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Friday, March 28, 2003At least three Hong Kong universities will shut their doors temporarily from Saturday, and another hospital chief was admitted to hospital on suspicion of having caught the disease. But It’s hard to quarantine a free people: Singapore newspapers said that instead of staying home and avoiding crowds, schoolchildren are now clogging up shopping centers and cinemas. And, many countries are closely scrutinizing travellers from Southeast Asia (on the advice of the WHO): Malaysia on Friday reported its first suspected SARS case, a nurse working in neighboring Singapore, and said it would post health inspectors at a causeway it shares with the city-state to screen out infected visitors. In the Philippines, the government will ask those arriving from infected countries to voluntarily quarantine themselves by staying at home for seven days after arrival. ..In Taiwan, where 10 people have been infected, the government began stringent health checks requiring passengers to declare if they had been to Hong Kong, China, Singapore and Vietnam in the past 10 days. They will need to say if they had contact with patients of the disease. In Hong Kong, travelers will be required to fill out health declaration forms at all checkpoints from Saturday. More government staff will also be posted at checkpoints to detect those displaying symptoms of the disease -- high fever, cough, chills and breathing difficulties. The CDC has advice for families in the midst of international adoptions, and the World Health Organization, which organized doctors from the around the world who were caring for people with SARS, says they can now confidently describe the disease's progression: What we were able to establish is that within the SARS group of patients, there are two groups. One group makes up the majority, about 90%, who will have all the characteristic symptoms upon presentation, will progress to about day 6 or 7 and then will spontaneously start getting slowly better. The other group, the remaining approximately 10%, has a more severe form of the disease and progress to acute respiratory distress syndrome, many of whom will require mechanical ventilatory support. The mortality among this second group is quite high and early indications from my clinical colleagues suggest that most of these who do succumb actually have significant other illnesses at the time of presentation. So, it is like having a really a bad flu. And, it looks more and more likely that the cause is a coronavirus: The first phase of the hunt for the causative agent of this disease nears completion. The majority of the laboratories in our network find corona virus in specimens from patients with SARS. At the same time, the second phase is beginning. The second phase is the development of a diagnostic test. These two phases overlap. We have to double and triple check that the corona virus is the causative agent and that takes place. At the same time, a diagnostic test has to be developed for the corona virus. These tests will be used tomorrow or beginning tomorrow, in Hong Kong. Three laboratories in Hong Kong will use two different tests and will identify SARS patients in Hong Kong. These tests will then be further rolled out to other countries quickly. But perhaps the greatest lesson in all of this is the difficulty in stemming an epidemic once healthcare workers have been infected in great numbers: But the difficulty in Hong Kong is that because they are so many health workers infected, who are the pillars of the health care system, it’s very difficult now to find all the extra health workers they need to increase their measures. We should take that lesson to heart. Imagine if this were smallpox, which instead of a 4% mortality rate has a 30% mortality rate. Which instead of lasting 6-7 days, lasts two or three weeks. And which has many more nonfatal complications than this virus. Many of those who don’t die are critically ill with smallpox. Yet it could be prevented by pre-attack vaccination. That is, it could be if our healthcare workforce were willing to make the sacrifice. (Which is a small sacrifice not withstanding all the hyped up reports you read in the media.) By the way, as pointed out at Instapundit, The Gweilo Diaries has a lot of good first-hand accounts of Asia in the time of the virus. UPDATE: CharlesMurtaugh has a nice rundown on SARS, too, including the possibility of developing a vaccine. (And I don't say that just because he nicely mentioned me twice.) A Different Virus: The war is taking its toll on San Francisco's psychology patients. (September 11 did, too. A year later this same paper had a story about psychologists being swamped with patients still stressed out by the terrorist attacks.) At least one San Franciscan says she’s been infected by a “Republican virus”: "I find myself lashing out at my husband -- and he agrees with me!" Ruth said. She ascribes her current health problems to the intense emotions the war has provoked. "Just as Iraq was invaded by the viral Republican administration, I have been invaded by these viral Republican conditions," she said. I’ve heard all sorts of excuses for being grouchy and mean (hormones,chronic pain, etc.), but this is the first time I’ve heard it blamed on the Republicans. (via Best of the Web) posted by Sydney on 3/28/2003 08:33:00 AM 0 comments 0 Comments: |
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