Canadian SARS outbreak mystifies experts

Canadian Press ^ | May 26, 2003

[Free Trapper]

Your two thoughts would also include food handlers and processors,restaurant help,......

[riri]

One sick waitress or cook could infect a whole lotta people.

[Free Trapper]

How long do you think it'll be before some of the terrorists become self infected to spread SARS across the country?

I'm sure in my own mind that some have considered this,so I don't think my post is giving them any "new" ideas.I don't believe they would miss this chance to do us major damage.

[Prince Charles]

Bttt.

[TaxRelief]

You are sounding like some of our leftist friends here. Why wouldn't they just call their pastor or rabii and let them know they are in trouble?

A recent neighborhood (rural, farm, "poverty stricken" area) occurence:

The 71-year-old farmer, across the street and up the mountain from us, was in a farm accident that resulted in him being pinned under his tractor, on the Saturday before Easter. He was badly hurt with 7 cracked ribs and a crushed pelvis. Two surgeries later, he has a metal frame holding his pelvis together, has lost so much weight he looks like "walking death" and is facing 14 weeks of painful recovery, and months of physical therapy.

You may wonder: How will our friend and his wife eat this winter? Who is tending the hay fields? Who will feed the cows? How will the cattle get to market? How will the medical bills get paid?

There is nothing for you to worry about, except any praying that may ease his pain and suffering he and his wife are experiencing. We, his immediate community, will handle their needs. All the farmers in the area have taken on a little extra work. Our family will deal with the garden and many folks will help with the canning. Donations have poored in from area churches. Food shows up every day.

The point is he does not need emergency government assistance and neither will any future SARS patients. They need only reach out to their local churches or neighborhood groups, and the help will come from all directions.

[TaxRelief]

Typhoid Mary did just that, served it right up to them on a plate, a silent carrier.

[Allan]

I don't think it has been reported on any thread
that all special precautions for health care workers
(face masks, etc.)
were removed on May 15.
(Unbelievable, but true).

The Canadian health care system triumphs once again

Now half the hospitals in Toronto are closed.
And 1/3 the ambulance drivers are likely to be quarantined.

[blam]

Excellent. Warms my heart to read such stories. Thank you.

[Prince Charles]

I don't think it has been reported on any thread that all special precautions for health care workers (face masks, etc.) were removed on May 15. (Unbelievable, but true).

You have got to be kidding! That has to be THE dumbest move yet in this outbreak.

[Bluewave]

SARS raises new questions, comparable to our early experience with HIV in the early 80's. In the absence of answers to the questions, we tend to conjure up imaginary scenarios and theories to explain what we are seeing. It is obvious that this virus is resilient, elusive, and tenacious.

Those who assign fault to socialized medicine in Canada are providing themselves temporary reassurance. Given the right group of carriers, this disease could overwhelm this country in a matter of weeks. A single prostitute in a truck stop, a sailor on leave in Seattle, or a homeless person in New York, could shift the infection from the traveling class to the general population.

There are so many unanswered questions about the infectious period of the disease, its incubation time, and the route of transmission, that it is ridiculous to make any judgment about whether it can be contained or not.

I am also concerned with the political/economic implications of this disease. The consequences of diagnosis of the disease are so grave that I fear corporate medicine and governmental agencies are going to be at least 30 days behind the disease, waiting for "someone else" to be first.

I said once before that millions could die from SARS in the US. I still believe it and pray that I am wrong. I have a family to worry about just like all the rest of you.

[dc-zoo]

Sars could prove to be much worse than 9/11. We should know in four or five months what we may be facing.

