Player Discussion Kaapo Kakko: Part III

[Black Aces]

If he is properly maintaining his T1D, like all diabetics should be doing anyway, he is not at a higher risk to contract COVID-19 than a non-diabetic.

The same goes for being a celiac. While it is an immunodeficiency, it is not close to being the same risk level as other immunocompromised patients and is being classified as such. A slightly elevated risk than normal patients, sure.

The bigger risk could be IF he gets it. But even then, properly managed T1D patients just need to be more aware of DKA. And the only celiac patients that are really at risk once they get COVID are the ones with malnutrition/severe weight loss/etc.

But in general, he's not at higher risk to get it just because of T1D or being celiac. And in the health/shape that Kakko is in, he's not inherently at higher risk even if he gets it.

Should there be caution? Of course. Is it something to raise all the alarms about? No.

Celiacs disease is not an immunodeficiency. It is an autoimmune disorder. Celiac's wouldn't weaken his immune system unless he were nutrient deficient from it. I strongly doubt this is the case.

When we discuss high risk preconditions, we are more focusing on outcomes if the person were to contract the virus. Not necessarily their risk of becoming infected if exposed.

 

[Irishguy42]

Celiacs disease is not an immunodeficiency. It is an autoimmune disorder.

You are right and that's my mistake. Regardless, of the autoimmune disorders, doctors are putting it very low on the list in regards to susceptibility to the coronavirus, mostly because of...

Celiac's wouldn't weaken his immune system unless he were nutrient deficient from it. I strongly doubt this is the case.

...this.

When we discuss high risk preconditions, we are more focusing on outcomes if the person were to contract the virus. Not necessarily their risk of becoming infected if exposed.

There is minimal to show that someone with "normal" (feels wrong to call it that) celiac disease would be that much more at risk if they were to contract coronavirus, especially an athlete who is under better medical care/oversight than the majority of people. This also includes T1D patients.

At the end of the day, Kakko is not really at an increased risk for this as long as he keeps following his normal regimen and with a little extra care. A lot of folks are making mountains out of molehills in regards to this stuff, even though there is no problem with increased caution.

 

[Jussi]

Under NHL's guidelines, Kakko probably will not be allowed to play.

 

[bl02]

The CDC has stated that type 1, type 2, and gestational diabetes are at higher risk for worse outcomes if they contract the virus.

We don't know if he is at more risk to get infected if exposed. But he is at higher risk for a worse outcome. How much I am not sure.

In addition to this, anecdotally the young people I have seen do poorly were T1 diabetics. Yes, they were not pro hockey players. But they were otherwise healthy individuals.

Do poorly from Covid? How so? These were young T1 you read about or knew?
Issue is it is a case by case basis. If a young T1 has high blood pressure (which you and I wouldn't know about unless you were privy to his medical data) and had a high a1c level (again which you and I wouldn't know about unless we were privy to his medical data) then for sure I would be more worried.
From the interviews I've read with endocrinologists if a young individual with T1 who has No other comorbidities contracts Covid he or she wouldn't necessarily more vulnerable to the complications.

 

[Irishguy42]

FWIW, the CDC website only lists Type 1 diabetes as "might be at an increased risk" for both contraction and overall health, whereas Type 2 remains in the "are at an increased risk". And their guidance suggests the best course of action is to keep your daily regimen as usual.

The JDRF states that T1D is not more at risk for coronavirus than normal, nor is it higher risk for worse outcomes. The ADA states that the only increased risk of health problems in diabetics from contracting COVID-19 is those who already have big health issues from diabetes, or if there is a more serious underlying issue (like heart disease).

Anecdotally, my fiancee's father is an EM physician and has diabetes (don't immediately recall if T1 or T2, can ask her when she wakes up to go to her night shift), and is in the hospital for 12+ hours a day with regular contact with COVID patients, and he's doing just fine.

