Starting Strength Weekly Report


March 09, 2020


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tori trains for her next meet
Tori trains for her next meet at WFC. Here she is setting up for her first single of 65x1x5. [photo courtesy of Efraim Mammon]
seth up 125 lbs in his squat
Rank novice Seth has gained 20 pounds and taken his squat sets from 65 lb to 185 lb in under 7 weeks of training. [photo courtesy of Starting Strength Denver]


Best of the Week

COVID19 Factors We Should Consider
Mark Rippetoe

BIRTH OF A VIRUS

Yngvi

The FDA, NIH and CDC have a combined budget of ~$50 billion annually.

It has taken them 3 months to develop and begin distributing a Covid-19 test. (A simple qPCR test that should cost less than 50 cents per kit to produce.)

Would anyone in their right mind ever consider giving more money to a private company that produced results so poor?

CommanderFun

3 months IS quick as far as this thing getting across the world like it has. It's sneaky, and only China has had the most long term contact with it. But we can't trust their findings on anything worth a damn, since it's not out of the realm of possibility that they made it to begin with and it got loose due to their legendary diligence. For making and distributing a test? I don't know about that. I'm not an epidemiologist, or any sort of medical professional. But a test seems to have existed for some time, and it seems like major population areas should absolutely have gotten some. Instead, here in New York, JUST NOW are they finally able to test and turning up positives. That's insane, considering this bug has potentially been here for 2-3 months. Doesn't surprise me to see federal agencies overfunded for the work they do though. Whenever the federal government funds anything it ends up paying way too much for what we actually get from it. It just ends up being too big and with too many cracks the money leaks into.

jfsully

Well, the second test kit may cost 50 cents, but the first one costs quite a bit more to design and test. How sensitive and specific should it be? How many similar coronaviruses should it identify as COVID-19 for the purposes of a “positive” test? They have to get this right, because unlike in China, our government agencies, as unwieldy and inefficient as they are, are still tenuously accountable to us. This is a major reason why the response to and the impact of this virus will be different here.

IlPrincipeBrutto

In a properly capitalist environment hit by a suspected epidemic, the price of a Testing kit should increase substantially; after all, the whole population should be tested, and the production capacity of the testing kits, not to mention the ability to process them is limited.

It might be that at some point, the price goes up so much that a lot of people will be unwilling topay the price of testing themselves, which will only increase the spread of the contagion (The Governor of the State of New York has recently mandated for NY insurers to waive testing costs, so this might not be that imaginary an issue.

In such an environment, it might also be quite likely that sick days are paid only up to a limit, or maybe not at all; thus, employees might consider not worth their while to call in sick if they suspect they have been infected, another factor that could spread the contagion even further (In a recent editorial, the NYT has called for paid sick leave to be provided, which makes me think it might not be widespread.

In other words, in a perfectly capitalist environment there might factors that might facilitate the spread of the contagion, more than in other social set-ups.

Michael Wolf

The production capacity of EVERYTHING is limited. Supply, demand, and the signals that can only be sent by market prices account for how we allocate our inherently limited resources to produce things. So basically, your assertion is completely wrong. You've asserted the price will go up and left it there.

Here's a much more likely, logical scenario in a true market economy: The price would indeed go up, at first, as demand spikes. This causes more entrants into the market of production - instead of making the same amount of pencils and plastic knives and band-aids and shampoo and washclothes and T-shirts and ice cream cones and radios and coffee makers etc...that are made during normal times, producers allocate their resources to get in on the booming testing kit business, driving the price back down very quickly. Likely driving it down below what it was in the first place. After all, aren't our socialist friends constantly railing against how greeeeeeeeedy the evil capitalists are? Would they not want to get their greedy, grubby hands on this big money that the testing kit business is now offering?

The main thing in a non-market economy that stops this is the gov't "saving us all" by placing a price ceiling on such an important good to avoid "price gouging," thus leaving little to no incentive for producers to ramp up production or new ones to enter the market. Thus limiting supply so lots of people remain untested.

johnst_nhb

You answered your own question (with my answer) attempting to point out that my question was dumb. The quip about it not being answered was a nice touch too.

Now for grins, should “you* be able to offer the test out of your garage?

Bureaucracy is very often a clusterfuck. Regulation too, but not always.

