Today marks the 120th day since I contracted COVID-19, so I thought I would give an update on things.

First and foremost, I am doing well with all things considered. I am not sure why my stress levels have not been higher, given some of the symptoms I had/have (i.e., tinnitus, fatigue, loss of smell, and taste). I still have my good and bad days, but they seem to be in the normal scope of things, and not higher due to the COVID infection. On another side note, I am getting my second shot today. I am anxious to see how this may influence my long-term symptoms. One of the groups I am in seems to suggest that it could help in that area. So, let’s go through the laundry list of things:

Smell: This is one of the most intriguing aspects to me. I would say that my overall sense of smell is about 30%. I seem to have periods of time when there is a constant smell of smoke which then becomes a smell of ammonia. There is usually a day (or 12 hours) where I can smell with nothing hindering it. I usually sleep with a dab of Vicks Vapo-rub under my nose as a test.

Taste: Taste is pretty much back, but things are a little bit blander. The biggest change right now is that I seem to taste salt in anything.

Breathing: I tested 2 weeks ago, and I was back to 83% of lung capacity. That is up from about 72% in January. I do not really notice it much unless I am doing any slight workload (carrying the trash cans, etc). It will be interesting to see where I am when I go back in May.

Fatigue: Still here and still bad. I try to fight through it so people do not notice, but the honest truth is that I could lay in bed all day probably. I have taken to constantly walking the floor when I am at practice, to keep me active. When I get home from work at the office or practice, I instantly need a nap for about 40-60 minutes. I really do wish I could explain this better. It is not like fatigue from working out or playing hard and it Is not like fatigue when you have the flu. Both have a physical “run down” feeling. This does not. It just feels like I have been up for 24 hours straight.

Dreams: Nonstop still. From the day I got infected until now, there has not been a night without a dream. Luckily, most are good with very few nightmares or sad dreams.

Tinnitus: Kent Taylors’ death, the founder of Texas Roadhouse, made me want to talk a little bit more about this. I guess because I have always had a little bit of tinnitus because of all the years of drumming. When I had my bells palsy in 2017 it was a notch up, but only for about 2 weeks. My current tinnitus is on a whole new level. It is suggested that Kent took his own life because the tinnitus became unbearable. The best way I can explain it is when you have a television turned on, but nothing on it. You can still sense/hear that the TV is powered on, but nothing is happening. It is like that but a few decibels louder. On a good day. On a bad day…Well…Imagine the sounds of a microwave oven cooking and now up the pitch a few octaves. It is not like I am sitting along the drag strip at Maple Grove Dragway, but in ways, much worse. I am not afraid to admit that it has brought me to tears a few times out of frustration, not pain. The only way I can really combat it is with counter-sound. Normally headphones. I almost always have headphones on if there is no other ambient music/sounds. I wear my Bose over-ear headphones most of the day, then wear my Power Beats in-earphones to sleep in. This is by far the worst of my symptoms and the one that not much can be done about. Sometimes I wish the people who see me understood how it affects me. It affects my speech, my thinking, my writing/typing.. It really disrupts everything.

Mental Fog: Still here and still pretty hard. I write almost everything down because I forget things a bit now. I also lose track of where I am in projects. It is not related just to work either. I find myself re-reading passages, my decision-making (nothing life and death or important) seems to be off. I find myself “zoning out” a lot more. I also do not have a lot of tolerance for chatty people. I get agitated with long stories, mainly because it takes a lot more energy and focus to follow them. Just get to the point and move on.

Overall Health: Things are ok. I have lost 21.6 pounds since the infection. Part of this is due to my bloodwork being crazy. I (we) am not sure how much is due to the infection vs being in lockdown. I do know that I was pre-diabetic prior to the infection. My levels were between 85-150 on a regular basis. In fact, I had blood work done with my arthritis two weeks prior to the infection and my blood sugar was at 120. When I got tested 2 weeks after the infection, my levels were at 380. Obviously, I made some changes, and I am back in the 120-150 range, but there is still more work to do. My uric acid levels did not rise, and my joints are feeling pretty good. I get tested every month, so it will be easy to monitor any changes in my blood/body moving forward.

I guess that really sums everything up. Overall, I am doing well both physically and mentally. I am checking in with the people I need to stay healthy, and I have an AMAZING wife and family to support me. My friends have been amazing and supportive, and my assistant coaches have been off the chart helping me out. There are just some days I “can’t do it” and they all understand.

