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HK Won't Rule Out Seeking China's Help Against SARS (has Monday's numbers)
Reuters ^ | April 14, 2003 | Tan Ee Lyn

Posted on 04/14/2003 7:50:47 AM PDT by EternalHope

HK Won't Rule Out Seeking China's Help Against SARS 1 hour, 24 minutes ago Add Science - Reuters to My Yahoo!

By Tan Ee Lyn

HONG KONG (Reuters) - Hong Kong's hospital chief said on Monday he would not rule out asking Beijing to send doctors to the territory to help fight a deadly respiratory disease as the number of new infections climbed.

Hong Kong said seven more people had died from the disease, the highest number reported in a day since its outbreak erupted early in March.

Forty more have been infected, including four health care workers, bringing the total to 1,190, the government said.

"We hope to use our own people first. But we don't rule out that we may have to ask others (mainland Chinese doctors) to help if our situation worsens. Actually we are buying a lot of things like masks and surgical gowns from mainland China," Hospital Authority Chairman Leong Che-hong told reporters.

Leong's comments come just days after Hong Kong leader Tung Chee-hwa told Chinese President Hu Jintao the territory has not been able to bring the disease under effective control, although it now knows more about it.

Doctors and nurses say the territory's health care system may collapse if more medical staff are infected. Health experts have said there are no longer enough intensive care beds nor isolation wards, sparking fears of more infections.

Hu told Tung in southern China last week that Beijing was ready to offer medical assistance to Hong Kong if needed, a statement from the Hong Kong government said. It would not say if Tung asked for any specific help.

The former British colony, which returned to Chinese rule in 1997, has been the worst hit by the disease after mainland China, where the disease originated.

Hu's low-profile visit to Guangdong province bordering Hong Kong was the strongest indication yet of how seriously Chinese leaders view the worsening health crisis in Hong Kong.

China has been sharply criticized for being too slow to report its outbreak, which began in November. The flu-like disease, which deteriorates rapidly into pneumonia for many Hong Kong victims, has been carried by travelers to about 20 countries, infecting more than 3,300 people and killing 144.

HEAVIER DOSAGES

In a bid to cut the number of cases swamping intensive care units, a senior health official told lawmakers doctors will begin administering large doses of the antiviral drug ribavirin and steroids to infected patients as early as possible.

Heavy dosages of ribavirin were formerly reserved mainly for patients who were severely ill, because of its side-effects.

"Even if they have very light symptoms, we will go full scale on the treatment from now, but the drugs are no small matter. The ribavirin has serious side effects on the heart and liver. And the steroids are used in large dosages," Hospital Authority official Ko Wing-man said.

Authorities have finalized plans to check the temperature of every passenger departing from the airport, to check the disease.

"We are ready, we are only waiting for the green light from the Department of Health," an airport spokeswoman said.

The government has not ruled out the same measures for incoming passengers at a later stage.

Universities in Hong Kong reopened on Monday after having been shut for two weeks to try to break the infection cycle of the virus, which has an incubation period of up to a week.

But at the Chinese University, where five were infected, most remained cautious and went to class in surgical masks.

All other Hong Kong schools have been shut until April 21. The government has not indicated if it will extend the closure.


TOPICS: Front Page News; News/Current Events
KEYWORDS: incubationperiod; sars
Monday: 7 deaths, 40 new cases.

Hong Kong no longer has enough intensive care beds or isolation wards.

Will start using large doses of ribavirin and steroids as early as possible, in spite of potentially severe side effects on the heart and liver.

1 posted on 04/14/2003 7:50:47 AM PDT by EternalHope
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2 posted on 04/14/2003 7:51:54 AM PDT by Support Free Republic (Your support keeps Free Republic going strong!)
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To: EternalHope
My question is: if you take out the questionable Chinese numbers, is the rate of deaths higher?
3 posted on 04/14/2003 10:13:48 AM PDT by Lady Heron
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To: Lady Heron
Good question...I'd like to know the answer, too. Apparently the US has had no SARS deaths, but that may be because of the case definition...
4 posted on 04/14/2003 10:17:55 AM PDT by Judith Anne (God bless our soldiers with swift victory...)
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To: Lady Heron
If you want the most reliable numbers on SARS, check out post 18 here:

Hong Kong SARS numbers

This table is just for Hong Kong. The bogus numbers for China are not included.

5 posted on 04/14/2003 12:37:38 PM PDT by EternalHope
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To: Judith Anne
I asked this question on another SARS thread - so forgive me if you saw it there - but does anyone have an educated guess what the death rate might be if no hospitalization is available? Say too many patients, not enough beds or medical workers? This is an important point I have hardly seen addressed.
6 posted on 04/14/2003 1:30:32 PM PDT by First Amendment
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To: EternalHope
http://www.nytimes.com/2003/04/15/health/15SPRE.html?pagewanted=1&ei=5062&en=8b4805194f6aa740&ex=1050984000&partner=GOOGLE

How One Person Can Fuel an Epidemic

By DONALD G. McNEIL Jr. and LAWRENCE K. ALTMAN


A child in China so infectious that he is nicknamed "the poison emperor." A Chinese doctor who infects 12 fellow guests in his Hong Kong hotel, who then fly to Singapore, Vietnam and Canada. An elderly Canadian woman who infects three generations of her family.