Michael Wolf

Why, it's almost as if this crazy wackadoodle theory is borne out empirically as well! The one thing I might need to revise about my comment above is that culture matters too - while 34 states have passed anti price gouging laws since 1995, there is also a cultural bias. I might argue that the laws contribute to this cultural bias and I suspect they do - but it's probably not solely due to the laws. So while gov't is the main impediment, a cultural bias against so-called "price gouging," due to lack of economic understanding of how beneficial that practice actually is, is also probably at work.

“I wish the Surgeon General had studied economics. The Law of Supply and Demand — the most fundamental principle of economics — tells us that shortages cannot exist when prices are allowed to adjust to changes in supply and demand. Or, to put it another way, shortages *only* arise when the price mechanism is impeded, whether by law or by custom.

In the United States, and around the world, both law and custom prevent market prices from adjusting when such adjustment is most urgently needed: when there is a supply disruption and/or a spike in demand for that product. That is happening right now, when it comes to “N95” masks, the type that filter out 95% of particles and are deemed most effective in preventing the spread of coronavirus.

I actually bought a box of 10 of these masks last year for a trip to Mumbai, India, where I used them — quite successfully — to protect me from the highly polluted air in that city. It cost about $15. Yet today at all of the drug and hardware stores around town that used to sell these masks, I see signs on their front doors that say, “No masks available.”

Demand has spiked for these masks. Whether this spike in demand is based on sound medical opinion or not, it is a fact. If prices were allowed to adjust, they would rise. This would have two effects. First, it would reduce the quantity purchased. Those who were not willing to pay the higher price for the masks would not get them, while those who urgently needed the masks — and could pay for them (think: hospitals!) — would find them readily available.”

Yngvi

My fault there. I honestly thought I wouldn't get an answer.

That is a very good question. I will overcorrect from my last response and leave it unanswered. Although, I suspect we may have damn near the same answer for it.


Best of the Forum

Lifting and Hemodialysis
JFord

In studying for my internal medicine board recertification, I came across a recommendation that anyone with an AV graft or fistula (used for access for hemodialysis) shouldn't lift anything greater than 5 lbs on the arm in which it was placed. I found little if any support in the literature for this recommendation.

I'm assuming that someone out there is training dialysis patients. Has anyone encountered this limitation? Is it an issue in the real world or is it excessive caution? Would this really clot off such access?

Mark Rippetoe

Doesn't sound plausible. We'll ask.

Jonathon Sullivan

Dialysis-dependent renal failure patients demonstrate gainz in strength and function with training...subject of a Cochrane meta-analysis a few years back, if memory serves.

AV fistulas are temperamental bastards, and I fucking hate them. First of all, they're kind of disgusting....but then so is dialysis. Second, when they bleed...it can be a real mess. Third, they do in fact clot off, quite often for no good reason, all the time. If the patient is training, the nephrologist will blame it on the barbell. No doubt about it. But how often will it happen? I have no way of knowing, and neither does anybody else. I have not encountered this particular clinical scenario, so I have neither canonical data nor field experience.

You pays your money and you takes your chances.

JFord

Never thought about it before but sad to say, they ARE kind of disgusting!

Yeah, my guess too. I just couldn't find a basis for this rec in a quick medline search though and I'd never heard it before.

Jeff Illingworth

Andy Bolton has apparently been on dialysis for some time (check his Instagram and Google). I'm not sure if he has either of these two types of fixtures, but I've seen videos of him training regularly with some sort of semi-permanent looking tubing in his arm. While he's not deadlifting a grand, he's certainly pulling and pressing way more than 5 lbs.

Pluripotent

I have no doubt they would blame the training, but it doesn't make any logical sense to me. I don't have any data, either, but just thinking about it, lifting is probably one of the best things you could do for cardiovascular health, so why would it predispose to AV fistula clotting?

Mark Rippetoe

That's never been a problem for them.

JFord

It's a VERY inspiring story but having read it online, it sounds like he had a central line, not a fistula or graft. That's a very different, more temporary form of access. But good on him for powering through this.

It looks like he's on the path to transplant. When he gets that, there'll be NO obstacle to heavy lifting!

Jonathon Sullivan

Roll of Shame would not be a good idea, but other than that, yeah. I have a client in Europe s/p renal graft (transplant), doing well under the bar.

Sounds like Andy probably has a dialysis catheter, SVC or subclavian. Once it's in a good position and scarred down, it should be fine. Bench presses might make me nervous, but that's prolly just the paranoid ER doc in me. I've never trained anybody with a dialysis catheter or a Quinton. I recently had a client on home IV Abx therapy with a PICC line for a few weeks. I was afraid his doc would shut him down for training, but he actually said to go for it. You just never know with those doctors.





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