Stay safe everyone, wear a mask, social distance, and get vaccinated!

Much love,

The post 120 Days. appeared first on Dan Mickle.

Hello Everyone!

I hope everyone reading this is safe and sane.  I know it is certainly a challenging time for us all, across the globe.  I must admit, I have been avoiding posting about this topic for some time.  There are a lot of reasons, but the main cause is that I really wanted to learn more.  For that to happen, we (the planet) needed to get more information, data, etc.  Then, the process of making the data available to the public had to happen.  It is nowhere near where it needs to be for a better understanding, but the truth of the matter is that we are out of time.  Albeit we are out of time by our own making.  However, before I begin, I feel I need to make a few things clear as this is the internet and things usually get taken out of context or broken down to 5-minute recaps that skew the points made.  Here is my nifty bullet point list (those that know me know how much I love them) of key points to start with before you continue reading this blog:

• The views in this post are mine. I do not claim to represent the views of any other person, persons, company, school, or any entity for that fact.
• I have been a coach in some capacity since August of 1992. I literally went from HS to coaching/instructing.  I am a lot of things, but a coach is second only to a son/brother/husband/father.  Coaching and I are and will be, forever intertwined in some capacity.
• I love my current coaching roles, both as a college coach, and with the ParaBeach athletes, I have the pleasure of working with. Sure, it can be a grind and frustrating, but I really do love it.
• I would love nothing more (in the sports sense) to have a season this fall. It is what drives me all year to be better and continue learning.
• As I am finishing this second master’s degree in Learning Technologies, I am already beginning the background work and foundations for my Ph.D. program I will start in August of 2021 in the Data Sciences field. I am excited to morph the worlds of sports psychology, learning technologies, and data sciences together.
• While I have tried my best to find current resources to use, things are changing every minute so I can’t promise that what I present or suggest will be accurate by the time you read it.
• This is my blog. I wanted to share my perspective and thoughts on this topic.  I am not looking to debate it.  I am not saying some of you won’t have good counterpoints, I just really am not looking to debate the topic.  I will continue to read the science and try to form the best opinions I can.  If you are going to post comments, then get upset that I don’t respond, save yourself the trouble and just do not post.
• Last point. I am not open to the concept that this is a hoax or not real.  It is very real and very serious.  If you cannot come to terms with that, there is no sense for you to continue reading.  Nothing else will matter.
• I will still love you, value you, and respect you even if our opinions differ.

Now that we have all that out of the way, let’s get on to the topic at hand.

I am going to just start off with the bang and no real build-up.  I do not think youth, high school, or college sports should resume until a COVID-19 vaccine is available.  I certainly do not think that the fall of 2020 should happen.  There are a lot of reasons I feel this way, and I am going to do my best to present what led me to this result. It may seem like it has come easy while reading it on the screen, but the truth is I have agonized over this for months.  I have agonized over it as a college coach, a coach of athletes in a higher risk demographic, as a partner in the ownership of a youth club, and as a parent of an athlete.  I cannot say which hat I wear has caused me the most stress, but it has been a large amount.

I want to start with some of the science I have been researching that has shaped by thoughts.  Please know that a lot of this has been complex and took me a while to understand it, even at the basic levels.  There is a chance that I have misinterpreted some data when researching or even took something out of context.  I have done my best to not do that and present things in an accurate and truthful manner.  Any errors are unintentional and not meant to trick or deceive.  First, I wanted to understand the transmission aspect of the virus.  We often see the argument that the season Flu is worse, infection-wise.  When I reference the “flu” I am talking about A and/or B strains.  That is where I wanted to start.

• The basic reproduction of COVID-19 (R₀) is approximately 3.2. The R₀  for the flu is 1.28 (Ayukekbong, Ntemgwa, Ayukekbong, Ashu, & Agbor, 2020).  This basically means that a person with the flu is likely to infect 1 other person, while a person with COVID-19 is likely to infect 3 people.
• The incubation period for COVID-19 is 2-14 days while the incubation period for the flu is 1-4 days (Ayukekbong et al., 2020). What I take from this information is that assuming a person is asymptomatic, a person with COVID-19 can infect others for almost 4 times as long as a person with the flu.  When I put this in real terms in my mind, I think about everyone I encounter daily vs two-weeks.  How many are the same versus how many are new?
• Using data from April 2020, the Case Fatality Ratio (CFR) of COVID-19 is 3.9% (John Hopkins University, 2020) while the CFR of the flu is <0.1% (Hadler, Konty, McVeigh, Fine, Eisenhower, Kerker, & Thorpe, 2010). According to the CDC, the CFR is “The case-fatality rate is the proportion of persons with a particular condition (cases) who die from that condition. It is a measure of the severity of the condition. The formula is:
  • Number of cause-specific deaths among the incident cases × 10 ⁿ divided by Total number of incident cases (TC x × 10 ⁿ / TNIC)

Again, in a lay nutshell, it is the measure of how severe a disease is.

