I think we are witnessing the chaos of the medical bureaucracy, which is not unlike the AIDS outbreak in the early 80's.
Bureaucrats are by the nature of their positions, obligated to be cautious and to not make speculative remarks. Nothing can wreck a career faster than a false or exaggerated statement.
In their effort to avoid the pitfalls of saying what they think they know, they typically rely on carefully worded announcements that can be backed up by documented facts or statements by other authorities.
Reporters are generally ignorant of the medical system and with all the mixed messages we are getting from authorities coupled with bad reporting I don't think any of us have any way to know what is really going on with SARS.
Consider the following:
1. There is not a reliable test to diagnose the disease,
2. The route of transmission is not understood,
3. We do not have an understandable definition of the disease,
4. There is no known treatment,
5. The window of transmission is unknown,
6. Medical privacy seriously restricts release of information,
7. Panic could crash the markets and ruin the government,
etc.
When you consider all the things that we don't know, you almost have to raise the question, is it a real disease? I wondered the same thing about HIV until I saw people around me get sick and die.
I have a paranoid friend who flew to California in February. Upon his return, he had a very bad cold and heard on television that someone on an airplane had SARS.
He put one and one together and concluded that he had a mild case of sars. He has since had another two or three colds, each one seemingly worse. He believes that SARS is cyclical disease, we will all become infected, get over it, and then get sick again. Interesting theory and at this point, who can refute it?
Nobody, and don't kiss him. ;-D
We are assured that it is not -- judge for yourself:
'Relapse' patients had other problems: HK
HONGKONG -- A dozen former Sars patients here who were initially thought to have suffered relapses actually had other medical problems, health officials said.
The Hongkong Hospital Authority caused international alarm last Wednesday when it said that 12 patients who seemed to have recovered from Sars had been readmitted to hospitals after apparently relapsing.
But Dr Liu Shao Haei, a senior manager of the authority, said on Sunday that while some of the patients had developed fevers or other symptoms of illness after their initial discharge from a hospital, not one turned out to be sick again with Sars.
Eight of them had since been discharged for a second time.
'One was discharged, but was then readmitted with discomfort but it wasn't a relapse... It could just have been one of the stages of the illness and the patient returned for further observation,' explained Dr Liu.
'Another patient presented some generalised discomfort...but the investigations' results came back negative and she was discharged,' he said.
In one case, a woman had developed leg swelling from deep-vein thrombosis apparently caused by her prolonged bed rest during her treatment for Sars, Dr Liu said.
'There are, of course, cases where they develop fever and they reported the symptoms to the clinical teams during their home stay, and the clinical teams to be cautious asked them to come back for further investigations.
'The chest X-ray and blood tests were clear and they have been discharged,' he added.
'They are all confirmed as not related to any relapse of Sars conditions.'
Mr Dick Thompson, a spokesman for the World Health Organisation (WHO), welcomed the re-evaluation of the cases here that were initially diagnosed as relapses.
'It sounds like there's lots of good news,' he said.
The WHO was scheduled to hold an international video conference yesterday to examine if the 12 Sars patients in Hongkong might have suffered relapses after they appeared to recover.
Dr David Heymann, head of the communicable diseases section at WHO, had noted that the reported relapses might be due to steroid therapy used in Hongkong which was tapered off too rapidly, 'but we're not yet certain'.
Hongkong said yesterday it had reached a crucial stage in the fight against Sars after reporting just eight new cases, keeping figures in single digits for a second day, and said it would talk to the WHO about lifting a travel advisory.
Three more Sars patients died in the territory, bringing Hongkong's toll to 187, and Health Director Margaret Chan said it was too soon to claim victory.
She urged the public to maintain good personal and environmental hygiene.
'This is perhaps the most critical period, and if we relax on these measures all the hard work we'd put in place in the previous two months might go waste,' she told a news conference.
http://www.straitstimes.com/sars/story/0,4395,188113,00.html?