[BostonCard]

This is an interesting perspective:

https://www.al.com/alabamafootball/2020/...eason.html

I don't know of Ackerman, and I think questioning how applicable findings from a study in middle aged Germans applies to young athletes is reasonable.  I would not be at all surprised if the incidence of myocarditis is lower in younger people, just as the disease in general is less severe in younger people.  On the other hand, I'm not so sure I would totally dismiss the concern just because it wasn't a study of young athletes.  To some degree, all of medicine is an extrapolation for which the precise study relevant to the patient you have in front of you may not exist.  You could reasonably say that given the potential seriousness of myocarditis, that until we can rule out an unacceptable risk for athletes that we shouldn't.

The Minnesota-based cardiologist leads the Windland Smith Rice Sudden Death Genomics Lab which studies, among other things, sudden death in young athletes. He explained to the Big 12′s leaders that a new myocarditis study in the Journal of American Medical Association that sparked panic across college sports didn’t have the “bandwidth” to be transferable in a useful way. The study, conducted in Germany and composed of middle-aged adults, found that 78 percent of the 100 participants had some cardiac abnormality. Ackerman said it’d be a “scientific foul” to infer that those findings are relevant for 18 to 24-year old athletes.

"You cannot make that leap," Ackerman exclaimed.

"There's just too many unknowns to say we have new damaging, alarming evidence that COVID-19 myocarditis is the big, bad spooky thing in town now, and we need to do something about it," Ackerman said. "Not new news at all; we've known that this virus can affect the heart muscle for five months now. It's not new, it just got put forward in a new way, and it's taken on a new life."

That is a reasonable position, of course.  But it would also be reasonable to say that in the absence of evidence that it is not relevant to 18 to 24-year old athletes, the better part of valor would be to postpone a season that is not essential.

And to be fair, Ackerman proposes some reasonable risk reduction measures:

Ackerman pushed for the Big 12 to consider additional heart-related protocols to mitigate any possible risks, with the conference adopting plans to test athletes who had the coronavirus with an EKG, cardiac MRI, echocardiogram and troponin blood test. He stressed that any player who contracts COVID-19 needs to have a “squeaky clean cardiac evaluation” before getting the go-ahead to return to play. He cautioned them to consider possible mental health ramifications of canceling a season, referencing past experiences with athletes who suffered after being medically disqualified for heart issues.

I think we have a cardiologist lurking on this board, so I'd be interested in their point of view, but a plan where you have adequate testing and athletes with positive tests undergo a thorough cardiac evaluation strikes me as a reasonable risk mitigation measure.

BC

[BostonCard]

This is an interesting perspective:

https://www.al.com/alabamafootball/2020/...eason.html

I don't know of Ackerman, and I think questioning how applicable findings from a study in middle aged Germans applies to young athletes is reasonable.  I would not be at all surprised if the incidence of myocarditis is lower in younger people, just as the disease in general is less severe in younger people.  On the other hand, I'm not so sure I would totally dismiss the concern just because it wasn't a study of young athletes.  To some degree, all of medicine is an extrapolation for which the precise study relevant to the patient you have in front of you may not exist.  You could reasonably say that given the potential seriousness of myocarditis, that until we can rule out an unacceptable risk for athletes that we shouldn't.

The Minnesota-based cardiologist leads the Windland Smith Rice Sudden Death Genomics Lab which studies, among other things, sudden death in young athletes. He explained to the Big 12′s leaders that a new myocarditis study in the Journal of American Medical Association that sparked panic across college sports didn’t have the “bandwidth” to be transferable in a useful way. The study, conducted in Germany and composed of middle-aged adults, found that 78 percent of the 100 participants had some cardiac abnormality. Ackerman said it’d be a “scientific foul” to infer that those findings are relevant for 18 to 24-year old athletes.

"You cannot make that leap," Ackerman exclaimed.

"There's just too many unknowns to say we have new damaging, alarming evidence that COVID-19 myocarditis is the big, bad spooky thing in town now, and we need to do something about it," Ackerman said. "Not new news at all; we've known that this virus can affect the heart muscle for five months now. It's not new, it just got put forward in a new way, and it's taken on a new life."

That is a reasonable position, of course.  But it would also be reasonable to say that in the absence of evidence that it is not relevant to 18 to 24-year old athletes, the better part of valor would be to postpone a season that is not essential.

And to be fair, Ackerman proposes some reasonable risk reduction measures:

Ackerman pushed for the Big 12 to consider additional heart-related protocols to mitigate any possible risks, with the conference adopting plans to test athletes who had the coronavirus with an EKG, cardiac MRI, echocardiogram and troponin blood test. He stressed that any player who contracts COVID-19 needs to have a “squeaky clean cardiac evaluation” before getting the go-ahead to return to play. He cautioned them to consider possible mental health ramifications of canceling a season, referencing past experiences with athletes who suffered after being medically disqualified for heart issues.

I think we have a cardiologist lurking on this board, so I'd be interested in their point of view, but a plan where you have adequate testing and athletes with positive tests undergo a thorough cardiac evaluation strikes me as a reasonable risk mitigation measure.

BC