 

[Irishguy42]

I am fully okay with Kakko sitting out because of being cautious. That's fine. It's just that mountains are being made out of molehills here.

Besides, Kakko was the worst player in the NHL last year, so him sitting out doesn't really affect the team negatively.

 

[Black Aces]

Do poorly from Covid? How so? These were young T1 you read about or knew?

Direct patient care. In their early 30s.


Do poorly as in worse morbidity and mortality.

Some data from the UK.
https://www.england.nhs.uk/wp-content/uploads/2020/05/valabhji-COVID-19-and-Diabetes-Paper-1.pdf

 

[KirkAlbuquerque]

Totally fine with Kakko sitting out the playoffs.

 

[n8]

It is true. Go look at the freely available statistics for people with Type 1. Just because there was extra precaution being taken doesn't mean there was imminent danger. If the idea is to avoid risk and make everything as safe as possible, then we need to outlaw cars. Covid-19 doesn't even compare in a minute way to the risk that people take every day when they drive a car. The level of fear has exceeded the actual threat. Do you take the same precautions during flu season?

this is the 2nd stupidest thing I've read on the internet all week. (1st was teens having covid parties). The US is the worst country in the world at handling covid. If you think we are out of imminent danger, maybe you should take a trip to Florida. The level of fear is no where near the level of the threat. See covid parties. See Florida. See the cubic growth rate of infections in the US. CUBIC - if that does not flatten 90% of the country will be infected in 2 months time. At a population of 328 million and a death rate of 4.5%, you are looking at 13 milllion dead people in the USA alone. That is about 4.6x more deaths than all combat casualties in every war in the HISTORY of the USA. Also, I think the flu-shot counts for people taking precautions during flu season - a vaccine we don't have yet for covid. What a ridiculous comparison!

If Kakko is in that danger population, he's best doing what is safest for him. The level of testing for the playoffs and access to some excellent doctors might make the playoffs a safe environment provided the participants are isolated to just each other. If they are allowed to go out to the store between games or order takeout, the whole thing is a sham.

 

[broadwayblue]

this is the 2nd stupidest thing I've read on the internet all week. (1st was teens having covid parties). The US is the worst country in the world at handling covid. If you think we are out of imminent danger, maybe you should take a trip to Florida. The level of fear is no where near the level of the threat. See covid parties. See Florida. See the cubic growth rate of infections in the US. CUBIC - if that does not flatten 90% of the country will be infected in 2 months time. At a population of 328 million and a death rate of 4.5%, you are looking at 13 milllion dead people in the USA alone. That is about 4.6x more deaths than all combat casualties in every war in the HISTORY of the USA. Also, I think the flu-shot counts for people taking precautions during flu season - a vaccine we don't have yet for covid. What a ridiculous comparison!

If Kakko is in that danger population, he's best doing what is safest for him. The level of testing for the playoffs and access to some excellent doctors might make the playoffs a safe environment provided the participants are isolated to just each other. If they are allowed to go out to the store between games or order takeout, the whole thing is a sham.

I'm not sure the 4.5% death rate is accurate. Isn't is closer to half that? Still a lot of deaths, but 4.5% is a scary number that I have not seen supported.

I actually see Johns Hopkins quoting that 4.5% figure. Seems really high.

 

[Shesterkybomb]

this is the 2nd stupidest thing I've read on the internet all week. (1st was teens having covid parties). The US is the worst country in the world at handling covid. If you think we are out of imminent danger, maybe you should take a trip to Florida. The level of fear is no where near the level of the threat. See covid parties. See Florida. See the cubic growth rate of infections in the US. CUBIC - if that does not flatten 90% of the country will be infected in 2 months time. At a population of 328 million and a death rate of 4.5%, you are looking at 13 milllion dead people in the USA alone. That is about 4.6x more deaths than all combat casualties in every war in the HISTORY of the USA. Also, I think the flu-shot counts for people taking precautions during flu season - a vaccine we don't have yet for covid. What a ridiculous comparison!

