Hong Kong SARS Turns Deadlier.

perloin

[per loin]

Hospitalized Hong Kong SARS (Chicom Flu) Cases

Time			Cases				Increase			Disposition														Dead as % of prior time
Day	Date		New	Week	Total		One Day	Week		Got well			Dead			Total Gone			Now In Hospitals			Total Hosp Days		Week	2 Week	3 Week
										Day	Total	%	Day	Total	%	Day	Total	%	Day	Total	%
Wed	03/12		10		10														10	10	100.0%	10
Thu	03/13		14		24		140.0%												14	24	100.0%	34
Fri	03/14		5		29		20.8%												5	29	100.0%	63
Sat	03/15		8		37		27.6%												8	37	100.0%	100
Sun	03/16		5		42		13.5%												5	42	100.0%	142
Mon	03/17		53		95		126.2%												53	95	100.0%	237
Tue	03/18		28	123	123		29.5%												28	123	100.0%	360
Wed	03/19		27	140	150		22.0%	1400.0%		5	5	3.3%	5	5	3.3%	10	10	6.7%	17	140	93.3%	500		50.0%
Thu	03/20		23	149	173		15.3%	620.8%		0	5	2.9%	1	6	3.5%	1	11	6.4%	22	162	93.6%	662		25.0%
Fri	03/21		30	174	203		17.3%	600.0%		2	7	3.4%	0	6	3.0%	2	13	6.4%	28	190	93.6%	852		20.7%
Sat	03/22		19	185	222		9.4%	500.0%		0	7	3.2%	2	8	3.6%	2	15	6.8%	17	207	93.2%	1,059		21.6%
Sun	03/23		25	205	247		11.3%	488.1%		0	7	2.8%	2	10	4.0%	2	17	6.9%	23	230	93.1%	1,289		23.8%
Mon	03/24		13	165	260		5.3%	173.7%		5	12	4.6%	0	10	3.8%	5	22	8.5%	8	238	91.5%	1,527		10.5%
Tue	03/25		26	163	286		10.0%	132.5%		2	14	4.9%	0	10	3.5%	2	24	8.4%	24	262	91.6%	1,789		8.1%
Wed	03/26		30	166	316		10.5%	110.7%		2	16	5.1%	0	10	3.2%	2	26	8.2%	28	290	91.8%	2,079		6.7%	100.0%
Thu	03/27		51	194	367		16.1%	112.1%		3	19	5.2%	0	10	2.7%	3	29	7.9%	48	338	92.1%	2,417		5.8%	41.7%
Fri	03/28		58	222	425		15.8%	109.4%		6	25	5.9%	1	11	2.6%	7	36	8.5%	51	389	91.5%	2,806		5.4%	37.9%
Sat	03/29		45	248	470		10.6%	111.7%		18	43	9.1%	1	12	2.6%	19	55	11.7%	26	415	88.3%	3,221		5.4%	32.4%
Sun	03/30		60	283	530		12.8%	114.6%		21	64	12.1%	1	13	2.5%	22	77	14.5%	38	453	85.5%	3,674		5.3%	31.0%
Mon	03/31		80	350	610		15.1%	134.6%		15	79	13.0%	2	15	2.5%	17	94	15.4%	63	516	84.6%	4,190		5.8%	15.8%
Tue	04/1		75	399	685		12.3%	139.5%		5	84	12.3%	1	16	2.3%	6	100	14.6%	69	585	85.4%	4,775		5.6%	13.0%
Wed	04/2		23	392	708		3.4%	124.1%		5	89	12.6%	0	16	2.3%	5	105	14.8%	18	603	85.2%	5,378		5.1%	10.7%	160.0%
Thu	04/3		26	367	734		3.7%	100.0%		9	98	13.4%	1	17	2.3%	10	115	15.7%	16	619	84.3%	5,997		4.6%	9.8%	70.8%
Fri	04/4		27	336	761		3.7%	79.1%		1	99	13.0%	0	17	2.2%	1	116	15.2%	26	645	84.8%	6,642		4.0%	8.4%	58.6%
Sat	04/5		39	330	800		5.1%	70.2%		8	107	13.4%	3	20	2.5%	11	127	15.9%	28	673	84.1%	7,315		4.3%	9.0%	54.1%
Sun	04/6		42	312	842		5.3%	58.9%		9	116	13.8%	2	22	2.6%	11	138	16.4%	31	704	83.6%	8,019		4.2%	8.9%	52.4%
Mon	04/7		41	273	883		4.9%	44.8%		11	127	14.4%	1	23	2.6%	12	150	17.0%	29	733	83.0%	8,752		3.8%	8.8%	24.2%
Tue	04/8		45	243	928		5.1%	35.5%		11	138	14.9%	2	25	2.7%	13	163	17.6%	32	765	82.4%	9,517		3.6%	8.7%	20.3%
Wed	04/9		42	262	970		4.5%	37.0%		4	142	14.6%	2	27	2.8%	6	169	17.4%	36	801	82.6%	10,318		3.8%	8.5%	18.0%
Thu	04/10		28	264	998		2.9%	36.0%		12	154	15.4%	3	30	3.0%	15	184	18.4%	13	814	81.6%	11,132		4.1%	8.2%	17.3%
Fri	04/11		61	298	1,059		6.1%	39.2%		15	169	16.0%	2	32	3.0%	17	201	19.0%	44	858	81.0%	11,990		4.2%	7.5%	15.8%
Sat	04/12		49	308	1,108		4.6%	38.5%		46	215	19.4%	3	35	3.2%	49	250	22.6%	0	858	77.4%	12,848		4.4%	7.4%	15.8%
Sun	04/13		42	308	1,150		3.8%	36.6%		8	223	19.4%	5	40	3.5%	13	263	22.9%	29	887	77.1%	13,735		4.8%	7.5%	16.2%
Mon	04/14		40	307	1,190		3.5%	34.8%		6	229	19.2%	7	47	3.9%	13	276	23.2%	27	914	76.8%	14,649		5.3%	7.7%	18.1%
Tue	04/15		42	304	1,232		3.5%	32.8%		14	243	19.7%	9	56	4.5%	23	299	24.3%	19	933	75.7%	15,582		6.0%	8.2%	19.6%
Averages			35	258			17.7%	197.0%		9		11.0%	2		3.0%	11		14.0%	27		88.8%			9.3%	18.6%	40.1%
										Day	Total	%	Day	Total	%	Day	Total	%	Day	Total	%
Day	Date		New	Week	Total		One Day	Week		Got well			Dead			Total Gone			Now In Hospitals			Total Hosp Days		Week	2 Week	3 Week
Time			Cases				Increase			Disposition														Dead as % of prior time

