Study offers first picture of effects of SARS

CTV.ca ^ | May 28, 2003 | CTV.ca News Staff

[DoughtyOne]

Thanks for those additional figures. It would be nice if we could keep this from spreading rampant through the US, but it may be only a matter of time until it does.

[Judith Anne]

If it will make you feel better, I'll add insult to injury. ;-D

But it isn't necessary--really. Not everyone would be as nice about it as you have been. There are a few who still think we're goofy, and I suspect they'll be the first ones screaming if and when there is a serious US outbreak this fall (as I think there will be).

[Future Useless Eater]

So, if China has stopped reporting any new cases, and now a Russian has a confirmed case near the China border, and Taiwan is fudging numbers, and Canada if fudging numbers...

Probably means it's out of control, that's my guess, and nobody's going to report numbers any more.

You are most likely correct. The best we can do is watch it and learn all we can from what little they will tell us.

I think cheating and fudging are universal. Take Germany for example, rarely if ever do they report a 'probable' case until AFTER s/he recovers.

And the U.S. still has 32 VERY sick patients it seems, as that number is refusing to come down. It's been considerably longer than the worldwide 'average number of days till recovery'. Several of them must be near death and kept alive by extreme measures.

And I don't have much confidence in that Kaiser Permanente SARS situation either. That organization was the WORST!!!

[DoughtyOne]

To be honest, most hospitals in the US have been downsizing. I know of one local hospital that used to be rated for 452 beds that is now approaching capacity with 325 patients. Rooms have been converted into offices etc, with reverse airflow rooms not being used to the degree they used to be. I'm not even sure if the three they had are still opperable.

My region's health care facilities have been savaged by having to provide services with inadequate reimbursements. Now when the system is going to be needed, it's not going to be there to the degree it should be.

[Future Useless Eater]

No problem D.O. ... Welcome to the discussion group.

[per loin]

Happy to supply them, and to see someone quickly change their opinions when others present facts.

[Judith Anne]

How well I know! You are absolutely right about the downsizing and capacity.

I'm guessing that there will be SARS facilities set up separate from regular hospitals (though I don't think it will keep SARS out of the hospitals). Another sobering read is the disinfection procedure required for ambulances, it will take longer than transporting the patients...

If there are outbreaks in the US this fall during the flu season, as many health authorities consider, the ability of hospitals to deliver critical care will be unmasked. The two small rural hospitals where I work would be overwhelmed in short order, with regular patients along with escalating numbers of SARS victims...

[DoughtyOne]

Thank you. My wife and I are under the Kaiser Permanente plan now. I've never been a big fan of the organization, but in some ways they have been helpful to me. I have to take anti-coagulation therapy, and their pharmacy tracks this. For the first time in about seven years, they have me dosing properly on a daily basis. I wasn't doing so under my old provider.

[Judith Anne]

Every organization has strengths and weaknesses. Glad to hear you are doing well...my concern is that SARS will expose all the weaknesses.

[backhoe]

Let's cross-link:

-SARS ( atypical pneumonia )- a partial archive --

[Judith Anne]

Yes, lets! And thank you, profoundly.

[DoughtyOne]

If SARS does break out in the US this fall, I agree that it will expose a myriad of evils. We've played fast and lose with our health care system. Perhaps this is what it will take for us to take health care seriously.

Hillary's, and other people's idea that medical centers and other health providers could simple eat the costs of health care, were ill advised. No business can operate at a loss or a very slim margin forever.

Thanks for the discussion.

[Judith Anne]

You're welcome.

[Movemout]

...my concern is that SARS will expose all the weaknesses.

A reasonable cocern, but I would stipulate that it is nearly impossible to maintain a position that would be able to absorb the effects of any pandemic. The O&M costs would be staggering. I am not saying that we shouldn't take reasonable steps which would allow us to move to a full up defensive posture more rapidly if this SARS turns out to be more deadly in the second round as was the Spanish Lady.

I have followed all of the SARS threads (or most of them). I dropped off posting early on in the SARS discussions because the uninformed naysayers were getting on my nerves. I note that you have hung in there from nearly the beginning. Kudos to you.

The latest round of speculation in the press is that we have paid too much attention to SARS to the detriment of more menacing problems, the latest being the West Nile problem. I guess some folks think everything is a zero sum game. The concept of parrallel processsing and dynamic response is totally foreign to their pea pickin' intellects.

[Judith Anne]

Thoughtful remarks, and you're right. As the system is now, there is no way to maintain a defensive posture all the time. I don't know what measures would enable us to ratchet up in case of outbreak(s). I am concerned about being caught with my (N95) mask off and my scrubs down, so to speak.

One of the scenarios I imagined at the beginning of these threads was a person with a broken bone or appendicitis, coming down with SARS all unsuspected, while in the hospital for the more ordinary illness.

Now I see that in Canada, it's happened, the man died, healthcare workers were exposed and sickened, and other patients infected. Not reassuring. And some called us panic-mongers for our speculation...

[Movemout]

I don't know what measures would enable us to ratchet up in case of outbreak(s).

I'm not in the medical profession so I can't say for certain. I would note that after 9/11 that the feds started stockpiling bio/chemical/medical gear and then palletized the material so as to be able to transport it to affected sites by military cargo planes. That wouldn't be out of the question. Surveying capabilities, by region, to deal with a SARS pandemic is doable. This would at least identify where investment in the infrastructure is critical. Even without SARS rearing its ugly head, the statistical occurence of pandemics suggests that we are overdue and if SARS goes away then what other bug is around the corner?

Given the role of viruses in nature, and given the total biomass available on the planet for a mutated virus to exploit, it is inevitable that we will be dealing with a massive problem, probably within most of our lifetimes.

[Judith Anne]

The surveys are probably being done, and thanks for that information...I'd forgotten and frankly, it's nice to be reminded.

[ExSES]

Question:

Do the majority of SARS patients require ventilators and, if so, just masks or with trach tubes?

The Fall/Winter could see a return of SARS in pandemic proportions and I certainly hope that the supply of ventilators will be sufficient for such a situation.

It appears that SARS outbreaks in areas without sophisticated medical device availability would result in a vastly greater mortality rate than that experience so far!

[Judith Anne]

About 20% require mechanical ventilation, is what I recall. I could be mistaken, and anyone who has better information, please correct me here.

[jacquej]

First thing I did this morning was check out this thread, and I am impressed! This is what FR was like in the good old days, when we had reasonable discussions with one another, seeking good information, learning from one another!

To see the open minds here, even if coming from different points of view, checking their own preconceptions, then revising these in light of newer information, gives me hope for the world!

By the way, Judith Anne... We have found that we get better medical care from our small rural hospital then from the city hospital nearby. We are about half way out in the country between the two. The rural hospital responds more quickly to true emergencies, and has excellent connections to a much larger city hospital about 90 minutes away be ambulance. Less by helicopter!

Of course, then we are left with the unending battle with the insurance company about the bill. I am guessing that if there is a SARS outbreak, the rural hospital will be a better bet for treatment, but that is probably silly, as probably all the normal rules will go out the window.