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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).

One additional late quote from Dr. Niman:

"Of note, Dr Frank Plummer of the Canadian National Microbiology Laboratory in Winnipeg is quoted in a NY Times article today: "Dr Plummer's team in Winnipeg has tested about 3000 specimens from 95 probable and 90 suspect cases in Canada and Asia. His team identified the SARS virus in about 40 per cent of the probable cases and 35 per cent of the suspect cases. He said he was surprised to find the virus in about 20 per cent of an additional 250 people who were not suspected of having SARS but who were tested because they had come to Canada from affected areas in Asia or who had mild symptoms not thought to be SARS. Although the 250 were not randomly chosen as scientific controls, Dr Plummer said he was still surprised at the number who tested positive."

The finding of 20% positives in 250 people in Canada with mild symptoms should have set off major alarm bells (50 people in April with the virus but with symptoms too mild to be called suspect or probable SARS is clearly something to follow, not dismiss). Instead the results were called "weird" and cited as evidence for questioning the role of the SARS CoV.

In late April the role of the SARS CoV in the etiology of SARS was firmly established, and the 20% positive PCR rate was solid evidence that the case definition was causing many of those infected with the SARS CoV to be missed.

It is still not clear to me as to whether the contacts of the SARS CoV positives were ever identified or tested.