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Mark Steyn: The system infected us
National Post ^ | April 24 2003 | Mark Steyn

Posted on 04/25/2003 6:47:59 AM PDT by knighthawk

One of the most tediously over-venerated bits of British political wisdom is Prime Minister Harold MacMillan's amused Edwardian response as to what he feared most in the months ahead: "Events, dear boy, events."

But even events come, so to speak, politically predetermined. If, for example, you have powerful public sector unions, you will be at the mercy of potentially crippling strikes. The quasi-Eastern European Britain of the 1970s was brought to a halt by a miners' strike in a way that would have been impossible in the United States.

So it is with SARS. The appearance of the virus itself was a surprise but everything since has been, to some extent, predictable. Because totalitarian regimes lie, China denied there was any problem for three months, and thereafter downplayed the extent of it. Because UN agencies are unduly deferential to dictatorships, the World Health Organization accepted Beijing's lies. This enabled SARS to wiggle free of China's borders before anyone knew about it. I mentioned all this three weeks ago, but only in the last couple of days has the People's Republic decided to come clean -- or, at any rate, marginally less unclean -- about what's going on.

As for our diseased Dominion, like the Chinese our leaders behaved true to form. When something bad happens in Canada, the priority is to demonstrate how nice we are. After September 11th, the Prime Minister visited a mosque. After SARS hit, the Prime Minister visited a Chinese restaurant. Insofar as one can tell, Chinese Canadians seem to be avoiding Chinese restaurants at a somewhat higher rate than caucasians. But, while it may have been blindsided by the actual outbreak of disease, the Canadian system is superb at dealing with entirely mythical outbreaks of racism. I think we can take it as read that if a truck of goulash exploded on the 401 killing 120, the Prime Minister would be Hungarian folk dancing within 48 hours. Personally, I'd have been more impressed if he and Aline had had a candlelit dinner for two over a gurney in the emergency room of a Toronto hospital. That's the issue -- not Canadian restaurants, but Canadian health care.

But the piped CanCon mood music has wafted over Jean and Aline's table and drowned out the more awkward questions. Toronto is the only SARS "hot zone" outside Asia. Of nearly 200 nations on the face of this Earth, Canada is one of only eight where SARS has killed, and currently ranks third, after China and Singapore, in the number of SARS deaths. Indeed, Canada had the highest SARS fatality rate in the world until one of two infected Filipinos died a few days ago -- and according to its government she picked it up from the mother of her Toronto roommate.

But why get hung up on details? "Over the past six weeks, health care workers across Toronto have done an amazing job," wrote Joseph Mapa, president of Mount Sinai Hospital, on our letters page yesterday. "We need to applaud these men and women for their dedication and commitment."

No, we don't. We can indulge in lame-o maple boosterism if we ever lick this thing. Until then, we need to ask: Why Toronto? London, Sydney, San Francisco and other Western cities have large, mobile Asian populations. But they don't have SARS. The excuse being made for China is that they have vast rural provinces with limited access to health care. So what's Toronto's?

Here's the timeline:

February 11th: The WHO issued its first SARS health alert, which was picked up by the American ProMed network, which distributed it to Toronto health authorities. The original alert has been described as "obviously significant" by those who saw it.

February 28th: Kwan Sui-Chu, having recently returned from Hong Kong, goes to her doctor in Scarborough complaining of fever, coughing, muscle tenderness, all the symptoms of the by now several ProMed alerts. As is traditional in Canada, the patient is prescribed an antibiotic and sent home.

March 5th: Having apparently never returned for further medical treatment and slipped into a coma at home, Kwan Sui-Chu is found dead in her bed. The coroner, Dr. Mark Shaffer, lists cause of death as "heart attack." Later that day, Kwan's son, Tse Chi Kwai, visits the doctor, complaining of fever, coughing, etc. He too is prescribed an antibiotic and sent home. Later still, the son takes his wife to the doctor. Likewise.

March 7th: Tse Chi Kwai goes to Scarborough Grace, and is left on a gurney in Emergency for 12 hours exposed to hundreds of people.

March 9th: Scarborough Grace discovers Tse's mother has recently died after returning from Hong Kong. But Dr. Sandy Finkelstein concludes, if Tse is infectious, it's TB.

