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Before developing that time line, Dr. Niman had this to say about the Reed case:

I think that the likelihood that the death was due to SARS is extremely high, but won't be confirmed until next week based on PCR results from tissues taken at autopsy or cytopathic results from virus from autopsy tissue.

However, I suspect that the real proof will come in two weeks when a number of contacts begin to show symptoms.

The patient who died had a chronic cough "for weeks" and I suspect he will eventually be classified as a super spreader.

Reed was in his mid-40's, and was from Wake County. This story may further indicate that he was already suffering from heart problems: Men's blood tests negative for SARS virus : Wake man dies of heart failure, pneumonia; Orange man cleared of disease .

Interesting comments by Dr. Niman. Bttt.

Dr. Niman comments further on that same thread:

I think that WHO wanted the linkage data, but it also shows the weakness of the case definition as well as the potential to under-report by excluding SARS cases because of no known contact.

The initial media report sounded like none of the initial links to SARS II were recorded as SARS. This led to many unknown cases evolving from the unreported links. I suspect the number of infected persons linked to more unreported cases is quite large, which is why Winnipeg was getting 20% PCR positives in patients that failed to meet the case definition (but teh patients had symptoms).

Thus, it seems that the data were there, but instead of looking harder, the results were called "weird" and used to make the initial claim that SARS CoV didn't cause SARS.

I think that the unreported links will make WHO look harder at the links to the unreported cases and require extensive follow-up along with antibody tests (it is too late to follow-up with PCR tests because the virus has been cleared by now by the infected patients).

I believe that the virus has spread very far and wide in the Toronto area, setting the stage for a significant happening in the Fall.

If Reed died of SARS, I suspect the Canadian repercussions will be severe. The first travel ban came right after the Pennsylvania traveler tested positive for SARS antibody (after returning from the religious retreat in Toronto), and now Toronto's downgrade follows an antibody positive result on another case exported from Toronto.

If Reed did become infected by the NC index case, the failure of Toronto to notify him of his Toronto exposure will loom large.

Moreover, I have said for sometime that the US was one super spreader away from a major media event, and I suspect that the next couple of weeks will test that hypothesis.

The US health care system certainly has a heads up in NC, and since the index case was mild, this may not evolve into a super spreader situation. However, there clearly was a pneumonia death in a co-worker of the NC index case and I think the evidence strongly points to the NC index case as the source.

The failure to follow-up (which is why Toronto was downgraded to C) and it has already been noted by WHO (and just about anyone else paying attention).