I've had tourists from big cities, Chicago, LA, etc., tell me the same thing about our rural hospitals. One of the ones I work at is rated in the top 100 US hospitals with an under 100 patient capacity. The other one should be, in my opinion. ;-D Both have helopads, of course. Doesn't everyone?
I agree about these threads, jacquej. We've ALL worked very hard to be responsible and to give out accurate information, to correctly assess the information we have, and to speculate from reliable facts. Kudos to all posters and to Free Republic for providing the most up-to-date and accurate SARS information available anywhere on the internet. In a number of cases, FR has been ahead of the news curve in evaluating SARS...
A huge benefit to the country is that there are a core of informed posters and readers who will have the latest accurate facts on SARS if needed. We all know where the hotspots currently are...In some cases, the breadth of knowledge shown in FR comments is more than impressive.
This might be off topic, but I thought it was an interesting article from Wired... long tho!
Behind the Six Degrees of SARS By Kristen Philipkoski
Story location:
http://www.wired.com/news/medtech/0,1286,58985,00.html 02:00 AM May. 28, 2003 PT
The concept that each person on the planet is just six handshakes removed from every other person has frightening implications when it comes to a highly communicable disease like SARS.
Yet the "small world" effect, also known as the "six degrees of separation" phenomenon, may also help explain how severe acute respiratory syndrome has spread so rapidly around the globe, some researchers believe. The disease has infected 8,221 people and killed 735 worldwide, according to the World Health Organization.
Physicists, psychologists and mathematicians who study network effects, the scientific field that the six-degrees-of-separation notion has engendered, are busy creating mathematical models that attempt to explain the quick spread of SARS.
"We're modeling interactions within households, between households, in schools, shopping malls and other public areas," said Lauren Ancel Meyers, an assistant professor of integrative biology at the University of Texas at Austin.
Meyers and her colleague, Babak Pourbohloul, director of the division of mathematical modeling at the British Columbia Centre for Disease Control, will use these models to predict which strategies will work best to control the spread of SARS.
The two researchers are working closely with Canadian public health workers on the project. After a brief respite from new cases, Toronto recently reported eight unique cases of the disease, which can cause death from symptoms of pneumonia, re-instituting a travel advisory from the Centers for Disease Control and Prevention in the United States.
"We would like to do something very useful for them," Meyers said. "We're working with a whole team of Canadian scientists who are developing vaccines and trying to characterize (and control) the virus."
They also intend to develop software that would allow public health workers to predict the effectiveness of various methods for stopping the spread of the disease, such as face masks or quarantines.
Mathematicians have long used equations to examine the spread of epidemics, and to help public health officials control them. A recent paper in Science applied these methods to SARS.
In the Science article, the researchers assume that most people -- excluding those who come in contact with so-called superspreaders, have about the same chance of developing SARS. Superspreaders, researchers believe, have the ability to infect more people than most patients.
Network science, on the other hand, assumes that each person's social habits can increase or lessen his or her chances of getting infected. For example, one might be much more likely to come into contact with someone with SARS by traveling on a plane to Taiwan, a country that has recently seen a high rate of SARS infections.
"You take account of the fact that you don't have contact with everyone, but rather certain people," said Mark Newman, a professor of physics and complex systems at the University of Michigan, who pioneered the application of network effects to epidemics. "Then you can make predictions about how the disease would spread or about how you could deploy vaccine programs or treatment programs to try to prevent its spreading."
The study of network effects grew out of a 1967 experiment conducted by the Yale psychologist Stanley Milgram.
Milgram instructed 300 randomly selected people around the country to send important packages to recipients they did not know.
The "senders" were given clues about the recipients, such as their general geographic locations and occupations. Based on those clues, the senders were instructed to forward the packages to someone else they thought might be "closer" to the intended recipients. This process was repeated until the letters finally reached the correct people.
Milgram published a paper in Psychology Today that said that the letters that made it to their intended destinations passed through an average of about six sets of hands. The six-degrees-of-separation school of thought was born.
The phrase "six degrees of separation" was made famous by playwright John Guare, who wrote a play of the same name (later made into a film) about a young black man who scams an upscale New York couple into believing he's Sidney Poitier's son and a classmate of their children. He does the same to other members of the upscale Upper East Side community, and since they are all connected, they discover the scam.
Film buffs came up with a parlor game that challenges players to connect other actors to Kevin Bacon by six degrees.
The concept also influenced science. In 1996, Duncan Watts applied the idea to his doctorate research on the mating chirps of crickets.
Watts wanted to understand how large groups of crickets synchronized their chirps. He realized they do this not by listening to the whole group but to their close neighbors. Gradually, a chain reaction occurs as each cricket synchronizes its chirping with a nearby cricket and so on down the line. The phenomenon, he concluded, is another example of the six-degrees effect in action.
When he and his advisor at Cornell, Steve Strogatz, published a paper on the phenomenon in Nature, it caused a stir. Researchers in various disciplines -- from business to computing to epidemiology -- wondered if network effects might apply to them as well.
Watts eventually wrote two books on network effects, Small Worlds in 1999, and in February he published Six Degrees: The Science of a Connected Age.