Watching as the mysterious illness called severe acute respiratory syndrome hopped around the world and exploded in new outbreaks, epidemiologists began to ask themselves an unsettling question: is it carried by "superspreaders"?
The notion that some people are hyperinfective, spewing

germs out like teakettles while others simmer quietly like stew pots, has been around for at least a century, ever since Typhoid Mary became notorious in 1907 [Page 6].

For some diseases, including tuberculosis, smallpox and staphylococcus infections, superspreaders definitely exist.........
7 posted on 04/14/2003 4:36:10 PM PDT by CathyRyan
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To: CathyRyan
Thankfully, most people are NOT superspreaders. 'Course, if they were, we'd be calling this one Captain Trips..
8 posted on 04/14/2003 4:40:43 PM PDT by EternalHope
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To: EternalHope
Hong Kong is part of China now, isn't it?
9 posted on 04/14/2003 4:50:45 PM PDT by Dog Gone
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To: pram
As far as the death rate being higher, if not enough medical personnel or special hospital rooms were available...I can only offer an educated guess. First of all, if you don't have negative air flow rooms--that is, rooms that don't let germs out--other patients could become contaminated. That's still a possibility if patients aren't put on isolation precautions...even from housekeeping or dietary if infection prevention protocols aren't used...or if someone slips up...

Then, if the pneumonia patients need respirators and they're all busy...

My guess is the death toll could go higher... The ribavarin/steroid combo--ribavarin is sort of expensive, steroid are mostly really cheap....
10 posted on 04/14/2003 4:58:45 PM PDT by Judith Anne (God bless our soldiers with swift victory...)
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To: Dog Gone
Hong Kong is part of China now, isn't it?

Of course. But Hong Kong is administered separately, and has its own "Chief Executive". Hong Kong is much more western, and its press is much more free, than elsewhere in China.

The reported numbers for SARS in Hong Kong and China are consistently reported separately. The numbers from China are transparently bogus. I have not seen anything casting doubt on the Hong Kong numbers.

Hong Kong has been much more open, and much more cooperative, than the rest of China throughout this whole ordeal. To lump them together may be technically correct, but would actually be quite misleading.

That said, I am sure the government of China could tell Hong Kong to jump, and the government of Hong Kong would say "How high?" Would Beijing tell Hong Kong to put the lid on?

11 posted on 04/14/2003 5:06:11 PM PDT by EternalHope
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To: EternalHope
They could, but I don't think they will. The cat's out of the bag there, and it's not going back in.

Even China can not successfuly minimize the problem forever. There is simply too much contact between China and the rest of the world to keep a story of this magnitude under wraps. They are still trying to manage the story as a public relations matter, but the damage only gets worse as their credibility continues to plummet.

12 posted on 04/14/2003 5:23:01 PM PDT by Dog Gone
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To: Dog Gone
If Hong Kong cannot control SARS, and so far they cannot, then how likely is it that the rest of China will do any better?

No matter how hard the other nations of the world try, SARS will eventually find its way into the slums of the world's mega cities.

What happens when SARS is running through the slums of Mexico City? What happens to the United States when millions of Mexicans flee north across the border?
13 posted on 04/14/2003 6:39:05 PM PDT by EternalHope
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To: EternalHope
Millions of Mexicans with SARS will be in no condition to try to sneak into the US. But your main point is valid. We don't even know for sure when somebody becomes contagious.

SARS is already loose on the world, and since we haven't (and probably can't) stop international travel, it's going to continue to spread.

We can slow the spread of it. That's important, because with good medical treatment, the fatality rate is manageable. It's far too high, but it's not like smallpox or the Black Death of the Middle Ages.

As long as we keep the spread slow, hospitals can keep up with it. If millions come down with it all at the same time, all bets are off.

14 posted on 04/14/2003 6:53:30 PM PDT by Dog Gone
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To: Dog Gone
Once the Mexican medical system was overwhelmed, we could easily find an enormous wave of people fleeing north to escape the disease.

Sick people who were still well enough to travel would flee, but many people who thought they were healthy would head north also.
15 posted on 04/14/2003 7:28:41 PM PDT by EternalHope
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To: Dog Gone
One thing I wonder about is if the death rate is about the same as flu, why are the health organizations so worried about it? Someone above answered my question about death rates being higher if medical care isn't available - I guess that is the concern...? I mean, I get flu every year and WISH I was dead, but somehow muddle through without medical care. But my question is: does SARS have a similar death rate to flu only when good medical care is available for all patients? And what is the death rate if there isn't care available?
16 posted on 04/14/2003 7:43:14 PM PDT by First Amendment
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To: pram
The death rate for SARS is much worse than the flu. It's much worse than the worst flu epidemic that ever hit this country.

It's not the flu at all, of course. It's a different virus that causes many of the same symptoms. In Hong Kong, it's sent over 20% of the people who caught it into the intensive care units of the hospitals. No flu does that.

I think that indicates that at least 20% would probably die without serious medical intervention.

17 posted on 04/14/2003 7:53:35 PM PDT by Dog Gone
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