March 13th: Tse dies, and Scarborough Grace calls Dr. Allison McGeer, Mount Sinai's infectious disease specialist, who finally makes the SARS connection.

March 16th: Joe Pollack, who lay next to Tse on that Scarborough Grace ER gurney for hour after hour, returns to the hospital with SARS. He's isolated, but not his wife. Later that day, while at the hospital, Mrs. Pollack comes in contact with another patient who's a member of a Catholic Charismatic group.

March 28th: At a meeting of the Charismatic group, the ailing Scarborough patient's unknowingly infected son exposed 500 others to SARS ...

Let's leave it there. If this is what the President of Mount Sinai calls an "amazing job," then we might as well head for the hills screaming "We're all gonna die!" Toronto health authorities have done an amazing job that's amazing only in its comprehensive lousiness. At every link in the chain, anything that could go wrong did go wrong.

In rural China, SARS got its start through the population's close contact with farm animals. In Hong Kong, it was spread by casual contact in the lobby, elevators and other public areas of the Metropole Hotel. Only in Canada does the virus owe its grip on the population to the active co-operation of the medical profession. In Toronto, the system that's supposed to protect us from infection instead infected us. They breached the most basic medical principle: first do no harm. Even after they knew it was SARS, Scarborough Grace kept making things worse.

Dr. Mapa's pathetic attempts at covering his profession's ass are understandable. But most people who've had experience of Canadian health care will recognize the SARS chain as an extreme version of what usually happens. The other day, a guy I know went to a Quebec emergency room, waited for six hours, was told he had a migraine, and sent home. It turned out to be a life-threatening parasite in the brain. I'm sure you've got friends and family with similar stories. A chronically harassed, understaffed, underequipped system reaches reflexively for routine diagnoses, prescriptions. Did Kwan Sui-Chu's doctor, an Asian Canadian herself with many Asian patients, get the Toronto Public Health alert? Is it normal for coroners to mark "heart attack" as cause of death for elderly patients even when they've been prescribed antibiotics for a new condition in the last week? Why, after Scarborough admitted Mr. Pollack, whom they knew to have been infected during his previous stay with them, did they allow Mrs. Pollack to circulate among other patients? Why did Scarborough compound its own carelessness by infecting York Central?

Most of what went wrong could have been discovered by a few social pleasantries: How's the family? Been travelling recently? The so-called "bedside manner" isn't just to cheer you up, it's meant to provide the doctor with information that will assist his diagnosis. In Canadian health care, coiled tight as a spring, there's no room for chit-chat: give her the antibiotics, put it down as a heart attack, stick him on a gurney in the corridor for a couple of days. Maybe you could get service as bad as this in, oh, a Congolese hospital. But in most other Western health care systems the things Ontario failed to do would be taken for granted. There might be a lapse at some point in the chain but not a 100% systemic failure all the way down the line.

You'll notice that just like Red China, the Prime Minister and Toronto's medical staff I've reacted reflexively, blaming it in my right-wing way on the decrepitude of socialized health care, which almost by definition is reactive rather than anticipatory, and belatedly so at that. But my analysis, unlike Dr. Mapa's, fits the facts. But not to worry: as our leader is happy to assure us, our no-tier health care "express da Canadian value."


TOPICS: Editorial; News/Current Events
KEYWORDS: deathcultivation; infected; marksteyn; marksteynlist; metropolehotel; nationalpost; populationcontrol; sars; socializedmedicine; system
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1 posted on 04/25/2003 6:47:59 AM PDT by knighthawk
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To: MizSterious; rebdov; Nix 2; green lantern; BeOSUser; Brad's Gramma; dreadme; Turk2; Squantos; ...
Ping
2 posted on 04/25/2003 6:48:42 AM PDT by knighthawk
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To: knighthawk
Mark Steyn nails it! Do we want single payer health care here seeing how poorly its worked in Canada? Toronto's health care system functioned a lot like one in a Third World country than what we would expect from a First World industrial democracy. It responded with slowness and measured alacrity to deal with a potentially lethal illness and in the end if SARS isn't spreading to the rest of Canada it must say something more for Canadians' innate caution than for all the wisdom of their own government. Something to think about when American politicians boast of how well health care in Canada covers the entire population that we should try it here. Then how come we don't have a SARS crisis like Toronto is having? One has to come to the conclusion America's health care system is working beautifully and what's lost on El Poco Loco and other liberal demagogues pushing for a government-run health care plan is don't mess with what works. Americans understand this quite well.
3 posted on 04/25/2003 6:56:29 AM PDT by goldstategop ( In Memory Of A Dearly Beloved Friend Who Lives On In My Heart Forever)
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To: knighthawk
Steyn could have titled this "Socialized Medicine Kills People".

