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    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

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    Sunday, June 06, 2004

    SARS Lessons: The lessons of SARS as learned by Canadians. The numbers are staggering:

    Results Toronto Public Health investigated 2132 potential cases of SARS, identified 23,103 contacts of SARS patients as requiring quarantine, and logged 316,615 calls on its SARS hotline. In Toronto, 225 residents met the case definition of SARS, and all but 3 travel-related cases were linked to the index patient, from Hong Kong. SARS spread to 11 (58 percent) of Toronto's acute care hospitals. Unrecognized SARS among in-patients with underlying illness caused a resurgence, or a second phase, of the outbreak, which was finally controlled through active surveillance of hospitalized patients. In response to the control measures of Toronto Public Health, the number of persons who were exposed to SARS in nonhospital and nonhousehold settings dropped from 20 (13 percent) before the control measures were instituted (phase 1) to 0 afterward (phase 2). The number of patients who were exposed while in a hospital ward rose from 25 (17 percent) in phase 1 to 68 (88 percent) in phase 2, and the number exposed while in the intensive care unit dropped from 13 (9 percent) in phase 1 to 0 in phase 2.

    One person with SARS managed to give the illness to 222 people. Think about that. And just three unrelated infected people resulted in the quarantine of 23,103 others. Even worse, 88 percent of hospitalized people- those least able to fight off infection - were exposed to the virus while in the hospital. The SARS epidemic was a vivid illustration of just how quickly a truly infectious disease can spread. We should consider ourselves warned against complacency when it comes to bioterrorism with highly infectious (and much deadlier ) agents, like smallpox. But our public health officials still continue to insist that things will be fine if we wait until an outbreak. And they still aren't doing anything to educate the masses (we physicians in the trenches) on recognizing bioterror diseases and how to respond.

    My own health department is still devoting all of their resources to educating me about the importance of childhood immunizations (something I learned in medical school) and of convincing my patients to stop smoking (also learned in medical school.) They are completely incapable of shifting their paradigm.

    posted by Sydney on 6/06/2004 08:17:00 AM 0 comments


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