Posted on 05/19/2003 12:00:08 AM PDT by Judith Anne
ATLANTA (AP) -- Long before SARS became a household word and a worldwide worry, the U.S. health system has tackled contagious diseases with success. But if the new respiratory disease gets out of hand, experts say, the nation's resources may be overwhelmed.
So far, health officials haven't had to resort to quarantines or other, more creative methods - like during a tuberculosis outbreak last year in southwest Oklahoma, when state health officials nailed a sign on a woman's house warning visitors not to enter.
In another case, officials had to take a TB patient to court to ensure that medicines were being taken.
With only one new probable case reported this month, it appears SARS has been kept at bay - for now. But officials worry a major outbreak could overpower the system because of too few medical workers and too little hospital space to fight the disease on a large scale.
"We're going to try to contain it and really prevent transmission within the community," said Dr. Jon Tillinghast of the Oklahoma State Department of Health. "So far that has been successful in the United States. We don't have a Plan B right now because Plan A works, or has so far."
As Dr. Julie Gerberding said recently, "the capacity to provide care is one of the weak links in the system."
Some state health departments complain they are spread too thin by bioterrorism preparations and now SARS. The federal government is promising more money.
"We've been quite lucky," said Dr. Martin Cetron, quarantine expert for the Centers for Disease Control and Prevention. "I think we're only one 'super-spreader' away, however, and our vigilance is quite high."
On Tuesday, officials with the Centers for Disease Control and Prevention will talk to state health officials about the experiences of frontline SARS doctors in Toronto and Singapore.
Singapore, for example, has compensated for a shortage of negative pressure hospital rooms - which contain infection - by grouping SARS cases in the same ward.
Gerberding said Toronto's experience with the disease demonstrated "you have to act boldly and quickly when you first discover that you have a chain of transmission established."
California was one of the first to act quickly when the World Health Organization announced its first SARS travel warning March 15. Officials in Los Angeles County created a plan with a special radio system to alert emergency rooms and hospitals. They stressed the importance of isolating possible cases and informing health officials.
A 10-member rapid response team worked closely with CDC teams at Los Angeles International Airport to inform arriving passengers about SARS symptoms and what to do about treatment.
The airport, which handles about 4.7 million travelers a month, has had only one suspected SARS passenger.
And California, despite its deep connections across the Pacific, has not had a SARS spread, managing to contain its handful of cases. There are two dozen probable infections in the state now.
"The system worked quickly and well but we can't let down our guard," said Dr. Jonathan Fielding, Los Angeles County director of public health. "We still have to treat this very seriously."
In China, the country hit hardest by SARS, thousands of people believed exposed to the illness have been quarantined. But in Florida recently, officials simply isolated a suspected SARS spreader - a 12-year-old boy - and told parents of children who might have been exposed to watch for SARS symptoms, such as fever or respiratory problems, said Dr. Landis Crockett, director of disease control for the Florida Department of Health.
Viewing the disease from afar has been a benefit to U.S. health officials, he said.
"I think we've shown with SARS we have an approach that's even more proactive using our ability to exchange information quickly and take unified, agreed steps around the world," Crockett said.
Yet doctors and other health officials say the system needs more resources.
"I think as a whole the medical delivery system and public health workers all feel uncomfortable that we don't have easily expandable capacity in our system anymore," said Dr. Craig Smith, who serves on the bioterrorism committee of the Infectious Disease Society of America. "If you take the average hospital and ask 'Are you prepared to have 500 new casualties in one hour?', the average hospital is not prepared to do that."
Likewise, larger cities also have problems. Funding problems have prevented Seattle hospitals from providing enough rooms to contain infectious patients, said Dr. Alonzo Plough, public health director for Seattle-King County, Wash.
"We're talking about major shortfalls in negative pressure (isolation room) capacity and hospitals' epidemiological capacity," Plough said.
Gerberding says the government will provide millions of extra dollars and a proposal for extra hospital capacity for emergencies.
Another problem is whether the country would be able to effectively use quarantine and isolation powers. The CDC currently doesn't recommend quarantining people coming to the United States from an area with SARS.
Having seen SARS spread in hospitals, apartments and a hotel in Asia and Toronto, CDC officials are asking health authorities to draw up plans for quarantine and isolation in such settings.
Isolation refers to keeping infected people away from the public during the period they are infectious. Quarantine involves temporarily keeping non-infected, but exposed, people separated from the community.
The problem is that the United States hasn't had much recent experience with large-scale quarantine measures. The last large-scale quarantine in the country was during the Spanish flu pandemic of 1918-19. One person was detained in 1963 - the last federal quarantine - to prevent the spread of smallpox.
To conduct a large quarantine, the federal government will have to rely on state laws and manpower, said James Hodge, deputy director of the Center for Law and the Public's Health, a joint center of Georgetown and Johns Hopkins universities.
States have the main responsibility for isolation and quarantine within their borders and the federal government's quarantine powers are focused on preventing contagious diseases from entering the United States.
Nearly two dozen states recently revised public health laws to allow quick quarantine and isolation action in an emergency. Many of the revisions are based on a model emergency health powers act created in 2001 by the center.
"That would be a big challenge," Hodge said. "I think the organizational ability to do that would be very quickly stretched."