The Economist did a Survey of Canada awhile back entitled "Nice country, nice mess". Unfortunately true.

But at least they're not Americans! They'll always have THAT to fall back on. I hope it's enough for them.
4 posted on 04/25/2003 6:58:58 AM PDT by You Dirty Rats
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To: knighthawk
And if it ever get to the point where Toronto has to be sealed off, the military probably couldn't do it.
5 posted on 04/25/2003 6:59:39 AM PDT by Grig
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To: knighthawk
Yet another triumph of caring, sharing socialism.
6 posted on 04/25/2003 7:01:12 AM PDT by headsonpikes
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To: knighthawk
Personally, I'd have been more impressed if he and Aline had had a candlelit dinner for two over a gurney in the emergency room of a Toronto hospital.

What a vivid imagination!

7 posted on 04/25/2003 7:04:40 AM PDT by facedown (Armed in the Heartland)
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To: knighthawk
This is the glorious system Hillary and Gephardt want to bring to the U.S. Ain't we lucky?
8 posted on 04/25/2003 7:04:42 AM PDT by Norman Conquest
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To: Grig
LOL! Like Canada has a military to even patrol its long borders...
9 posted on 04/25/2003 7:05:36 AM PDT by goldstategop ( In Memory Of A Dearly Beloved Friend Who Lives On In My Heart Forever)
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To: Norman Conquest
We are lucky. Fortunately the Democrats are too dense to understand the implications of what's happening North of us to draw the correct conclusions about a health care system appropriate for the needs of America.
10 posted on 04/25/2003 7:07:01 AM PDT by goldstategop ( In Memory Of A Dearly Beloved Friend Who Lives On In My Heart Forever)
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To: knighthawk
Steyn paints a compelling portrait of the inability of leftist thinking to deal with real problems. The Canadian Prime Minister eats a symbolic dinner at a Chinese restaurant, apparently in the belief that this is an adequate response to the failure of Canada's health care system...

In time, the global leftist pandemic will come to an end.

The remaining question is how many more people will die before it finally burns out.

11 posted on 04/25/2003 7:22:02 AM PDT by Interesting Times
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To: Pokey78
Ping
12 posted on 04/25/2003 7:25:17 AM PDT by Tares
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To: Interesting Times
World Death Rate Holding Steady At 100 Percent
13 posted on 04/25/2003 7:30:14 AM PDT by tictoc (On FreeRepublic, discussion is a contact sport.)
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To: goldstategop
the Democrats are too dense to understand the implications of what's happening North of us to draw the correct conclusions about a health care system appropriate for the needs of America.

This morning my favorite Lefty, Bill Press, told us that he was "stunned, dumbfounded" why the SARS epidemic has affected Canada, but the United States is so much less affected. The handwriting is on the wall, but the Liberals cannot see it.

14 posted on 04/25/2003 7:31:51 AM PDT by COBOL2Java
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"As for our diseased Dominion, like the Chinese our leaders behaved true to form. When something bad happens in Canada, the priority is to demonstrate how nice we are. After September 11th, the Prime Minister visited a mosque. After SARS hit, the Prime Minister visited a Chinese restaurant."

The best lines written in a long long time.

15 posted on 04/25/2003 7:34:47 AM PDT by Jakarta ex-pat
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To: headsonpikes
The horrors of socialism don't really hit home till you see them presented in graphic detail, as Mark Steyn has done in this piece: A signal service.
16 posted on 04/25/2003 7:41:32 AM PDT by ricpic
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To: knighthawk
the Democrats are too dense to understand the implications of what's happening North of us to draw the correct conclusions about a health care system appropriate for the needs of America.

