Why are a higher percentage of Canadians dieing of SARS?

[DarthVeda]

I think botched socialized medicine has something to do with it

[SpencerH]

The current worlwide mortality rate is 5.9% which has jumped from 4% as more numbers from the Chinese have come in.

A couple of interesting points.

SARS in Canada has pretty much only killed the elderly (the youngest was 43 but most patients are 60-70). So in Canada the pathogenesis is similar to a virulent pneumonia.

There may be more or less virulent strains within the SARS outbreak. In Singapore, the first infectee gave it to her immediate family and friends, almost all of whom died. In contrast none of the american SARS patients have died.

Given the Canadian experience as well, its interesting to postulate that the severity of SARS is not due to the strain variation in the coronavirus itself but may be due to variations in the carriage of other opportunistic organisms.

[SpencerH]

Originally posted by Starchild
SARS is related to the common cold in the fact that they both belong to the same family of virii called coronaviruses. Whether SARS displays the extreme mutability of it's cousin is something still to be seen.

Both the Canadian and CDC sequences (derived from different outbreaks) agree to within a few bp out of 25K bp. So the evidence to date does not suggests hypermutation.

[DaShi]

The virus was designed for minimum fatality among the Chinese.

[lightblue]

Originally posted by DaShi
The virus was designed for minimum fatality among the Chinese.

Guess they screwed up badly then

But seriously, I doubt that this is a bioweapon running loose.

[Seeker]

In Canada the severity of the disease is related to the series of events causing one infected person to infect a large number of other patients with weakened immune systems.

Actually, it's a bit perplexing why this is getting so much attention, it's just a kind of pneumonia, which, like all pneumonias, can be dangerous for old folks in hospital.

The only worrying note is that one of my comrades is going back to work in the most at risk group...toronto health care workers (Sunnybrook).

[optimus2861]

Originally posted by Seeker
Actually, it's a bit perplexing why this is getting so much attention, it's just a kind of pneumonia, which, like all pneumonias, can be dangerous for old folks in hospital.

The media needs the headlines. The whole thing in Toronto has been seriously overblown by W.H.O.; we're talking about, what, 300 cases in a city of over 2.5 million? A whopping 16 deaths? You can get 10x that many people dying of cancer or heart disease every day in this country, and on bad days, probably that many from traffic accidents too. And, as you've said, pneumonia or the flu can be as bad for seniors as this thing seems to be.

Whoop-de-friggin-doo, says I. If it ever does reach pandemic status, then start clogging the airways with it. Until then, I wish the media would just shut the hell up about it, all they're accomplishing by focusing on it is fear-mongering.

[SpencerH]

Originally posted by optimus2861

The media needs the headlines. The whole thing in Toronto has been seriously overblown by W.H.O.; we're talking about, what, 300 cases in a city of over 2.5 million? A whopping 16 deaths? You can get 10x that many people dying of cancer or heart disease every day in this country, and on bad days, probably that many from traffic accidents too. And, as you've said, pneumonia or the flu can be as bad for seniors as this thing seems to be.

Whoop-de-friggin-doo, says I. If it ever does reach pandemic status, then start clogging the airways with it. Until then, I wish the media would just shut the hell up about it, all they're accomplishing by focusing on it is fear-mongering.

A DL from a Chinese government official perhaps?

The facts so far are: that this disease is highly communicable (possibly airborne), has a mortality rate similar to the 1918 swine flu (which killed 20M people worldwide), and like that epidemic can kill previously healthy people. Sticking your head up your ass (as the chinese did) and waiting for it to be a pandemic before anything is done isnt gonna work. Because of modern air travel this is a pandemic already. Now that we recognize the problem to some extent, the only question is whether we will contain the spread better than the 1918 pandemic. Hopefully we will.

[RedFred]

I think my opinion on this is somewhere in between SpencerH and optimus2861. Public health officials have to consider the worst case scenario which would be something like the 1918 flu epidemic. We may have gotten lucky this year with SARS cases hitting near the end of flu/cold season. Next year could be worse.

But WHO may have overreacted issuing that travel advisory on Toronto. I don't know if it is the warmer weather or what but I haven't heard of many new cases in the last few days there. More people will die from many other things this year including West Nile.

I am no doctor but I think if the virus mutates it will become less deadly not more. The idea from a virus's standpoint is to replicate yourself as often as possible. That doesn't work so well if you are killing your host.

[Seeker]

Now West Nile IS something I'm worried about.