Others have written on the role of network effects in the spread of epidemics, including Albert-Laszlo Barabasi, a professor of physics at the University of Notre Dame and author of Linked.
"The small-world property is bad news for all viruses: it means that if the virus is not contained, and very virulent, it could, in principle, reach every single person on earth," said Barabasi. "I do not need to know an individual to pass the virus to him. It is enough to be close to him."
Despite the flurry of interest in network effects, the six-degrees-of-separation theory itself came into question in 2001. A researcher named Judith Kleinfeld, a professor of psychology at the University of Alaska at Fairbanks, dug up the Yale data and found that only 29 percent of the packages Milgram sent actually made it to their recipients, and some that did make it required more than six intermediaries.
Kleinfeld couldn't find any evidence that the world, or even the country, is connected by six degrees. Other studies, like Watt's, she argues, use variations on Milgram's original study. They were more likely to achieve a network effect, she said, because they took place in smaller communities, such as high-rise apartment buildings, a specific urban area or a college campus.
But researchers say the size of the group doesn't matter. For the network researcher, what's important is the ability to define the essential characteristics of the network itself.
In Meyers' study, that would include the people with whom SARS patients and their caregivers come in contact. Using that information, Meyers can create a model for predicting the effectiveness of proposed strategies for fighting the disease.
"Despite questions surrounding the original (Milgram) experiment," Meyers said, "there is no doubt that network models of various biological, sociological and technological systems can offer great insights."
I found this just a few minutes ago, and thought it was interesting. Shall we speculate how he got it?
SARS case raises questions
Husband gets disease after visiting wife in hospital
Lisa Queen, Staff Writer
May 29, 2003
Fred Fifield did everything North York General Hospital advised when visiting his wife, Shirley, who underwent double knee surgery earlier this month.
But, somehow, the 71-year-old previously healthy man contracted Severe Acute Respiratory Syndrome anyway.
And that has left his Aurora daughter suspicious health authorities have downplayed the danger of catching the deadly respiratory disease when visiting a hospital.
"I think people should be aware. It just makes you think they're not telling how easily you can get this disease," said Judy Epworth, now at home under quarantine.
"What scares me is how did he get it and how easily it can be caught."
Weak and on a respirator, Mr Fifield is listed in stable condition at North York General, now the focus of Toronto's renewed SARS outbreak.
Dr. Murray McQuigge, York Region's public health physician consultant, said Mr. Fifield's case is a further example the disease is confined to health-care settings, rather than a threat in the general community.
"Basically, what we're saying is this is a hospital disease. It has been from the start and it continues to be. It doesn't do well in the community," he said.
"We're very optimistic this is anything but out of control. It's dismaying that we did (get new cases but) ... far from being out of control, this is better than our wildest dreams of a month ago."
Dr. McQuigge would not comment specifically on Mr. Fifield's case until he has seen a review of the man's file.
Ms Epworth said her father contracted SARS through unknown means while visiting his wife, who had double knee surgery May 9 at North York General.
She said both her parents, residents of Parry Sound, wore masks and continuously used antiseptic cleaners to wash their hands while in hospital, which included a pre-operation visit May 8.
On May 14, Mrs. Fifield was transferred to St. John's Rehabilitation Centre, which also had SARS cases in the past week. Her husband never visited her at St. John's.
Mrs. Fifield has not displayed any symptoms of the disease.
On May 18, 10 days after his first visit to North York General, Mr. Fifield began feeling unwell.
"He had a fever and he was not feeling good at that point. He felt chesty," said Ms Epworth, who along with her brother, sister and sister-in-law are quarantined at their homes in Aurora, Barrie and Mount Forest because they visited their mother at North York General and St. John's.
On May 20, Mr. Fifield saw his family doctor in Parry Sound, who diagnosed him with a virus and sent him home.
Last Saturday, his children advised him to call the hospital in Parry Sound and seek further medical assistance when he complained about his worsening health.
He was instructed to come to the hospital and was then airlifted to North York General.
Ms Epworth said her family is angry North York General scheduled her mother's elective surgery when the hospital was apparently not SARS-free.
"They assured us SARS was under control. My father was there four times when my mom was in hospital and took every precaution the hospital offered. How did he get this, by pushing an elevator button? I don't know," she said.
"Needless to say, we're angry. We were assured at the hospital everything was under control. A perfectly healthy man goes to sit with his wife for elective surgery and comes down with SARS."
Meanwhile, she wonders if there was political pressure on health authorities to prematurely declare the outbreak over because of the economic toll SARS was taking on the Greater Toronto Area.
Meanwhile, Ms Epworth said neither she nor her husband and three children, who aren't under home quarantine, have exhibited any symptoms of SARS.
But she admits being anxious because her father stayed at her home while visiting her mother in North York General.
"If my dad caught it, why couldn't I?" said Ms Epworth, whose quarantine ends Saturday.
She is one of almost 3,000 York residents now under quarantine at home due to SARS.
There are seven suspected cases of the disease in the region, four of whom are health-care workers.
One patient is being treated in York Central Hospital and another is being care for at Southlake Regional Health Centre.
The other five are being treated in Toronto hospitals.