Regards, Ivan
Posted on 04/26/2003 4:09:44 PM PDT by MadIvan
It's an ill wind that blows nobody any good, and while the citizens of Beijing don their white masks before nervously venturing out, and travellers on flights out of Hong Kong view the most innocent of sneezes with deep suspicion, they are hanging out the bunting at the Geneva headquarters of the World Health Organisation. The Sars epidemic has arrived in the nick of time to salvage the reputation of - in the words of Richard Horton, the editor of The Lancet - "this heavily-corroded bureaucracy that over the last two decades has variously 'failed', 'neglected' and 'provided no urgent sense of leadership in combating the health problems of the world's poorest people' ".
Dr Horton's caustic comments reflect the common opinion that after four years in office the WHO's outgoing director general, Dr Gro Harlam Brundtland, a former prime minister of Norway, has failed to re-orient her organisation's priorities to combating the downward spiral of ill health that affects the countries of sub-Saharan Africa. Rather, it continues to fritter away its energies on a mind-boggling array of peripheral issues and unrelated tasks. Three-quarters of its resources go to paying its own staff in their expensive offices around the world. Notoriously the WHO spends more on stationery and office supplies than preventing the major cause of childhood deaths in the Third World - diarrhoeal diseases.
The Sars epidemic could almost have been custom made to distract attention from these failings. They have certainly been clever in their choice of name for the new mystery illness. It is, by definition, Severe as people die from it, and Acute as it comes on rapidly, and tacking on Respiratory Syndrome, because it affects the lungs, produces the catchy acronym. Sars rhymes with Mars and is vaguely suggestive of Star Wars, both of which subliminally hint at some alien menace from "out there". This is certainly a lot more threatening than other possible names that might have included Cars (alluding to its origins as the Chinese Acute Respiratory Syndrome) - or even the Acute Respiratory Syndrome Epidemic which would never do - the laughter would be contagious in itself.
The WHO has also been lucky that Sars has come so soon after the fall of Baghdad. This has ensured maximum media coverage as news editors look for a different story to put on their front page. There are, however, striking similarities with the war on international terrorism. Sars too is a hidden danger travelling incognito around the world - in the nasal secretions of ordinary citizens - selecting its victims apparently at random and with devastating effects. And the call last week for "an immediate aggressive global response at the highest level" just about sums up the coalition forces' campaign against Saddam and his weapons of mass destruction.
Further, the facility with which Sars can be transmitted from person to person is a great help to the cause of WHO. Where the organisation's previous cause celebre - the Aids virus - rarely posed a threat in the West to anyone outside the recognised at-risk groups, with Sars "coughs and sneezes really do spread diseases". Indeed the event that initiated the international spread of the virus has been identified as a single coughing fit by a Chinese professor, Liu Jianlun, in the crowded lift of Hong Kong's Metropole Hotel on February 21. By the time he died in hospital 12 days later, 70 of the hospital's staff had contracted the virus. The following day another of the lift's occupants, 78-year-old Kwan Siu-chu died 4,000 miles away in Toronto and yet another - a businessman - carried the virus to Hanoi and infected a further 50 healthcare workers.
There may not be a lot the WHO can do about a novel virus that spreads itself around with such facility. It is, however, very adept at collecting statistics and the day-by-day update of the numbers of new cases around the globe has helped to convey an appropriate sense of doom and gloom over the scale of the epidemic and the speed with which it is spreading. The initial tally of 150 cases back in mid-March, had tripled to 460 a week later, which within a month had leapt to 4,439 - in 26 countries - with 263 deaths giving a mortality rate of around 5 per cent.
This is not to be sneezed at but, as ever, it is necessary to maintain some sense of proportion. This is not the bubonic plague with its 100 per cent mortality devastating the towns and cities of medieval Europe. China may be way out in front with its tally of 2,422 but that is not so many in a population of 1.3 billion. Its current death toll hovering around the 100 mark remains an imperceptible blip when added to the 173,000 Chinese who died from respiratory diseases last year.
