SARS SHUTS TORONTO SCHOOL, 6,400 IN QUARANTINE (Nurses' Calls Not Heeded!!!!!)

WashingtonPost ^ | May 28, 2003 | Rajiv Sekhri

[travelnurse]

SARS Shuts Toronto School, 6,400 in Quarantine Reuters Wednesday, May 28, 2003; 5:24 PM By Rajiv Sekhri TORONTO (Reuters) - Concern about SARS shut down a Toronto-area high school on Wednesday, sending staff and students into quarantine and raising fears the virus may have spread from hospitals to the broader community.

[travelnurse]

just to stir a little: if the hypothesis of transmission from fomites 40 days after initial contamination is correct, how are we gonna deal with the rooms' furniture, beds, etc. prevention of patient-patient transmission looks problematic at this early stage....

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I am not too sure what you are speaking of... if you mean in a hospital setting, then proper standard decontamination of of all equipment, furniture, etc. is the protocol. This should be done on a daily basis, OR WHENEVER NECESSARY. That's what you have a "housekeeping" department for.

[blam]

"Yeah a cold with a 20% chance of killing you. "

...and if you're 65 years old or older, that goes to 50%. (I figure if I catch it, I have a 50/50 chance of dying, that'll get your attention.)

[travelnurse]

I understand how that would make sense if there was not an incubation period but if as some say, it can be 40 days long, I don't see how basic infection control guidelines could help prevent an outbreak.

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You wear the PROPER protective gear outlined by Infection Control Protocol however long it is. If you work in a TB unit, you are never without your gear. If you work in the ER, the same. In the ER all patients must be PROPERLY SCREENED and triaged (catagorized) before entering an area where others are. The Triage Nurse has her/his proper protective gear on. This is standard procedure.

[travelnurse]

One more thing that I would like to emphasize is that Toronto is so concerned about its image and tourism, that they are doing everything to cover up the problem. Why would you become lax on your infection control protocol?

They do not want tourists to come into the city and see people with masks on; even in their hospitals they are pretending that it doesn't exist. Their Govt. sponsored Health Care is making the problem worse by trying to cover up the problem in the first place.

What reasonable medical facility will let up on an Infection Control Protocol unless they are trying to pretend it doesn't exist?

[Future Useless Eater]

SARS Mortality Rates [reflects treatment] for 'PROBABLE' cases only Based on World Health Organization daily tables                 (Revised:  May 28 pm)
Area	Recoveries to date	Deaths to date	Recent** Death Rate		Active Cases still in Danger	Projected Future Deaths	Projected Cumulative Mortality
China	3036	325	8.7%		1962	170	9.3%
Taiwan	111	81	63.8%		418	267	57.0%
Hong Kong	1295	270	11.1%		165	18	16.6%
elsewhere [30 countries]	449	70	11.9%		61	7	13.3%
**  Recent deaths are based on findings from the Imperial College of London...... that deaths take 12 days longer on average than recoveries on average..... = (12-day recent deaths) / (12-day recent deaths + prior 12-day recoveries)

Observations - Treatment:
• Taiwan only reports 'probable' cases when they are the most obvious, or in CRITICAL condition, which is why their recent death rate is so high.
• Taiwan maintains an additional shamelessly high 'suspected' SARS count exceeding 1150 patients.
• China's numbers are grossly underreported.
  China abruptly STOPPED classifying ANY NEW 'PROBABLE' cases in their 'outland' areas about 2 weeks ago.

Trend - Active Cases Still in Danger [reflects containment] for 'PROBABLE' cases only
Date	China [Bogus]	Taiwan	Hong Kong	elsewhere 30 countries	World-wide all 33 countries
May 13	3061	153	374	89	3677
May 14	3046	170	343	85	3644
May 15	3034	196	309	78	3617
May 16	2969	193	297	79	3538
May 17	2918	221	276	76	3491
May 18 (est.)	2870	254	263	73	3460
May 19	2799	249	250	70	3368
May 20	2700	268	236	69	3273
May 21	2618	295	227	65	3205
May 22	2526	349	217	62	3154
May 23	2438	396	209	59	3102
May 24	2326	386	196	68	2976
May 25 (est.)	2259	386	184	61	2890
May 26	2170	401	183	58	2812
May 27	2057	408	174	59	2698
May 28	1962	418	165	61	2606
May 29	...	459	...	...	...
(includes new daily cases... excludes cases resolved by death or recovery) (some tables are supplemented with government data when WHO data is missing)

Observations - Containment:
• Taiwan's 'probable' count should be FIVE or SIX HUNDRED higher.
• Taiwan is withholding less-serious 'probable' cases and calling them 'suspected'.
• This raises their 'probable' cases' mortality rate, and obscures their real containment.
                              May 29  (459) ACTIVE 'probable' cases
Apr 30   (41)      [a eleven-fold increase in one month]

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• China's 'official' numbers in the charts and their recent 'improvements' are bogus.
• They abruptly stopped ALL REPORTS of NEW 'PROBABLE' cases in most places (besides Beijing) about 2 weeks ago.
  Here are some examples...