Enough of the sugar coating. There's nothing dense about it. Radical liberals WANT epidemics. They are all over-population junkies. They want at least 5/6s of humanity destroyed. They WANT a health car system that is ineffective. Why else do you think that an ineffective one is the only kind they create when given the power to do so?

It's the radicals that control the organizations and their murderous intent is quite obvious. Obvious that is to anyone who is capable of seeing past the veneer of liberal smokescreens.

17 posted on 04/25/2003 7:46:17 AM PDT by Seruzawa (commies- nuke 'em til they glow and shoot 'em in the dark.)
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To: goldstategop
In no way would I ever suggest America adopt our system. If it's a flop in a small country like Canada, imagine how bad it would be in the U.S. You'd be kissing your superpower status good bye soon if you did that.
18 posted on 04/25/2003 7:49:07 AM PDT by IvanT
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To: Interesting Times
Steyn paints a compelling portrait of the inability of leftist thinking to deal with real problems. The Canadian Prime Minister eats a symbolic dinner at a Chinese restaurant, apparently in the belief that this is an adequate response to the failure of Canada's health care system...

Yes, in response, he ate at a chinky restaurant, then left for the Dominican to hang out and play golf with Bubba Bill. You know what the idiots response to 9-11 was? The french tw@t visited a Mosque.....

19 posted on 04/25/2003 7:50:57 AM PDT by IvanT
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To: goldstategop
I have to rise to the defense of the Canadian health care system. If you follow these rules, you will be fine:

1. Don't get sick, this obviates the need to enter the health care system.

2. If you do get sick make sure you have a competent GP who is really good at diagnosis and can get you in to see a specialist stat if you need it. Otherwise, you are in the soup.

20 posted on 04/25/2003 8:06:31 AM PDT by Former Proud Canadian
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To: knighthawk
Bookmarked.... And Memorized, if possible.
21 posted on 04/25/2003 8:42:23 AM PDT by Celtjew Libertarian (No more will we pretend that our desire/For liberty is number-cold and has no fire.)
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To: Former Proud Canadian; IvanT; Mother Abigail; CathyRyan; per loin; Dog Gone; Petronski; ...
Will SARS end socialized medicine in Canada? Will SARS end Communist totalitarianism in China?
22 posted on 04/25/2003 8:49:44 AM PDT by aristeides
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To: knighthawk
Quite a good article. It lowers my confidence that Canada can beat this, however. We ARE talking about human beings here.

It also helps explain why we still have SARS in its box in the United States. Still, if it reaches pandemic status in Canada we will not be able to keep it out of the U.S. The same comment applies to Mexico.
23 posted on 04/25/2003 9:05:54 AM PDT by EternalHope (Boycott everything French forever.)
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To: knighthawk
In rural China, SARS got its start through the population's close contact with farm animals. In Hong Kong, it was spread by casual contact in the lobby, elevators and other public areas of the Metropole Hotel. Only in Canada does the virus owe its grip on the population to the active co-operation of the medical profession.

Steyn missed the mark with this statement. Hong Kong, Singapore, and Vietnam had extensive spread of the disease by the medical profession. In fact, it was a medical doctor who brought the disease out of China to Hong Kong. He passed it to the first Toronto victim.

24 posted on 04/25/2003 9:07:15 AM PDT by per loin
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To: knighthawk; Tares; Howlin; riley1992; Miss Marple; deport; Dane; sinkspur; steve; kattracks; ...
Thanks to you both!

Steyn ping.

25 posted on 04/25/2003 9:08:36 AM PDT by Pokey78
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To: knighthawk
Great piece. I'm sending it to my doctor friends and relatives.
26 posted on 04/25/2003 9:21:46 AM PDT by Dog Gone
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To: mvpel
I work with a bunch of Canadians, should be interesting to hear their take on this situation.
27 posted on 04/25/2003 9:27:04 AM PDT by mvpel (Michael Pelletier)
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To: knighthawk
But in most other Western health care systems the things Ontario failed to do would be taken for granted. There might be a lapse at some point in the chain but not a 100% systemic failure all the way down the line.

I am not all that certain that the US health care system would have handled SARS that much better. If it spreads to the USA we shall see.

28 posted on 04/25/2003 9:34:17 AM PDT by harpseal (Stay well - Stay safe - Stay armed - Yorktown)
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To: harpseal
I am not all that certain that the US health care system would have handled SARS that much better. If it spreads to the USA we shall see.

