100 million cases of SARS within a year? (Excellent post from Brad Delong's website)

Brad Delong's website ^ | April 24, 2003 | Jonathan King

[ErnBatavia]

Check the news - it's already going away in Toronto.

[templar]

And still NO fatalities in the U.S.

I've noticed that. Maybe more of a comparison of genuine effectiveness of the different health care systems than of the deadliness of the disease itself?

[ido_now]

JUST LEAVE IT UP TO ME, AND THERE WILL BE 1,000,000,000,000,000 (THAT'S QUADRILLION) REPORTED CASES OF SARS NEXT WEEK.

THERE WILL ACTUALLY BE JUST 200 ACTUAL CASES, BUT WHO WILL KNOW?

[Tarsk]

"Check the news - it's already going away in Toronto."

It's going to take many weeks to establish that. Anyhow, from the National Post today:

But in the medical community, unease was evident.

Writing for the Canadian Medical Association Journal yesterday, two U.S. epidemiologists warned "the number of cases so far reported/observed is only the tip of the iceberg of the true actual number. It may be that there are 10 to 20 times as many cases or greater that have not been recognized or just missed."

The instructive point for Toronto's public health officials is not that there may be hundreds of unreported cases, but that it only takes one breach of Toronto's defenses to start an epidemic elsewhere in the country or the world, Dr. Watts said.

"Toronto is not just having its own little epidemic," he said.

"It may be true that they have it under control, but the problem with this disease is that it's a very easy one to lose control of.... That's what happened in China. They tried to put a good face on things, now no one trusts the government. What [Toronto's officials] have to remember is that one person started this whole thing."

http://www.nationalpost.com/home/story.html?id=1B45603B-6F55-40FE-9BE9-410373613C1B

[Tarsk]

"Maybe more of a comparison of genuine effectiveness of the different health care systems than of the deadliness of the disease itself"

Or perhaps just dumb luck?

[handk]

SARS Scam Web Site

[Jim Noble]

I remain convinced, as I have been saying since mid-March, that it is reckless and foolish to permit entry into the United States of travellers arriving from SARS hot zones.

At a minimum, they should be detained in quarantine for fourteen days at the border (although logistics argue against this).

Why is this so hard to understand?

[browardchad]

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.

How about factoring in the reaction of the populace to "mildness" in Singapore and China? Fearing their repressive governments, people are less likely to report symptoms and hand themselves over to isolation, thus spreading contagion. In Canada's case, factor in socialized medicine, which means long waits for doctor appointments, and add the government's "culturally sensitive" policies which inhibit singling out any one country/ethnic group of origin -- both probable contributing causes to the spread of the disease early on.

[Mears]

I agree with you.

As I've said in previous posts on this subject why tell us not to go to places with SARS if we are not stopping people coming into the US from those places.

The logic escapes me.

[FITZ]

And still NO fatalities in the U.S.

How many SARS cases have there been in the US?

[Carry_Okie]

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.

Read this one for what it says this time, and think about what I've been trying to tell you.

Infection control in our border hospitals is a joke compared to Singapore.

[Lucas1]

No new cases that we know of in Toronto in the past two weeks. THIS IS GREAT NEWS...possibly contained here at this time!

Let us hope so! The more we can slow this down the better chance that we can find a way to treat this disease...before things get really out of control.

It can be contained...don't give up hope just yet folks!

Toronto is a great example of how it can be contained...

It just takes a WHOLE lot of work!

[Dark Wing]

fyi

[Axenolith]

That [Zaire Ebola] is the kind of fatality rate that this quote was referring to...

Usually, a scary rate like that doesn't persist for very long with a fatal disease.

[Axenolith]

There's been 210 new ones since yesterday.

[FITZ]

A lot of the coronaviruses are spread by migratory birds ---I don't know about this one ---but quarantining humans might be a waste of time. Chronic diseases like TB are coming in from Mexico ---but I'm not sure something like cold viruses are going to be prevented even with border enforcement.

[1234]

...it is reckless and foolish to permit entry into the United States of travellers arriving from SARS hot zones.

At a minimum, they should be detained in quarantine....

AGREED

[Carry_Okie]

You could be right about the border and birds, but there has been a less than completely satisfying association between the presence of coronavirus and SARS.

Avoiding infection may come down to relative isolation and personal hygene and the one place I would not want to be is in a hospital near the border (my wife is an RN). From what I have seen, infection control practices have become very lax, and the tolerance for sick employees on the floor is way too high.

I almost wish that I was back in the viral barrier protection business again. Almost.

[FITZ]

The bad thing about the border is that we know that Mexico never takes care it's own problems but will ship them over to us ---if an epidemic does break out in Mexico, the ill will be sent to the US for their medical care just as they do with the others. They already figure they have a right to free medical care here so the border hospitals would be filled up by Mexican nationals and the epidemic could spread from there.

[Carry_Okie]

Completely agreed.

There is considerable traffic between mainland China and Mexico supporting trade in purchased parts for final assemblies made near the border. The commute travel between those companies and poor high-density urban communities is a hazardous mix for containing transmission from China to Mexico. If there is a general outbreak on the Mexican side of the border, it will likely be bad enough that people trying to make connections for a coyote in a border town, or drug runners for that matter, will have a high probability of being exposed to the virus. The speed with which those people disperse into the American heartland is sufficient to make a fast moving virus with a two week incubation period a very difficult moving target.

I am less sanguine about the birds, in part because I am out of my epidemiological ken on that front but also because I don't see it as a an effective delivery mechanism for high counts of virus to humans. They might cause sporadic outbreaks but would seem to me to be more containable than a direct contact among large numbers of people in cities. How would you anticipate that transmission between wild migrating birds and humans in the US would work? Chicken farms? Do you think the virus would survive on fresh produce handled by farmworkers? I doubt it, but it might be possible for the virus to survive on prepared food in a restaurant.

IMO, the Singapore case will demonstrate whether a sophisticated urban society has the discipline to control infection sufficiently to prevent a general outbreak. I frankly don't have as much confidence in most American hospitals as I do in the Singaporeans.