If Kakko is in that danger population, he's best doing what is safest for him. The level of testing for the playoffs and access to some excellent doctors might make the playoffs a safe environment provided the participants are isolated to just each other. If they are allowed to go out to the store between games or order takeout, the whole thing is a sham.

To add to this, you can be left with lifelong lung issues with this virus, it happened to me with H1N1. I never had any lung issues before contracting it but ever since I have yearly lung issues mid winter, I've heard coronavirus can do the same. I'd hate to see Kakko end up with something that limits his abilities.

 

[EdJovanovski]

I don’t get how Kakko would be more safe living regular life than playing hockey in a protective bubble with 24/7 access to world class medical care.

 

[Amazing Kreiderman]

I don’t get how Kakko would be more safe living regular life than playing hockey in a protective bubble with 24/7 access to world class medical care.

Normal life in Finland >>> Living in a buble in NA

 

[bl02]

Direct patient care. In their early 30s.


Do poorly as in worse morbidity and mortality.

Some data from the UK.
https://www.england.nhs.uk/wp-content/uploads/2020/05/valabhji-COVID-19-and-Diabetes-Paper-1.pdf

The study was a good read and i've seen it before. If you scroll down to the very end of the study where tables are shown. the age range group 1-39 for type diabetes has an asterisk (Suppressed due to small numbers). Kakko is 19.
From the discussion part of the study " Even with the additional risk associated with Type 1 diabetes or Type 2 diabetes, people under the age of 40 years with either type of diabetes were at very low absolute risk of in-hospital death with COVID-19 during the observation period of this study in England."
If there were any serious complications or even death to anyone under 30 in this study I would love to see their Hemoglobin a1c levels along with other Data like BP.

 

[Levitate]

Under NHL's guidelines, Kakko probably will not be allowed to play.

What? That just seems to say that if team doctors say they shouldn't be playing because they're at higher risk then they won't be allowed to play. It sounds like it's still pretty much up to the team

 

[Black Aces]

The study was a good read and i've seen it before. If you scroll down to the very end of the study where tables are shown. the age range group 1-39 for type diabetes has an asterisk (Suppressed due to small numbers). Kakko is 19.
From the discussion part of the study " Even with the additional risk associated with Type 1 diabetes or Type 2 diabetes, people under the age of 40 years with either type of diabetes were at very low absolute risk of in-hospital death with COVID-19 during the observation period of this study in England."
If there were any serious complications or even death to anyone under 30 in this study I would love to see their Hemoglobin a1c levels along with other Data like BP.

I know he is 19. And, yes, I read that quote as well. It doesn't not say that he is not at increase risk. He is young so yes his absolute risk is low. Still, with type 1 diabetes he has added risk compared to those that do not.

 

[Black Aces]

I don’t get how Kakko would be more safe living regular life than playing hockey in a protective bubble with 24/7 access to world class medical care.

He can distance at home.

The bubble isn't perfect by any means.

 

[n8]

I'm not sure the 4.5% death rate is accurate. Isn't is closer to half that? Still a lot of deaths, but 4.5% is a scary number that I have not seen supported.

I actually see Johns Hopkins quoting that 4.5% figure. Seems really high.

I simply looked up number of reported cases vs reported deaths and did the math. 4.5% and pretty much the country's top medical institution has the same number too. Believe it. This shit needs to be taken seriously. The only caveat you can make is that there are a lot of people out there who probably have it and did not get tested. In the beginning it was really hard to get a test so a lot of people were just told to go home and self quarantine and tough it out but because they weren't tested, if any of those died, I don't think the data correlates to the existing figures. Could be wrong but for all statistics, the standard deviation goes in both directions so you can ball park it to 4-5%

 

[n8]

I don’t get how Kakko would be more safe living regular life than playing hockey in a protective bubble with 24/7 access to world class medical care.

