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SARS & THE CDC


DEFCON

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I know that this illness is disconcerting, but a local YVR station yesterday reported the folwing facts.

-This disease has been determined to have been around since last September
-Since then there have been about 60 deaths reported worldwide
-in comparison, last year alone around 1400 BC residents died from the (common)flu

The local public health doc was visibly astounded that this affliction is getting the press it is.

If all of the above reporting is true it would seam to me that the fear of this disease is it's greatest threat IMO

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Guest George

From CCN web site

"If there's any good news about SARS right now, it's that the majority of patients do appear to recover, and the death rate is lower than what we see with influenza epidemics," she said.

Hum, sounds like another media attempt to sensationalize a disease.

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Guest CabinDweller


"…it would seam to me that the fear of this disease is it's greatest threat."



That’s the one statement I’ll agree with.

The reality is that the general public is at very low risk.
Most Centres still believe it’s droplet transmission and the precaution/protocol we’re taking reflects that. What’s confusing is a few patients here in Toronto don’t fit the criteria for travel history or close contact with an infected person. Suggesting: the virus is airborne – but transmission history strongly suggests otherwise, because these few patients are part of the second and thidr wave of infections it’s remotely possible the virus mutated to become more aerosol than droplet spread, thirdly, it’s possible that in some people SARS is communicable during (what is believed to be) the incubation period (2-3 days). This is the reason all staff at Hospitals are now wearing masks. (Makes for great camera bite “Coming up tonight at six…”)

Mask FYI: the general surgical masks protect against all droplet trans. only. For anyone that comes into contact with patients, PCM 2000M (called Duckbill – the shape) or the equivalent 3M’s N95 are both in use(of course along with goggles/shields, gown, gloves, etc…) Both filter to 0.1 micron and stop 99% of diseases over 3 hrs. The N95 (so named as it meets the gov std of 95%) has an outlet valve making it a little heavier but far more comfortable for extended ues as moisture build-up is negligible. But if the person wearing it is infected, offers little protection (on exhale) while the PCM filters in both directions.

Yes, something like 3000-5000 people die in Canada each year because of Influenza, but almost every one of those that die already have compromised immune systems. Not so with SARS.
Yes, it’s only 4-5% mortality, but 12-15% get seriously ill for several weeks and many of those would deteriorate without intervention. Now that health care workers are all taking precautions and the public are (should be) aware of what to look for, mortality in particular should peter out soon.

November 2002 in Guangdong Province had previously reported an epidemic of atypical pneumonia. This epidemic is reported to be under control.
The index case (source patient) for SARS was first identified in China around Feb 25/03 meaning all the activity were seeing has taken place in just the last month. Not exactly small potatoes! Especially considering this is still an unknown.

Just before coming on the web this morning we took a call from a small community hospital in Southern California to help triage a new patient of theirs. A 55 y/o M who flew in on China Airlines who meets all the algorithms save being febrile. He’s a probable case, Ca 1st, USA 63rd. Called us because they heard about our assessment clinic on the news. Their next call is to the CDC. Also just reported is a case of a Woman arriving in Singapore 3 days ago on China Southern Airlines and taking a cab directly to hospital. She was general warded and subsequently diagnosed with SARS. Using the standards employed here in Ontario, everyone who came into contact with both these cases (cab drivers, all other pass, crew, TA…) would have to be quarantined for the remainder of 10 days from that primary contact, unless they were wearing (the higher standard) protection of course.

Just to put a little context for those who think it’s all media hype, this is the jet age. I can be in any city in the world in 36hrs, peple routinely are. There is no road map for treatment; this is a newly discovered virus. And it could be years before a vaccine is available the way most around the globe can get one for that other well known contagion – the flu (apples & oranges). Back to the mortality rate, it’s so low because of aggressive western medical treatment. How many places in this world of ours have speedy access (or any access at all ) to aggressive western medical treatment???


DL

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Guest CabinDweller

"…the bug can apparently survive for at least several hours on objects it lands on.


It’s a good idea to assume things you touch may be infected, wash hands often, avoid hand face contact.
But until conclusive identification of the causative agent is determined, the development of a precise diagnostic test is out of reach. Only such a test can confirm longevity.

On another note, there’s a bio-terrorism aspect to this I’d like to discuss on this site…probably won’t have time today though.

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