[Future Useless Eater]

SARS Mortality Rates [reflects treatment] for 'PROBABLE' cases only Based on World Health Organization daily tables                 (Revised:  May 26 pm)
Area	Recoveries to date	Deaths to date	Recent** Death Rate		Active Cases still in Danger	Projected Future Deaths	Projected Cumulative Mortality
China	2829	317	10.2%		2170	222	10.1%
Taiwan	112	72	76.4%		401	262	57.1%
Hong Kong	1276	267	13.8%		183	25	16.9%
elsewhere [30 countries]	448	70	11.9%		58	7	13.4%
**  Recent deaths are based on findings from the Imperial College of London...... that deaths take 12 days longer on average than recoveries on average..... = (12-day recent deaths) / (12-day recent deaths + prior 12-day recoveries)

Observations - Treatment:
• Taiwan only reports 'probable' cases when they are the most obvious, or in CRITICAL condition, which is why their death rates seem so high.
• Taiwan maintains an additional shamelessly high 'suspected' count exceeding ONE THOUSAND patients, and has stopped reporting 'suspected' cases to hide this problem.
• China's numbers also seem manipulated and underreported.

Trend - Active Cases Still in Danger [reflects containment] for 'PROBABLE' cases only
Date	China	Taiwan	Hong Kong	elsewhere 30 countries	World-wide all 33 countries
May 12	3068	138	399	95	3700
May 13	3061	153	374	89	3677
May 14	3046	170	343	85	3644
May 15	3034	196	309	78	3617
May 16	2969	193	297	79	3538
May 17	2918	221	276	76	3491
May 18 (est.)	2870	254	263	73	3460
May 19	2799	249	250	70	3368
May 20	2700	268	236	69	3273
May 21	2618	295	227	65	3205
May 22	2526	349	217	62	3154
May 23	2438	396	209	59	3102
May 24	2326	386	196	68	2976
May 25 (est.)	2259	386	184	61	2890
May 26	2170	401	183	58	2812
May 27	...	408	...	...	...
(includes new daily cases... excludes cases resolved by death or recovery) (some tables are supplemented with government data when WHO data is missing)

Observations - Containment:
• I believe China's numbers are highly fictional.
• Taiwan's 'probable' count should be FOUR or FIVE HUNDRED higher.
• Taiwan is withholding 'probable' cases and calling them 'suspected'. This raises their 'probable' mortality rate, and obscures their real containment.
                            May 27  (408) active 'probable' cases
Apr 30   (41)      [a ten-fold increase ]

[Future Useless Eater]

SARS - Treatment/Containment tables - updated through Monday's numbers here

[Future Useless Eater]

Since Toronto has local transmission, they do not have a way to wiggle out.

No, I think Toronto is still INSISTING they have had no local transmission.

And never underestimate The Canadian socialists to find another loophole to keep from reporting more SARS cases. Just look at how the weasels treated these Toronto cases that traveled to other countries before they were diagnosed...

Australia: A family of five (2 adults, 3 children) residing in the Greater Toronto Area departed Toronto on March 28, 2003 and arrived in Australia on March 29, 2003. Child A had onset of influenza-like illness symptoms on March 31, 2003 and was hospitalized on April 3, 2003 with high fever and respiratory distress; a chest x-ray revealed infiltrates. Child A was diagnosed as a SARS case according to the WHO case definition, which differs from the Canadian SARS case definition by including Toronto as an "affected area". Child B had onset of cough on March 25, 2003. Child C had onset of cough April 1, 2003. Both Child B and Child C were subsequently reported as probable SARS cases according to the WHO case definition. All three children have since recovered. Both adults remained well. No clear epidemiologic link to any known SARS cases in Canada could be established. No secondary transmission was observed. In Canada, none of the children would have met the case definition for a probable or suspect case of SARS. Child A would have been classified as GEO-linked, that is, a person with fever and symptoms consistent with severe atypical pneumonia who has been in an area with local chains of transmission of at least 3 generations, who does not have an epidemiologic link. Children B and C would have been classified as Persons Under Investigation (PUI).

