If they want to prove transfusion, that is exactly what they will have to do. Not make it likely he transfused, prove it.
Define your terms, GJB. What does “prove” mean, to you, that you distinguish it from “likely”? Most people take “likely” to mean preponderance of evidence, which is the minimum standard WADA needs to prove, by their code’s definition, doping. So if it is concluded that transfusion was likely, that is sufficient for a sanction. Likely in this case is the same thing as proof.
As I said before, the arbs can use a higher standard of proof than bare preponderance or “likely”, 60%, 70%, 90%, whatever. If it is 90%, you could say that likely, in the minimum sense, is not the same thing as proof. But if it is 90%, that means this standard is applied to contaminated meat. IOW, if the arbs decide on 90%, then WADA has to prove it is 90% certain that it wasn’t contaminated meat, or if you prefer, no more than 10% chance that it was.
And if it is 90% certain that it is not contaminated meat, then it is 90% certain that it is transfusion. Because, again, everyone agrees, beginning with RFEC, that those are the only two reasonable possibilities. If you want, you can assign a 1% possibility to each of the other alternatives, but that does not significantly alter this fact.
If you can show me where in the WADA code it states two different standards, then I’ll change my mind, but I’ve never seen that mentioned.
edit: Courtesy of I watch cycling (posted below):
Its in article 3.1
The standard of proof for anti doping violations is "comfortable satisfaction", lying between balance of probability and reasonable doubt. The standard of proof for athletes rebutting established facts is only balance of probability.
So if it is concluded to 51% certainty that Bert transfused, that is enough to sanction him for CB—as it prevents him from satisfying the balance of probability for contamination—but does not rise to the necessary level for sanction for transfusion.
OK, I’ll buy that. I stand corrected. So he might get sanctioned for CB while avoiding a sanction for transfusion, if the probability for transfusion is deemed to fall somewhere between 50+% and whatever the level of comfortable satisfaction is. Outside of that range, he could still be liable for transfusion sanction.
However, now that I have revisited the DEHP test situation (see below), I’m inclined to believe WADA is going to have some problem reconciling the discrepancy in time of peaks for DEHP vs. CB. That being the case, I think it will be hard to prove transfusion to comfortable satisfaction.
If memory serves, Alberto was having allergy issues that spring and withdrew to do private training for those 3 weeks in May.
This most likely would not have been May. It would have been in June after the DL. If he was on a withdrawal-transfusion cycle, storing the blood refrigerated, he would have to withdraw every five weeks, at most. His TDF blood would then be withdrawn in June. And the window between the DL and the TDF was only about three weeks IIRC. I always felt this was helpful to Bert's case, that there wasn't a lot of time to take CB then.
The thing that confuses me with this argument is why he would do the red cells one day and the plasma the next. I would have thought he needs to get the plasma in straight away otherwise his hemoglobin concentration will be too high if the vampires visit. Unless he is having plasma most days to mask what would otherwise be an ongoing very high hemoglobin concentration.
If I understand this argument correctly, it’s made to explain the fact that DEHP metabolites appeared in the urine before CB. Some of us have been saying this can probably be explained by differences in pharmacokinetics. If WADA is seriously pushing this scenario, they must believe that the pharmacokinetic argument will not work. After doing some digging around and some thinking, I think indeed it won't.
I have some links below that indicate that DEHP is cleared from plasma much faster than CB. But times of peak urine concentrations of the substances would not differ that much, not by twenty-four hours. So I'm inclined to think that pharmacokinetics alone will not explain the discrepancy, unless the samples taken on those two days were much closer than 24 hours apart, or unless the timing of the first sample was just right. But the mere fact that one has to go to such extremes to make the argument work is a sign that the argument is weak.
But the proposed explanation in El Pais is rather weak, too. if you buy the scenario where plasma was infused later, there should be two DEHP peaks, one for the red cells and one for the plasma, and the plasma peak should be higher. There was only one peak on that graph that appeared on the internet last year, but since we know nothing more about the situation, including how accurate that graph was, I can't really say more.
Here is the relevant kinetic information:
DEHP appears to be cleared from the body quite fast. Here is a passage from an old review:
Whether administered by oral or parenteral routes, DEHP and di-n-butylphthalate(DBP), the two compounds studied most extensively, are rapidly cleared from the body (3-6,15).The bulk of the chemicals is cleared within 24hr and nearly none is left 3-5 days after exposure; there is little or no evidence of tissue accumulation or prolonged tissue retention.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1569014/pdf/envhper00462-0010.pdf
These studies were in rats. However, clearance is also very fast in humans:
Human metabolism of di(2-ethylhexyl)phthalate (DEHP) was studied after a single oral dose of 48.1 mg to a male volunteer. To avoid interference by background exposure the D4-ring-labelled DEHP analogue was dosed. Excretion of three metabolites, mono(2-ethyl-5-hydroxyhexyl)phthalate (5OH-MEHP), mono(2-ethyl-5-oxohexyl)phthalate (5oxo-MEHP) and mono(2-ethylhexyl)phthalate (MEHP), was monitored for 44 h in urine and for 8 h in serum. Peak concentrations of all metabolites were found in serum after 2 h and in urine after 2 h (MEHP) and after 4 h (5OH-MEHP and 5oxo-MEHP). While the major metabolite in serum was MEHP, the major metabolite in urine was 5OH-MEHP, followed by 5oxo-MEHP and MEHP. Excretion in urine followed a multi-phase elimination model. After an absorption and distribution phase of 4 to 8 h, half-life times of excretion in the first elimination phase were approximately 2 h with slightly higher half-life times for 5OH- and 5oxo-MEHP. Half-life times in the second phase-beginning 14 to 18 h post dose-were 5 h for MEHP and 10 h for 5OH-MEHP and 5oxo-MEHP. In the time window 36 to 44 h, no decrease in excreted concentrations of 5OH- and 5oxo-MEHP was observed. In the first elimination phase (8 to 14 h post dose), mean excretion ratios of MEHP to 5oxo-MEHP and MEHP to 5OH-MEHP were 1 to 1.8 and 1 to 3.1. In the second elimination phase up to 24 h post dose mean excretion ratios of MEHP to 5oxo-MEHP to 5OH-MEHP were 1 to 5.0 to 9.3. The excretion ratio of 5OH-MEHP to 5oxo-MEHP remained constant through time at 1.7 in the mean. After 44 h, 47% of the DEHP dose was excreted in urine, comprising MEHP (7.3%), 5OH-MEHP (24.7%) and 5oxo-MEHP (14.9%).
http://www.ncbi.nlm.nih.gov/pubmed/14576974
This compares with a slower, bi-phasic elimination of CB. As reported in articles previously discussed here, CB does accumulate in tissues, and only about 20% of a single dose is excreted within three days. Half life of clearance from blood was 35 hours. So while these studies involved oral administration, whereas what is relevant to transfusion is direct administration into the bloodstream, it seems fairly clear that DEHP is cleared from the blood much faster than CB.
But the key point is that once a drug gets into the blood it starts being cleared immediately, which means the peak urine concentration occurs quite soon. This is true unless the half-life is really long, or unless it has weird kinetics (as is the case, e.g., for marijuana metabolites, where urine concentrations can go up and down). I did see one study of CB in cows, which have a faster half-life of humans, where the peak might have been delayed as much as eight hours, but a twenty-four hour delay seems unlikely.