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Inner Mongolia (province) - TOTAL 'probable' case count
                               May 28 (285 TOTAL 'probable' cases)
April 28 (114 TOTAL 'probable' cases)
[abrupt change occurred May 10]

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Guandong (province) - TOTAL 'probable' case count
                               May 28 (1512 TOTAL 'probable' cases)
April 28 (1395 TOTAL 'probable' cases)
[abrupt change occurred May 10]   ...vertical scale = 1350 to 1520

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Tianjin (municipality) - TOTAL 'probable' case count
                               May 28 (175 TOTAL 'probable' cases)
April 28 (43 TOTAL 'probable' cases)
[abrupt change occurred May 14]

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Shanxi (province) - TOTAL 'probable' case count
                               May 28 (450 TOTAL 'probable' cases)
April 28 (243 TOTAL 'probable' cases)
[abrupt change about May 14]   ...vertical scale = 200 to 450

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The only way these graphs could flat-line SO ABRUPTLY is China cheating
on their reporting, and to stop reporting any new SARS cases as 'probable'.

[Future Useless Eater]

SARS - Treatment/Containment tables - updated with Wednesday's numbers

plus... China cheating on their SARS reporting - smoking gun evidence here

[Judith Anne]

Another really excellent SARS thread in a long long list of excellent threads...

FR is way way ahead of the learning curve, on this illness.

[Prince Charles]

Good work on those charts, which clearly show a pattern.

[greccogirl]

I'm not surprised. After all tourism is more important any day than health, is it not?

[Judith Anne]

bump for an excellent thread...

[cricket]

"The risk of getting SARS in this kind of setting (a school) is very low," [Based on what evidence?]

truly an amazing conclusion given the 'evidence' of flu epidemics and what they do to school populations. . .

[ExSES]

In the ER all patients must be PROPERLY SCREENED and triaged (catagorized) before entering an area where others are. The Triage Nurse has her/his proper protective gear on. This is standard procedure.

Maybe in textbooks but not in practice. Unfortunately, I have had to take a relative to the emergency room several times since SARS hit the scene and there was NO ONE in "proper protective gear" anywhere to be seen.

Intake clerks, various medical personnel AND the "Triage Nurse"..., all without even a simple mask!

Obviously, since only one suspected local SARS case has even been noted in the area (Central Florida), the precautions seem to be considered unnecessary.

I suspect that very few emergency rooms around the USA are observing the protocols you describe and will only do so AFTER experiencing a major SARS outbreak!

I am certain that it has been determined not to be "cost effective" to do so (for now)!

[firewalk]

Thanks

[Judith Anne]

Sadly, I agree.

[sakic]

You wear the PROPER protective gear outlined by Infection Control Protocol however long it is.

That's fine for exposure within hospitals but doesn't address exposure in the general populace. If it's airborne it will spread despite efforts in the hospital. Is that incorrect?

[aristeides]

The evidence seems to suggest it's not truly airborne (which doesn't prevent in from spreading waterborne in the air on droplets of sputum, saliva, or the like).

[aristeides]

Ont. SARS cases to triple under WHO criteria .

[Judith Anne]

...Or aerosolized in sneezes and coughs, or through machinery like the maximist, routinely used in flu pneumonia treatment...

[Judith Anne]

From your link:

Many of those who are sick in this latest cluster are health-care workers, and some nurses are blaming officials for relaxing SARS precautions too early.

Young said now is not the time to assign blame. "Right now we've got to focus on getting control and making sure this gets stopped."

I'm going to take slight exeption to the remarks in that article; officals don't "relax" precautions, they mandate that full protection not be used. Just TRY using a mask, gown and gloves when taking care of someone who, according to the hospital "officials" does not need them...

[Rummyfan]

I guess Chretien will have to go eat a steak in the school cafeteria now, to prove that neither SARS nor Mad Cow disease is a problem!