Germany: A 26 year old woman was temporarily residing in Toronto. On March 31, 2003 she flew from Toronto to Germany. She was asymptomatic until April 3, 2003 she developed headache, nausea and vomiting. She subsequently developed fever (maximum 37.8°C) and cough. She was admitted to hospital on April 7, 2003 and diagnosed with pneumonia. Chest x-ray revealed infiltrates. No clear epidemiologic link to any known SARS cases in Canada could be established. No secondary transmission was observed. In Canada, this woman would not have met the case definition for probable or suspect SARS. Rather, because of her sub-38°C and lack of epidemiologic link, she would have been classified as a Person Under Investigation.

United States: A 52 year old man residing in Pennsylvania travelled alone by car to Toronto on March 28, 2003 He drove back to Pennsylvania alone on April 1, 2003. On April 3 he became symptomatic with chills, fatigue, myalgia, headache and diaphoresis (excessive sweating). On April 6 a fever of 38.2°C was documented and on April 7, 2003 he developed respiratory symptoms and was hospitalized on April 14, 2003 with pneumonia. Chest x-ray showed bilateral patchy infiltrates, serum was positive for coronavirus antibodies and he was diagnosed with suspect SARS , and would have been diagnosed as such in Canada. This man was discharged from hospital on April 21, 2003. The suspected exposure was thought to have occurred at a religious meeting he attended in Toronto on March 28-29, 2003, where a symptomatic SARS case was also present. Pennsylvania health authorities have reported that a family member had symptoms consistent with the suspect SARS case definition, but the onset of symptoms in the family member occurred before having had contact with the 52 year old man case. Therefore, this family member cannot be considered a transmission of any sort from the case.

Philippines: A 46 year old woman residing in the Greater Toronto Area departed Toronto on April 3, 2003 and arrived in Manila, Philippines on April 4, 2003 via Narita Airport in Japan. This case had onset of fever on April 6, 2003. On April 11, 2003 she developed diarrhea and cough; on April 12, 2003 she was admitted to a local hospital at which time a chest x-ray revealed bilateral infiltrates. She continued to deteriorate. On April 13, 2003 five family members drove her to a speciality hospital in Manila where she was admitted and diagnosed with probable SARS. She continued to deteriorate and died the following day. The suspected exposure was thought to have occurred in Toronto on April 1 and April 2, whe n on each occasion, she spent a short period of time in the home of a symptomatic probable SARS case. She did not have direct contact with this SARS case; it is hypothesized she may have had contact with fomites in the home of the case. The Philippines authorities have reported secondary transmission to a health care worker, who has been diagnosed as a probable SARS case. In addition, the father of the woman, who was ill with cancer, died and is now being reported by the Philippine Department of Health as a probable case of SARS. There is insufficient information at this point to judge whether these two cases of transmission would have been classified as such in Canada, but the woman would have been classified as a probable case of SARS in Canada.

Summary: Of the 6 persons originating from Canada who were diagnosed abroad as cases of SARS, 4 would not have met the case definition for probable or suspect SARS in Canada. Only the case reported in Pennsylvania and the case reported in the Philippines would have met the SARS case definition in Canada.

...So the Canadian Hillary!@#$Care would have released all but two people to go infect others.

And U.S. and Canada would ONLY classify the PA man as SUSPECTED?
He even tested positive for coronavirus! (for crying out loud)

[Future Useless Eater]

I found Taiwan's SUSPECTED case count... For a couple days it was difficult or impossible to find.

I see it is now up to 1127, and 'suspected' cases are almost completely 'off the radar'. Most news media only reports and focuses on 'probable' cases.

[firewalk]

Thanks

[Prince Charles]

Interesting case histories there.

[Technocrat]

Is there any way to correllate anecdotal reports from afflicted areas in China to actual reports and generate a more realistic number? Only two or three cities would be needed.

[Dr. Eckleburg]

Thanks for the pings and all your good work.

[Judith Anne]

"The consequences of diagnosis of the disease are so grave that I fear corporate medicine and governmental agencies are going to be at least 30 days behind the disease, waiting for "someone else" to be first.

Well said. Sadly, I agree.