this bubble does not exist every step of the way from his home to Toronto. Grant it, playing in Canada right now is probably 10x safer than playing in the USA but world class medical care doesn't mean too much if you are already infected. Sure we can say he survives but does he survive with chronic lung issues? the NHL has money to access stellar medical care but the on staff medical care is all sports physicians. I'm guessing none of them are pulmonary virologists. Additionally, my point above - does anyone know if the NHL players and staff are to quarantine within the NHL bubble? What if someone decides to order food delivery? Who is catering food otherwise? Where are they getting their food delivered from? Will they have relatives and family coming in and out? There are currently many unknown points of entries that could make this entire plan fool-hardy. I'm assuming the NHL is going to take every measure to insure nothing pierces their bubble but I think it's naive thinking because they are in an assumed to-be-confirmed bubble that the system has no holes. Then it's just a matter of whether or not you want to take that risk. I'll respect any player's decision to come or not come. It'll suck to hear about the one player who opted out and have their team with the Cup and miss out on all that and getting their name on it but, strange times. Strange times...

 

[Jussi]

this bubble does not exist every step of the way from his home to Toronto. Grant it, playing in Canada right now is probably 10x safer than playing in the USA but world class medical care doesn't mean too much if you are already infected. Sure we can say he survives but does he survive with chronic lung issues? the NHL has money to access stellar medical care but the on staff medical care is all sports physicians. I'm guessing none of them are pulmonary virologists. Additionally, my point above - does anyone know if the NHL players and staff are to quarantine within the NHL bubble? What if someone decides to order food delivery? Who is catering food otherwise? Where are they getting their food delivered from? Will they have relatives and family coming in and out? There are currently many unknown points of entries that could make this entire plan fool-hardy. I'm assuming the NHL is going to take every measure to insure nothing pierces their bubble but I think it's naive thinking because they are in an assumed to-be-confirmed bubble that the system has no holes. Then it's just a matter of whether or not you want to take that risk. I'll respect any player's decision to come or not come. It'll suck to hear about the one player who opted out and have their team with the Cup and miss out on all that and getting their name on it but, strange times. Strange times...

By the way, that's "granted", not grant it.

 

[gwh]

Under NHL's guidelines, Kakko probably will not be allowed to play.

Fantastic.

Here is the beef: "players who, after consultation with Club doctor who conducted PPME, and the Club’s infectious disease expert, are determined to be at substantial risk of developing a serious illness as a result of exposure to the novel coronavirus"

Diabetes 1 is a major risk factor for serious illness -> unfit to play. Based on this Kakko and Domi are done.

 

[Kakko Schmakko]

Kakko out Kravtsov in? I guess it makes sense.

 

[Jaska]

He can distance at home.

The bubble isn't perfect by any means.

In Finland we have had an average of two cases per 100.000 people over past two weeks. No one in ICU. The first wave is done here, but the epidemic is not of course.

 

[romba]

Lots of arm chair hysterical doctors drawing hard facts from limited data. Overall diabetes has more mortality, so all diabetics are at risk right?. Wrong. Also, Celiacs is too rare to really draw strong conclusions but the data I’ve seen suggests that much like type 1 diabtes, when not controlled it is a liability, when it is controlled it is not. The real question here is whether NHL is interested I differentiation between controlled and uncontrolled disease states. I’d say ‘not likely’.

 

[Larrybiv]

I don’t get how Kakko would be more safe living regular life than playing hockey in a protective bubble with 24/7 access to world class medical care.

If the NHL does what they need to do (and you bet your sweet bippy, they will), I absolutely believe he will be safer "in that bubble" then galavanting in the outside world. I want him to play, but NOT be the "worst player in the NHL".
I am of the ilk, that believes kakko will benefit from this long pause. It gave him a chance to evaluate, and probably more importantly relax. I believe he's going to come on strong and be much more of a force than what we've seen. He seems like he takes too much on and he doesn't need to be like that, so the break might slow him down a little in a positive way.