EDS: AP Writer Danny Pollock in Los Angeles contributed to this report.
Please, I am no communist-sympathizer! I am not her! Don't get paranoid. Frankly, before I read this thread, I never heard of her nor know that she is a leftist. I do now have to be more careful about what she have told me in light of some of you who have followed her other activities. So I am thankful for you pointing this out. My independent calls to several offices do seem to confirm my suspician that there is something wrong & perhaps a cover-up in that hospital. i will share my independent findings later on this thread.
My question is then how did Kelly and 4 other medical staffs get sick with the same SARS-like symptoms? From the patient(s)!I confirm from the hospital several days ago that Kelly was not working, that she has been sick, a FACT.
I asked her how many autopsies were done? She does not even know. What kind of investigation is that? Let me stress without autopsy showing attack on lungs..., one can't be sure whether it REALLY is SARS or not.
The press representative office for Ca. public health dept. is 916-657-3064. How about you call & confirm that this is what I discovered?
I asked what kind of virus the patients there have at XX hospital? She has no answer. I also sense she is not telling me something they know. I told Leah," I know that that hospital has had at least 68 patients with SARS-like symptoms and 20 deaths, is that not a high number, consider the flu / pneumonia season is over back in March? No real reply. She never disputed my figure of 20 deaths. More later tonight about my discovery of how many more people died in that county in April. A big jump! Nuff said for now.
Good question. Loss of business, bad image, liabilities because the hospital did not tell staffs to have to wear masks. Potential lawsuits IF patients find out the truth. Panic in the area. Profits. $ talks. It's easier said than done. If you are the director of a profitable hospital and this hits you. If you tell, you are dead (your business), and if you cever-up, you are dead. They are in a dilemma.
Also, have you ever called that hospital & got a clear hunch that they are covering up something? I did. I don't wish to name that hospital to this day. My sincere desire is NOT to cause a panic. I care about public health & I don't wish to see someday we all wearing masks on the streets! When I told the manager last week," I know you must have a health crises going on there. I know that Kelly is sick with SARSlike symptoms. You guys are probably so scared you don't know how to handle this (to tell or not to tell). He was so nervous that he repeatedly said," I am sorry. I can't comment on this. I am not allowed to" Think again. If there is no coverup & no SARS-like illnesses, why didn't he just come out & say "It's a lot of baloney. It is not true...." ? We can usually tell if someone is lying or hiding something.
The hospital’s PR spokesman still has not returned my inquiry.
What i posted here, i have already sent to many of these media personalities. You ask them why they do not take this up? I even know personally a few of these media reporters & talk hosts. Are they afraid of triggering PANIC? Why don't some of you who posted here do your own investigation. it's Kaiser hospital in Vallejo, Ca. Okay? The number is 707-651-1000. Ask to talk to Kyle Kim. Assist. Manager of Respiratory Therapy. It was he who told me nervously," I can't comnment on this..." Why don't you take up my challenge & call them yourselves , you arrogant skeptics & tell me later here whether they will give you a 'No reply. No comment. "It's a rumor only type reply?" Go back to my earlier posts & ask them those questions I posted & tell me what they tell you.
Their tactics keep changing, now they got another pointman to take the questions, Cynthis, head of Respiratory care dept. see if she will bother to return your phone call.
Pretend that you have done some nosing around & talking to people & ask her," From what I can gather, dozens of your patients & several medical staffs have become infected with 20 dead in 4 weeks. I know the Ca. public health dept has begun an investigation. They are not finished yet, right? Is that not an unusually high number this season of the year? The Solano Ct. corona office recoreded a high number of 130 total dead, 20 more than in March 03. Could those 20 be from Kaiser, Vallejo? How many of them have had autopsies performed on them to determine whether they have SARS? Why are your 10 isolation rooms reportedly very busy with a lot of patients going in? If there is no real infectious diseasex going around, why are thoses rooms so busy, according to respiratory therapists? What are they being isolated for? SARS-like illnesses, pheomonia with Hi fever, diarrhea, breathing difficulties"? ,/p>
Watch her squirm & sweat. I am eager to see if any of you have liuck. Hey, put the pressure on them. If there is really nothing to be worried about, show the public the charts, & the record. No, they will hide behind "patient's rights of privacy. This has made the investigation harder.
Dr Brundtland urged countries to work together to fight diseases Global health chiefs have urged countries around the world to be on alert for new killer diseases. The World Health Organization has warned that new diseases could spread in the wake of the deadly Sars virus.
Even if it is not SARS at this hospital, it should be more alert & quick to act & report flu killer diseases, right? Officials have urged governments to work more closely together to try to deal with the threat.
The call was made at the WHO's annual assembly of its 192 member states in Geneva on Monday.
'More outbreaks'
Dr David Heymann, head of its communicable diseases unit, suggested fresh outbreaks of deadly viruses were almost inevitable.
"There will be more outbreaks like SARS, there's bound to be more," he told journalists.
There will be more outbreaks like SARS -Dr David Heymann
Well, could this SARS-like disease be one of these?
He said the biggest threat would be an outbreak of a deadly strain of influenza. "The big concern is influenza," he said.
The last flu pandemic in 1919 claimed 40 million lives across the globe.
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