Canada has a **** of a lot of mosquitoes, a malaria like disease could be really bad, especially since we'd be defenceless against it.

They say that even the NWT are experiencing some West Nile.

[Q Classic]

no offense, but i find a lot of media coverage about infectious diseases far too overblown..

west nile? west nile only harms those with weakened immune systems: hiv+, elderly, children... not your average 20-30 year old human.

'course, the way the media broadcast it, you'd've thunk it was the worst thing ever since the bubonic plague.

same with this sars thing.

and starchild, even if canada's really british, i'm sure the majority of you were infected with the virus d'quebecois... (izzat how you do it? ) meaning that your immune systems are probably weaker than say, the regular units of the iraqi army.

[optimus2861]

Originally posted by SpencerH
A DL from a Chinese government official perhaps?

I resent that.

The facts so far are: that this disease is highly communicable (possibly airborne),

If it were airborne, it would probably already be a pandemic (and I find your definition of 4,400 cases & 263 deaths worldwide as "already a pandemic" laughable, to be blunt). If it were airborne, you'd think Toronto would have diagnosed one new case in the past 19 days (they haven't). The fact is, scientists don't yet know how communicable it is.

Sticking your head up your ass (as the chinese did) and waiting for it to be a pandemic before anything is done isnt gonna work.

I'm saying the media should tone it down and quit fear-mongering. The health organizations have generally done a good job, though I think the travel advisory against Toronto was overkill.

It's right to be cautious. But to portray this as a parallel to 1918 is just blatant alarmism at this point.

[Kramerman]

Re: Why are a higher percentage of Canadians dieing of SARS?

It because they're weak!

[Dauphin]

Originally posted by optimus2861
I'm saying the media should tone it down and quit fear-mongering. The health organizations have generally done a good job, though I think the travel advisory against Toronto was overkill.

The UK media is treating the whole deal with a bit of bemusement. All the UK correspondents that I've seen on location in Beijing, Hong Kong, Singapore and Toronto have not been wearing healthmasks like all the locals, and have been visiting all the hotspots in a very nonchalant manner.

The report at Heathrow had all the tourists coming back from China saying "What's all the fuss about?", and all those being told that their trips to China have been cancelled/postponed are being shown as disappointed and irritated.

Quite unusual for our media to not hype it up.

[SpencerH]

Originally posted by optimus2861

I resent that.

so?

If it were airborne, it would probably already be a pandemic (and I find your definition of 4,400 cases & 263 deaths worldwide as "already a pandemic" laughable, to be blunt).

Its not my fault you dont know the definition of pandemic. I suggest you look it up.

If it were airborne, you'd think Toronto would have diagnosed one new case in the past 19 days (they haven't). The fact is, scientists don't yet know how communicable it is.

Thats right, scientists, like me, who work on the pathogenesis of infectious disease, dont know whether it's airborne. But guess what? There is evidence for more than droplet spread. For example, one of the first reported Hong Kong cases was a nurse with protective clothing including a mask working 6 ft from a SARS patient. She's dead. Airborne spread would explain why it hasnt been contained by health care workers using droplet protection measures and why the new recommended infection protection measures published by the CDC include those for airborne transmission ie negative pressure rooms and respirators.

I'm saying the media should tone it down and quit fear-mongering. The health organizations have generally done a good job, though I think the travel advisory against Toronto was overkill.

Travellers to Toronto have now spread SARS to the Phillipines and possibly to Australia. I would say that travellers to Toronto should be made aware of that.

It's right to be cautious. But to portray this as a parallel to 1918 is just blatant alarmism at this point.

Please feel free to cite your expertise in the field of infectious disease. There are a number of important parallels between the current pandemic and that which occurred in 1918. When this hit the news a few short weeks ago it was troubling but it looked like it was contained to a small number of cases in HK and that the authorities were doing the right thing ie quarantine. Since then, some of the truth has come out. The Chinese sat on their hands and given the fact that it is present in the far north (Beijing) and south (HK) as well as reports of multiple deaths in Shanghai, it has probably spread across China where it is the begining of their flu/cold season (RedFred).

Hopefully I am being an alarmist, but colleagues of mine who smiled at me two weeks ago are changing their tune. Its not like there is any treatment for SARS. All we can do is make people aware of the risk and try to reduce the rate of transmission. Personally, I think its a lost cause. Unlike other emerging diseases that cause flash epidemics but havent spread worldwide I think SARS will be around for a long time. I'm gearing up to run diagnostics in my lab now.