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Posted on 04/26/2003 5:48:54 AM PDT by Tarsk

I think some people are missing the message here. If you take the data from the WHO sars page, you can easily find out that:

1) The death rate worldwide is 11% if calculated by the deaths over deaths plus recoveries method, or "only" 5.9% if you calculate it by dividing deaths by total cases.

2) The rate at which cases are growing is currently about 3.5% PER DAY (divide today's reports by yesterday's). That means the number of cases doubles every 20 days or so. Usually, a scary rate like that doesn't persist for very long with a fatal disease. Well, so far we have been almost "spot on" as the British might say for the last 20 days.

3) I agree that media reports are probably making some people outside of Asia feel more panic than they should (so far), but the situation is beginning to look completely horrible within China and Hong Kong. Right now, many people are leaving Beijing for the countryside, and you can almost hear the epidemiologists screaming "No! Don't do that!" If this is a 10% killer for hospitalized victims in major cities, you don't want to think about what it could do in the Chinese countryside.

4) A very valid point can be raised that we don't know how often transmission of the virus leads to full-blown SARS. The data collected in Canada and Hong Kong now are somewhat confusing. The Hong Kong data suggest they can extract the coronavirus from tissue in 90% or more of the SARS patients they have, and from very few people who don't have it. The Canadians have a lower success rate with patients (which is weird), and find 20% or so of non-SARS people who travelled in affected regions have the virus. Something is screwy here, and needs to be resolved.

5) The problem with controlling epidemics is that you have to do it early while you still only have a handful of cases. I actually believe that the Canadians have seen the worst of their current outbreak, but every announcement of "we have it in control" in Hong Kong has so far proven to be over-optimistic. And there is every indication that things are *still* even worse in China than the government there allows.

6) The situation I find most worrisome at the moment is actually in Singapore. The government there does not have a reputation for, um, "mildness" or lack of control, but their growth rate in cases this month has been about 3% PER DAY. That is better than 3.5% (especially when compounding), but does not qualify as "control" in the big picture.

7) I said that Canada my have the situation in hand, but if I'm the WHO, I look and see that their growth rate in cases has been the same as the world average, and has doubled in the last 20 days. 140 cases in all, the vast majority started from a single chain of transmission in a single individual. In other words, with aggressive quarantine, modern facilities, a hyper-cooperative population, and every advantage really, that's what it has taken to control this.

8) Another point is that it is not unlikely that the current outbreak will be arrested within several weeks. But then, next fall and winter, there is no reason to believe it could not come roaring back.

9) Exponential growth is just plain deadly. At a 3.5% daily growth rate in cumulative cases, do you know how many cases you *could* get in a year? If you had one case to start, that would be 283,941. If you had 4439 cases to start (like we do today), that's over 1 billion cases.

Now, if aggressive control measures could bring that down to a 1.5% daily growth rate, then you're only talking about a horrific but manageable 100,000 cases in year from our current position. So 10,000 people might die, rather than 100 million.

That is why I don't think the media is really over-playing SARS.

Posted by: Jonathan King on April 24, 2003 03:09 PM

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