Regrettably, the WHO is not very good at "a sense of perspective", as the mayor of Toronto discovered when he woke up on Thursday morning to find his city on its blacklist of places deemed "unsafe to visit", resulting in mass cancellation of flights into the city. This, he pointed out angrily, was something of an over-reaction as the 300 suspected cases - out of a city of three million - were all being safely looked after in medical institutions and were thus scarcely in a position to transmit the infection to visitors.
Meanwhile, for the moment, the WHO's prominent role in this self-styled "first international health threat of the 21st century" does get it off the hook of having to explain why two-thirds of its staff are concentrated in Geneva and other expensive capital cities rather than in poverty stricken nations whose citizens daily confront a much more substantial threat from readily preventable infections such as cholera and malaria. Or why indeed it spends more on parties and receptions, paper, pens and pencils, and international meetings than the total healthcare budget of many nations.
There will be more than enough time to reflect on such matters in a few months when, if the Sars epidemic behaves true to form, it should begin to recede. It is, after all, in the nature of virtually all new infectious diseases to become rapidly less virulent as time passes. Then it will join the host of other bacteria and viruses that can be both severe and acute and affect the respiratory system but which we rarely hear about because they do not come with a catchy acronym.
Regards, Ivan
Schadenfreude!
And washed-up rock group.
Disgusting.
So does the author think we should wait until a few hundred thousand are infected. This is the kind of thing that the WHO and UN could help at. Canada is experiencing a 12.67% death rate and that is an underestimate because many of the newly infected will die and the WHO diagnosis guidelines mean that a lot of viral pnuemonia cases will be considered a SARS cases. It is being spread in isolation rooms to properly prepared staff in world class hospitals. This disease is nothing to let go just to see if it is really dangerous. IT IS.
It's not something to dismiss entirely.
A separate article in the National Post notes that WHO hasn't even been Toronto or otherwise offered any assistance. The UN/WHO is a joke. As usual, it falls to the US to provide real help. The CDC has people physically in Toronto, working with the doctors now.
It's just not true. There were many who were somehow immune to even the bubonic plague. It was only a 100% fatality rate for those who succumed to the disease, which is also questionable.
Common knowledge in virology, as I understand from many years of pre-SARS reading. Let's all hope it's true.
No, but it is more like the mumps coming back than the return of the plague. Remember how they always said you should get mumps/measeles/chicken pox as a kid because it was dangerous to come down with them as an adult? I suspect that this is true here too, which does raise some concern, but no cause for panic, for us adults.
James Le Fanu, author of this piece, is THE BEST.
His book "The Rise and Fall of Modern Medicine," is essential background to SARS and a whole lot else.
That is the most laughable statement I have seen on these threads. It totally eliminates you from any part of a serious discussion.
Le Fanu is an expert on 2oth century medical history but perhaps not on that of the Middle Ages. On the other hand, given lack of definitive tests and the weakness of sources, I question whether one could prove these claims one way or the other. Obviously all we do know it that it wasn't 100% fatal to everyone in the world.
And Dr. Oxford also:
SARS Virus Will Not Cause Pandemic
Careful reading of my last post will show that although I compare SARS to mumps, that does not mean that SARS is trivial. It does mean that some posters here have been a bit on the panicy side.
How old is the youngest truly confirmed victim to date? I don't think any have been less than about 35, and this fits the pattern of the old childhood illnesses. There is a suspected 13 year old death in Saudi Arabia, but suspected means probably not. Now what does this tell you?
In medicine, history does repeat itself.
An 18 month old died today I believe in Hong Kong.
Again any comparison to mumps is totally ridiculous.
Mumps has about a 1 % death rate and the majority of the population is not susceptable. SARS is pushing 15%, is evidently capable of repeated infections, and there is no one (that we know of) that has an immunity.
Persisting in comparing them is ridiculous.
I welcome any help in this situation. This evidently has been stopped dead in North America. I want to keep it that way. In a few weeks we will see how deadly it is. China is about to burn over.
Why don't we see any broadcasts from Bejing anymore? I haven't seen one in a week. The closest I've seen is Hong Kong.
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