• As of May 7, 2020 COVID-19 has 3,836,215 illnesses and 268,999 deaths globally (Ayukekbong et al., 2020) while annually, the flu infects approximately 5,000,000 and kills up to 650,000 (World Health Organization, 2017).
• SARS, which is also a coronavirus, has very similar traits to that of COVID-19. When we look at the data from a 2-year study of SARS, we can see what the same result from COVID-19 infections may be.  A key finding in the study was 52% of SARS survivors had persistent impairment in DL_CO and that exercise capacity and health status were significantly lower than the normal controls of the same age groups at 24 months post-illness. In addition, only 78% of SARS survivors had returned to work and 29% of the HCW had not resumed duty (Ngai, Ko, Ng, To, Tong, & Hui, 2010).
• The last “science” aspect I want to touch on is the fact that the virus is novel is problematic. There has not been enough time to research aspects like re-infection, re-activation, immunization after contraction, and other key areas.  There continues to be more and more research done, but the few studies that have been published are admittedly small and no consensus, either way, has been formed on these areas.

Now that I have given the big chunks of the science that I have been looking at and trying to understand, I wanted to offer my opinion on why I think fall sports are a bad idea.  In fact, I feel like all sports seasons until a vaccine is found, or at least a lot more research can be done, should not happen.  I am not going to get in the professional aspects of sports, as that is a topic for another day.

Reason #1 – First and foremost, above anything else, is the fact that we have no data yet on what the long-term damage or issues of infection can be in population, let alone the youth/adolescent population.  If SARS is an indicator, there could be diminished lung capacity and function for up to two-years and maybe beyond.  What are the effects on an athlete who is training in that period with lung damage?  There are also studies currently looking at the functions of other areas of the body like brain function, liver function, and strokes.  Even if we use the argument that the younger population is not as “at-risk”, are we willing to put the older population in jeopardy for the sporting events?  Coaches, officials, statisticians, reporters, administration, parents, bus drivers, athletic trainers, and the list can go on for who helps events happen.

Reason #2 – We have no evidence that herd mentality will work.  It will great if that is a possibility, but for now, I am not willing to play that game of Russian roulette.  Are we willing to put masses in jeopardy and hope that they may contract it, recover, and be able to move on?  With not knowing the lasting effects, I can’t see how this is a good option. Also, most of the studies calculating the risk of the virus and be shown to have major flaws.  Again, this goes to the point of not having enough time yet to complete meaningful research.

Reason #3 – I do not care about death rates.  I pondered talking about Simpson’s Paradox and the relationship between cases vs mortality, but that would be a 10-page post on its own.  When looking at my values as a coach and what I believe in, it comes down to harm.  Am I willing as a coach to put players in a position to be harmed?  It is possible there is no harm, but personally I am not at that point where I can believe there is an answer one way or the other at this point, so I choose to pick the side that is less harmful (I understand that not having sports may cause psychological harm to some).

Reason #4 – Logistics.  This, like every other part, could be its own post.  The logistics of having a season at this moment are tough.  The amount of unknows makes it tough.  Should athletes have to wear a mask to train, to play, to be transported?  How am I supposed to clean equipment?  Even if you keep game balls separate from practice balls, it is the same group of players using them.

Reason #5 – Unintended consequences.  While I have read all the releases from federations, conferences, schools, etc. there has always been something tingling in the back of my mind.  What are we missing?  The answer is a lot.  This part has a lot more questions than answers.  What happens if we play team A on Monday and Team B on Wednesday.  On Friday we learn that Team A has a positive test.  Do we now have to quarantine all of Team A, B, Us, and D (assuming Team A had a second match as well)?  In the course of 3 days, we have now eliminated 4 teams from competition for 2 weeks.  Once we all get back, it is likely to happen again with other teams.  There is a high likely hood that the cycle would just continue.  If we look at LSU Football, 30 of their 115 players testing positive.  If we use the module from research, there is a high probability that those 30 infect 90.  So, then those players (infected) must be symptom-free for 14 (policies seem to vary, so I am using the most frequent) days before returning.  That means 14 days AFTER hopeful recovery.  It is not “Hey, I tested positive, see you in 14 days”.  That is just the athletic aspect.  What about the bus driver who must bus kids to school, or the official who is a bank manager for their fulltime job?   The other part I have started to think about is teachers teaching to empty classrooms.  As more and more student-athletes get exposed, more and more go to quarantine, more and more miss class (in person).  I just think there are a lot of “and then..” to warrant the return.

