Docs Wrangle Over SARS Death Rate

Wired News ^ | Apr. 21, 2003 | Kristen Philipkosk

[CathyRyan]

The fatality rate for severe acute respiratory syndrome, or SARS, has been widely reported as 4 percent. But many experts take issue with the way the CDC is calculating the death rate -- and say that the infection may be much more, or less, deadly.

[EternalHope]

It's interesting to see how long it took an obvious point like this to finally make it into print.

We've known this on FR ever since the disease started. And even though the official press releases did not mention it, I'll bet the docs at CDC and WHO knew it too. (If they did not, then I am REALLY worried.)

[CathyRyan]

I thought I would post the this just to put it on record. Did you have a good weekend?

[Blue_Ridge_Mtn_Geek]

"We've known this on FR ever since the disease started. And even though the official press releases did not mention it, I'll bet the docs at CDC and WHO knew it too. (If they did not, then I am REALLY worried.)"

Yes, they know it, and I suspect that they have internal estimates that are based on all of the considerations raised in the article. Those estimates, because of those considerations, undoubtedly have fairly large error terms to reflect the uncertainty in deriving estimates from immature (and, in this case, severely censored) worldwide statistics. What's interesting, really, is that this is being discussed in the public press. Generally, journalists are not particularly well versed in the issues behind the data they report, and in my experience, when you try to give them a clue, their eyes quickly glaze over and they move on to other topics, or sign off quickly.

Maybe this source has a slightly better class of reporter on staff. Bears watching, anyway.

[EternalHope]

I thought I would post the this just to put it on record. Did you have a good weekend?

Yes I did, thanks for asking.

Kinda shocking to see how much happened on the SARS front while I was out of touch, however.

[First Amendment]

Another point that I have only seen mentioned once or twice is that the death rate for patients with access to the best medical care may be vastly different if there aren't enough hospital beds or medical care for people. If people just have to stay home and care for themselves, and thereby infect their familes... I can imagine (if this really spreads) whole familes being sick, unable to care for themselves and each other... That is scarey.

[aristeides]

I think the corporate media are very much interested in preventing panic. Bad for commerce. Makes advertisers unhappy.

[aristeides]

The disease seems by and large not to affect children and young adults. So most families will have some healthy members.

[libravoter]

The disease seems by and large not to affect children and young adults. So most families will have some healthy members.

Not from what I've read. In fact, one of the first patients to be identified was a child they nicknamed "the poison emporer" because so many hospital workers who treated him got sick and died.

[Judith Anne]

That's an excellent point. Really excellent. It deserves to be mentioned again:

"Another point that I have only seen mentioned once or twice is that the death rate for patients with access to the best medical care may be vastly different if there aren't enough hospital beds or medical care for people. If people just have to stay home and care for themselves, and thereby infect their familes... I can imagine (if this really spreads) whole familes being sick, unable to care for themselves and each other... That is scarey."

[Judith Anne]

Another question that I haven't seen addressed is the condition of those who have "recovered." Reading the story posted by the nurse in the far east who "recovered" --she still has significant disability and it certainly doesn't sound like she's well.

I'd also like the CDC to address the "scarring of the lungs" that we've heard about, and the possibility of reinfection with the same virus.

Those remain huge questions, imho.

[ex-Texan]

The death rate is going up rapidly. First it was reported to be < 2.5% but that figure evaporated after about one week. Then it was adjusted to about < 4%. Then it was increased to 4.9% then last week we saw it hit 9.5% in Canada. But that figure was wiped out by new figures showing a 10.3% death rate in Canada.

Excuse me while I rant and rave a bit.

The true death rate figure needs to be re-calculated as a percentage of all those who were admitted to the hospital, diagnosed with SARS and then released as "cured." I saw the figure on the Internet this morning and it was above 18% ....

Meanwhile, there is even more disturbing news. A Hong Kong medical expert told a symposium yesterday that SARS was looking to be the ideal bio-weapon: There is no natural immunity to the virus, the death rate is getting worse rather than better, there is no known cure, the virus is mutating rapidly, and SARS attacks major organs in the human body besides the lungs.

I saw the report early this morning on Google but they removed it rapidly and the link has disappeared. Saw it later posted here but you have to scroll down to see it.

I do not worry about SARS killing 7% or 10% but numbers above 10% is very scary data indeed.

