to blithely go back to CA and mingle with the populace? If the County's banning of contact sports is truly necessary and not just kabuki theater, shouldn't there be outrage at what the Niners are doing?

(12-03-2020 05:39 PM)illiniowl Wrote:  I understand how football is played, thanks. Nevertheless, the fact remains that there has been essentially no proven transmission of the virus in the various fields of play (football, running, etc.). The generally accepted standard for considering oneself "exposed" is spending 15 continuous minutes in close quarters -- indoors, mind you. Is it literally impossible that it could happen in a football game (or a XC race, or a soccer match, etc.)? Perhaps not, but the data show that the probability is not meaningful in any rational, statistical sense. Literal impossibility is an irrational standard to construct policy around, and generally we don't, but with COVID, policymaking has at many times seemed geared more toward appeasing neurotic fears or trying to give the appearance of "doing something, anything" rather than being more soberly and scientifically calibrated.

Santa Clara County's "experts" have decreed in their incontestable wisdom that all contact sports must cease in the name of public health. The 49ers will now play in Arizona for the next 2 weeks. To my knowledge, football isn't played any differently in Arizona. So the Niners are quite literally flaunting "expert" advice, are openly and notoriously practicing activity officially deemed an unacceptable threat to the public health, and then they expect to blithely go back to CA and mingle with the populace? If the County's banning of contact sports is truly necessary and not just kabuki theater, shouldn't there be outrage at what the Niners are doing?

Outstanding response.

(12-03-2020 06:03 PM)Hambone10 Wrote:  

(12-03-2020 05:39 PM)illiniowl Wrote:  I understand how football is played, thanks. Nevertheless, the fact remains that there has been essentially no proven transmission of the virus in the various fields of play (football, running, etc.). The generally accepted standard for considering oneself "exposed" is spending 15 continuous minutes in close quarters -- indoors, mind you. Is it literally impossible that it could happen in a football game (or a XC race, or a soccer match, etc.)? Perhaps not, but the data show that the probability is not meaningful in any rational, statistical sense. Literal impossibility is an irrational standard to construct policy around, and generally we don't, but with COVID, policymaking has at many times seemed geared more toward appeasing neurotic fears or trying to give the appearance of "doing something, anything" rather than being more soberly and scientifically calibrated.

Santa Clara County's "experts" have decreed in their incontestable wisdom that all contact sports must cease in the name of public health. The 49ers will now play in Arizona for the next 2 weeks. To my knowledge, football isn't played any differently in Arizona. So the Niners are quite literally flaunting "expert" advice, are openly and notoriously practicing activity officially deemed an unacceptable threat to the public health, and then they expect to blithely go back to CA and mingle with the populace? If the County's banning of contact sports is truly necessary and not just kabuki theater, shouldn't there be outrage at what the Niners are doing?

Outstanding response.

So we don’t need to be doing any of these testing protocols? I had assumed games were being canceled because of risk of transmission outside of the program, not because teams were worried about spreading it internally during game day, when they spend far more time together outside of game day.