Replies

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?

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....