Reason #6 – Nothing is trending in the right direction.  At the time of this posting (July 10), Pennsylvania is back on an upward trend (https://bit.ly/COVIDRATES)

New Cases per Day

• 3 Weeks Ago: 405
• 2 Weeks Ago: 495
• 1 Week Ago: 639
• This Week: 704

The problem is most people are fixed on two things:  The notion that “more testing” is causing more results.  While that is true, there is enough proof that it is not the sole reason numbers are spiking.  A quick search will find you those documents.  Another scary number is that 1 in 5 tests in Arizona is coming back positive.  That is pretty much on track with the research I posted earlier.  That is why I am concerned.  I would most likely have a bit of a different stance (maybe not) is everything was trending downward.  But it isn’t.  Not by a long shot.

That leaves me with where I am today.  A mixture of sadness, concern, anger, and empathy.  I understand that people want things “back to normal”.  We all do.  I just don’t think it is ready to happen yet.  I am also not limited to thinking about sports.  I am not sure the current methods and plans to open schools, in general, is a good one.  You can do a search and find any number of forums, posts, and blogs from the teacher and the concerns they have from how it will work to who pays me when I must quarantine.

Yet, here is the honest hypocritical truth from me.  If my team has a season, I will be there.  I would rather not be there, but no way that I let that happen.  My team and I have a bond and I have always told them I would battle with them no matter what.  I never figured it could actually be a life and death situation for some people (yes, I can hear some of you saying how overdramatic that is).  I have had the talk with my family and talked about if (or when) I must quarantine.  I can’t help but think about the hundreds or even thousands of coaches who do it for free or almost free (shout out to all my former high school colleagues).  We are asking coaches to maybe put their professional and personal lives on hold for some abbreviated season.  I can’t imagine most people want to use sick leave from their day job to cover the time off needed from sports quarantine.  I am also not immune to the feelings that current seniors have.  I know not having a season would be devastating, but in the grand scheme of things, is it worth it?

I can’t state enough how much I love my school, team, staff, and administration.  I know that everyone is trying to navigate through this and no matter what there will be some downsides.  I just really wanted to put out there where I am coming from and my feelings.  As I said, I will support whatever decisions are made and what will be asked of me.  I just will not do it without voicing my thoughts and concerns.  I don’t know what the future will hold for any of us, but I do know that we will get through it.  One way or another.  I am just not sure now is the time to start that sports journey.

Sorry for the long read and any typos.  I have been trying to organize this for some time and I finally just decided to put it out there.

References:

• Ayukekbong, J., Ntemgwa, M., Ayukekbong, S., Ashu, E., & Agbor, T. (2020). COVID-19 compared to other epidemic coronavirus diseases and the flu. World Journal of Clinical Infectious Diseases, 10, 1-13. doi:10.5495/wjcid.v10.i1.1
• Hadler, J., Konty, K., McVeigh, K., Fine, A., Eisenhower, D., Kerker, B., & Thorpe, L. (2010). Case Fatality Rates Based on Population Estimates of Influenza-Like Illness Due to Novel H1N1 Influenza: New York City, May–June 2009. PloS one, 5, e11677. doi:10.1371/journal.pone.0011677
• John Hopkins University. (2020). Coronavirus (COVID-19) Global Cases. Retrieved from https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
• Ngai, J., Ko, F., Ng, S., To, K., Tong, M.-W., & Hui, D. (2010). The long-term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status. Respirology (Carlton, Vic.), 15, 543-550. doi:10.1111/j.1440-1843.2010.01720.x
• World Health Organization. (2017). Up to 650 000 people die of respiratory diseases linked to seasonal flu each
• Retrieved from https://www.who.int/news-room/detail/14-12-2017-up-to-650-000-people-die-of-respiratory-diseases-linked-to-seasonal-flu-each-year

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