[EternalHope]

Obviously, if all this is true, then SARS cannot be contained. (It's too soon to know for sure.)

BTW: What happens in a world wide pandemic?

[IYAAYAS]

I'm not going to panic until Dan Rather tells me to, or it becomes the consensus here on FR, whichever comes first.

Seriously, my wife and I have discussed this since we live in a densely populated area that has at least one case already. We will not attempt escape nor will we take any precausionary measures since none seem to work. No one lives forever.

[EternalHope]

The statistics I saw on the 1918 Spanish Flu in the United States were:
25% of the population infected.
2.5% mortality rate.
0.5% overall death rate.

We don't know what percent of the population would be infected by SARS, but the mortality rate would be a lot more than 2.5%.

Sample calculation:
75% of the population infected (no prior immunities).
20% mortality rate (not nearly enough ICU capacity).
15% overall death rate.

Result: In a population of 280 million people there would be 42 million deaths. If only 25% of the population was infected, the calculation would give 14 million deaths.

This assumes no panic in the population, and no breakdown in essential services.

[TaxRelief]

SARS may exist in persons as an asymptomatic disease. These must be tracked as well.

You are absolutely correct. One cannot build a model without complete information. There are several important factors missing from this equation. Here is a great book with all the facts, for those of you who want to panic. Here's the condensed version: Wash or sanitize hands. Keep hands off face and fingers out of noses and eyes. Wash hands. Avoid touching public surfaces.

[aristeides]

This other SDA link has a different listing of symptoms:

Signs: (may include one or more, and may be different for each rat in the colony)
-Excessive sneezing
-Exophthalmos (abnormal protrusion - bulging of the eyes)
-Squinting, excessive blinking, eye rubbing
-Chromodachryorrhea (red tears, excessive porhyrins are secreted with tears)
-Swollen face and neck
-Lesions (damaged cell tissue) in the lacrimal duct may result in corneal drying with severe secondary ocular lesions (dry eyes, conjunctivitis, ulcers of the cornea, bleeding inside the eye).

[aristeides]

New SARS cluster in Toronto raises questions.

[aristeides]

Doctors save baby of pregnant SARS victim .