There ARE cases in the US already, it just hasn't spread becuase of proper precautions. If you read the story, Stein makes it clear that Toronto is the only place where there is a problem outside Asia, despite the fact that Asians from the affected areas travel all over the world.

29 posted on 04/25/2003 9:48:48 AM PDT by TomB
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To: knighthawk
A Steyn BUMP!
30 posted on 04/25/2003 10:15:22 AM PDT by Gritty
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To: knighthawk; Dog Gone
Brilliant work by Mr. Steyn, as usual.

Unfortunately, he gives the US too much credit. We are patsies for this disease because of political correctness and the degree to which we have socialized medicine as well.

Open borders will bring in a flood of the infected and they will sit just as dangerously in the hallways of County USC as Chinese victims did in Toronto.

Bureaucracy is rife in American private medical care too. Consider how hard it is to get past a primary care physician to an infectious disease doc. Note too that an HMO doc spends less than ten minutes with a patient.

There is also the general American attitude that freedom without personal responsibility is equivalent to liberty, that freedom constitutes the latitude to do whatever pleases the individual regardless to the risks to society at large. One outcome of that public faith is the worshipping of "victims' rights." How hard will it be to institute quarrantine in this legal atmosphere after the way gay AIDS patients have been allowed to flout public health laws concerning communicable diseases? Remember the way Irwin Memorial Blood Bank was still recruiting donors in the Castro district of San Francisco? Another result of "freedom without accountability disease" (FAD) is the way Americans also suffer from "hero complex," where even doctors and nurses are encouraged to come to work when they are sick in order to appear committed, while bureaucrats get to think they are saving money on temporary help. My wife at Stanford Medical Center was virtually forced to share a desk yesterday with a physician who recently returned from Taiwan, and he's as sick as a dog. So, whom do I call who has the balls and power to isolate him?

No Mr. Steyn, Canada's disease isn't unique, it's merely in an advanced stage. Anybody who laughs at this doesn't know much about the reality of American healthcare and isn't thinking.

31 posted on 04/25/2003 10:18:40 AM PDT by Carry_Okie (There are people in power who are truly evil.)
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To: knighthawk
Let's leave it there. If this is what the President of Mount Sinai calls an "amazing job," then we might as well head for the hills screaming "We're all gonna die!" Toronto health authorities have done an amazing job that's amazing only in its comprehensive lousiness. At every link in the chain, anything that could go wrong did go wrong.



Steyn belts it out of the park again.

32 posted on 04/25/2003 10:20:45 AM PDT by Paul Ross (From the State Looking Forward to Global Warming! Let's Drown France!)
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To: Dog Gone
I wish to add that my wife reports that this same physician is scheduled to work an OB-GYN floor today, a sick doctor handling women delivering babies. This at Stanford.

Yeah, we got it together all righty.
33 posted on 04/25/2003 10:26:20 AM PDT by Carry_Okie (California! See how low WE can go!)
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To: Carry_Okie
No Mr. Steyn, Canada's disease isn't unique, it's merely in an advanced stage. Anybody who laughs at this doesn't know much about the reality of American healthcare and isn't thinking.

SARS showed up in the US about the same time that it did in Canada.

34 posted on 04/25/2003 10:27:50 AM PDT by TomB
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To: knighthawk
So this is the kind of health care system Dick Gephardt wants for the U.S.? Doesn't sound so bad.
35 posted on 04/25/2003 10:36:17 AM PDT by kevao
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To: EternalHope
This may sound really Callous, and I'm sorry, but the fact is, if it takes SARS to shut down our borders, then I am all for it.

If it reaches epidemic proportions up north and down south, what choice are we going to have? but to shut down the borders and not let ANYONE cross until this thing burns itself out.

I am afraid though that it is too late, we have a number of cases here in Washington, and I think that it is just gonna get worse. I just hope that our health care system can get a quick handle on it, they seem to be doing well so far, so I will just sit back and cross my fingers.
36 posted on 04/25/2003 10:37:28 AM PDT by Aric2000 (Are you on Grampa Dave's team? I am!! $5 a month is all it takes, come join!!!)
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To: Carry_Okie
I can't defend a sick doctor tending to patients, but certainly somebody there has considered whether he might have this illness. Has your wife said anything to anyone?
37 posted on 04/25/2003 10:39:44 AM PDT by Dog Gone
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To: goldstategop
LOL! Like Canada has a military to even patrol its long borders...