[CathyRyan]

SARS-infected health worker ‘belligerent’

Ontario health officials say they are worried that a SARS-infected health worker who should have known better attended funeral and church services last week and may have infected “hundreds.”

At a press conference on Monday morning, Dr. Hanif Kassam, York Region’s acting medical officer of health, said the man had all the symptoms of severe acute respiratory syndrome but ignored voluntary quarantine orders and attended the services anyway.

“He had a fever, he was coughing, and he potentially put many others at risk,” Dr. Kassam said.

When public health contacted the man, who works at an unidentified downtown Toronto hospital, told him he should have quarantined himself, he became “obnoxious, threatening and belligerent,” Dr. Kassam said.

He said he may issue a court order on the man this afternoon and did not rule out legal action.

For the rest of the story....

http://www.globeandmail.com/servlet/story/RTGAM.20030421.wsars0421/BNStory/Nationa

[EternalHope]

The almost complete absence of stories about survivors is getting downright spooky...

We also are not hearing anything about how long the average person is spending in the hospital.

At some point, the ABSENCE of information becomes informative.

So far, SARS is NOT in the U.S. except in fully controlled and isolated cases. My guess is that it will take about a year before we see any significant numbers of SARS patients in the U.S. That's long enough for all kinds of good things to happen. But I'm startin' to get kinda nervous.

[aristeides]

Experts look to contain SARS

Monday 21 April 2003, 10:05 PM

The virus that causes SARS and has killed more than 200 people worldwide has the potential to be developed into a biological weapon like anthrax, according to a scientific researcher.

Yuen Kwok-yung, a microbiologist at the University of Hong Kong, told a conference that the SARS virus, a family of the coronavirus, not only hits the respiratory system of a patient but the spine, spleen and even the neural system.

Although experts are only "beginning to learn about the virus," Yuen said it tends to mutate and change and becomes more severe during the process, giving it the potential to be "developed into a biological weapon" like anthrax.

Yuen made the comments yesterday at a conference where hundreds of officials and experts from 10 Asian countries are seeking ways to contain severe acute respiratory syndrome. The conference ended on Monday.

Most of the more than 3,800 SARS cases have been in Asia, particularly mainland China and Hong Kong.

Health officials and epidemiologists today urged people to be on the alert to prevent SARS from spreading further.

"Prevention is by far the most important thing," Joseph Sung, a medical professor from the Chinese University of Hong Kong, said.

"Treatment is at a very experimental stage and it could be difficult and painful," Sung said.

The combination of antiviral drug Ribavirin and steroids has been the best treatment so far but still not very effective in many cases, he added.

Chang Shan-chwen, a medical doctor at Taiwan's elite National Taiwan University Hospital, said he was worried how less developed countries with limited medical resources could contain the disease.

Although thousands of Taiwanese travel to China and Hong Kong a day, Taiwan has reported only 29 SARS cases. There has been no deaths and the outbreak has not spread in hospitals nor moved to the community at large.

Chang attributed Taiwan's success in containing the disease to strict quarantine orders, low-pressure isolation wards and other facilities at its hospitals.

His hospital had treated Taiwan's first SARS patient without noticing the man contracted the deadly disease at first. But medical staff at the emergency room had not been infected because they put on protective gear as a routine measure, Chang said.

In cases where patients did not respond well to the standard antiviral drug and steroids, they were given massive doses of immunoglobulin intravenously, an expensive treatment at the cost of the government, he said.

http://www.theage.com.au/articles/2003/04/21/1050777215431.html.

[aristeides]

That story from The Age talks about SARS attacking the nervous system. Could it affect mental health? Could that guy's belligerence be a result of the disease?

[Judith Anne]

Yes, we know far less than we need to know, but at least we have FR. There is so much information here....

[CathyRyan]

Judith Anne would be the one to ask. :)

[Joe Hadenuf]

Ontario health officials say they are worried that a SARS-infected health worker who should have known better attended funeral and church services last week and may have infected “hundreds.”

Boy, kinda makes you want to jump into a sealed tube with 300 other people.....Fly the infected skies.......

[Judith Anne]

Could be, might not be. Maybe he was just a belligerent guy who got sick. There are lots of those, in my experience.

Other common viruses, like chickenpox and measles, can affect the nervous system; I'm thinking of measles encephalitis, and shingles, for instance.