[aristeides]

Intense Hunt Is On to Find Existing Drug That Works.

The new studies may show that ribavirin does not inhibit the growth of the new human coronavirus. However, that does not necessarily mean it is of no clinical use in SARS. First, I don't think it's yet absolutely certain that that coronavirus is the cause of SARS. Second, even if it is, then, if the resulting secondary infections that are the real problem, ribavirin may still inhibit secondary viral infections.

[riri]

Nevada First SARS Case

[Dog Gone]

I'm debating whether I should try to catch SARS now, while ICU beds are available, or whether I should wait until they're all full, and try to live in a bubble.

I'm mostly joking, but not entirely...

[Fitzcarraldo]

I'm debating whether I should try to catch SARS now, while ICU beds are available

Since catching it now may not confer immunity against a future infection you may wish to consider an alternative strategy.

[aristeides]

There are apparently several strains of SDA in rats, some much more dangerous than others. Becoming infected with a relatively benign form of human coronavirus might provide enough protection to enable one to live through later infection with the worst SARS.

[Dog Gone]

It had better confer immunity or there is no hope for a vaccine.

[Prince Charles]

Bump...

[Judith Anne]

I know that health care workers, especially in our ED and doctors' offices, have a low index of suspicion for SARS in our area (rural Ozarks). However, every year we have millions, yes, millions of tourists from all over the world. The area hospitals have few rooms for negative air flow, and while we ALL know how to prevent infection, I have a little concern that somebody somewhere may not take it too seriously, especially if the patient doesn't require a vent....

The very long hospitalization times would definitely strain resources to the max if there were very many patients, because while there may be an outbreak, you still have the "ordinary" patients suffering from other illnesses that may require ventilators...how would a choice be made?

If I'm part of a team taking care of a SARS patient, I might not want to leave the hospital or go home...what if I had a subclinical infection and passed it along?

I'm wondering how long the virus lingers on clothing, bedding, walls, tv remotes...a smallpox outbreak in Germany in the 70s was spread by housekeeping/laundry personnel, if I remember correctly.

If family visits the patient (let's assume one for the time being) what if they carry infectious material away to local merchants, other hospital patients walking in the hallways, or back to their homes? Even with mask, gown and gloves--by the way, wouldn't we have to fit every visitor with an N95 mask and discard it in the isolation room's vestibules, disinfect the visitor before leaving, and on every visit re-fit the mask--the virus might get out...

I can imagine someone saying that SARS patients could have no visitors...it would take security personnel to keep some of them out...("My God, my wife is calling for me, I'm not going to just stand here!"--or a mother with her child, a daughter with her aged mother, this is a nightmare) I hope you can understand what I'm getting at with this post--how on earth do we deal with this?

[Dog Gone]

Becoming infected with a relatively benign form of human coronavirus might provide enough protection to enable one to live through later infection with the worst SARS.

Wouldn't that be interesting if the best defense to SARS is to catch the common cold this year?

[aristeides]

In the 18th century, before Jenner's vaccination with cowpox became the method, what people did to avoid the worst smallpox was to get themselves inoculated, i.e., infected with smallpox (variola) through the skin. Inoculation carried with it a death rate of 2 or 3%, but that was much better than the 30% death rate and vicious scarring for inhaled smallpox.

[Dog Gone]

I've always marvelled at the bravery (and perhaps stupidity) of someone who would be the first to try such a thing.

"Hmmm, let me see if intentionally giving myself smallpox is a good idea..."

"I'll bet a parachute would work..."

[Judith Anne]

Think of all the personnel who daily come into contact with each patient:

Doctor Er
Doctor on Floor
Nurses in ER
Admissions Personnel
Nurses in shifts on the floor (minimum of six or seven)
Respiratory Therapy
Lab
Radiology
Food Service
Housekeeping

And all these people COULD be exposed before SARS was suspected....Suppose someone infected with SARS comes in with a sick gall bladder, or appendicitis, then shows symptoms after, say, surgery has been done, they've passed through surgery, recovery, another whole team of doctors, nurses, nurse anesthetist or anesthesiologist...if they come down with fever and a cough AFTER the surgery, is it SARS or is it a relatively more normal reaction to the surgery?

What if the surgeon does another surgery or forty before he begins to show symptoms, and sheds the virus to those patients? What if he starts having symptoms during surgery?

I wonder when SARS patients start to shed virus? Before the fever and cough? It could happen....