That's our job, isn't it? I mean, their long border is with a single neighbor...

38 posted on 04/25/2003 10:41:12 AM PDT by Peter Porcupine
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BTTT
39 posted on 04/25/2003 10:45:36 AM PDT by Amelia (Tag line? What tag line?)
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To: Dog Gone
I can't defend a sick doctor tending to patients, but certainly somebody there has considered whether he might have this illness.

I doubt it. I don't think it would happen unless he had himself admitted. People don't challenge routinely doctors on such things. This one has a God complex.

Has your wife said anything to anyone?

She didn't. I did. Guess what? Her nurse manager shows up for work sick too (stomach flu). I left her a message registering my concerns, and indicating that I made a record of conversation. Nobody takes risks like that with my wife and kids without me doing something about it.

40 posted on 04/25/2003 10:50:25 AM PDT by Carry_Okie (California! See how low WE can go!)
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To: Carry_Okie
Regardless of whether SARS is present, you did the right thing. People who are sick should not be running around trying to be a hero. They should be making every effort not to infect others.
41 posted on 04/25/2003 10:59:08 AM PDT by Dog Gone
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To: Dog Gone
Regardless of whether SARS is present, you did the right thing.

The call was a deliberate nudge, a wake-up call to get management to remember that I know SARS is no joke and will hold them to it if they don't take it seriously. They know I mean it too.

I told the wife in no uncertain terms (me being the tactless husband that I am :-) that if there is another management failure like this arrogant Chinese creep doctor sitting down at her desk to use the phone while sick as a dog, that she just calmly don a mask, gloves, and goggles, whip out the disinfectant, and quietly get to work cleaning up around him.

Tactful, ain't I? What could anybody say about it?

I used to do research and development work in the viral barrier protection business. This idiot is dangerous. I can now report that they sent him home today.

42 posted on 04/25/2003 11:12:24 AM PDT by Carry_Okie (California! See how low WE can go!)
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To: TomB
Given many of the hospitals in the USA do some of the same emergency room type situations it is not impossible that this could have occurred here, particularly in a city of equivalent size. I will be willing to listen to the superior US response next month when we a certain we are not facing a major problem with SARS.
43 posted on 04/25/2003 11:26:06 AM PDT by harpseal (Stay well - Stay safe - Stay armed - Yorktown)
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To: knighthawk
I've got to send this to a co-worker who's totally conservative "except for socialized health care." She needs to know what it really looks like.
44 posted on 04/25/2003 11:43:14 AM PDT by stands2reason ("...und keine Eier.")
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To: You Dirty Rats
But at least they're not Americans! They'll always have THAT to fall back on. I hope it's enough for them.

But they are way nicer than us. Unfortunately, nice = dumb.

45 posted on 04/25/2003 11:46:17 AM PDT by stands2reason ("...und keine Eier.")
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To: aristeides
Will SARS end Communist totalitarianism in China?

Actually I thought occasional mass human sacrifice is what kept the wheels of Communism "greased."

46 posted on 04/25/2003 11:54:30 AM PDT by stands2reason ("...und keine Eier.")
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To: knighthawk
...the decrepitude of socialized health care, which almost by definition is reactive rather than anticipatory, and belatedly so at that.

AKA Hillary Care
47 posted on 04/25/2003 12:10:04 PM PDT by aruanan
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Comment #48 Removed by Moderator

To: All
FOX has just said that Canada is saying two more have died.

America will not be able to handle SARS much better.

There are only so many beds, nurses, Dr.s etc.

There are very few reverse air isolation rooms.

Time will tell its ugly tale.

Think about the thousands of Asian illegals crossing our borders every day.Are the border guards taking temps?

In my opinion, this WMD is from Islamic terrorists with love.
49 posted on 04/25/2003 12:49:15 PM PDT by Betty Jo
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To: knighthawk
bookmark bump
50 posted on 04/25/2003 12:53:23 PM PDT by lepton
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