Why are a higher percentage of Canadians dieing of SARS?

[SpencerH]

Originally posted by Urban Ranger

It has been speculated that hot weather inhibits the virus. That's why you don't see a lot of cases in tropical countries including Vietnam and Singapore.

Its possible but I doubt that. HK isnt exactly cool. Singapore is essentially a dictatorship so they were able to close down travel from China and quickly quarantined the infected population (as did Vietnam). Even so, their index case infected and killed most of her immediate family and some close friends.

This is from the Singapore govt Apr 2

"To date, 91 cases have arisen from the first index case, comprising 45 family members, friends or close contacts, and 46 hospital staff.

So far, apart from the first imported case, the 6 other imported cases have not given rise to any SARS cases. "

As of today they have 195 SARS cases and 18 deaths.

[Willem]

Originally posted by Lancer


So, my point is that we're dealing with a cold gone mad, but still a cold. You can get them again and again...

But you're not necessarily getting that same cold again, there's small variations within the virus. Once you overcome one particular strain, you're much less likely to get it again.

[yago]

http://news.bbc.co.uk/2/hi/health/2977035.stm

Death-rates update.

[Willem]

Originally posted by 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.

More media hype. The mortality rate from West Nile is something like 1%, and almost always they're people who are already immuno-compromised by some other condition. To get overly concerned about it is just being paranoid.

And no it's not in the NWT, it's a warm weather virus at the moment, it hasn't moved much past the US border. They're not even sure yet whether it can survive in that type of climate.

[Willem]

Originally posted by Lancer


I hope this thing mutates out of existance. Could it be that the longer SARS is in human beings the less nasty it gets?

Probably, provided it doesn't mutate into a zillion strains. As a coronavirus, measles as well as the common cold, our bodies seem to be pretty good at developing antibodies against them. If you get them once, you'll probably never get them again. It may end being just another of those childhood diseases we all have to go through.

But then of course, we still know very little about it.

[Seeker]

Any biology types want to tell us what this 'hyper-carrier' 'hyper-transmitter' thing some articles are on about is....umm....about?

They seem to say that some infected people are hundreds of times more infectious than normal, so that while it's like a cold for most people, when a 'typhoid mary' walks into a hospital ward, she can potential infect the lot just walking around for a few hours.

[Lincoln]

Sorry for the long post but I thought that this first hand report from Rural China was worth posting here:

===============================

I'm an American living in the countryside of China. I've been in this country for four years now.

I've also lived in Beijing, Shenyang and Shenzhen. I have friends, foreign and Chinese, all over the country, who have also clued me in to the situation where they are.


HUBEI PROVINCE

The town I live in is not far from Wuhan, in Hubei province. The official word is that there are no cases in Hubei, except a couple in the capital, Wuhan. Information is tight, and as many of you have probably guessed, despite official claims of forthrightness, the central government still considers this a matter of internal security, and is still reluctant to reveal all of the truth. As for this province, my friends in the hospitals here in this city have informed me they definitely have cases of SARS. In an even smaller village about an hour from here, a class of high school seniors volunteered that there were "no SARS cases in their class."

"That's great, but what about in the rest of the school?"

"Um," they replied, "maybe."

The school's administration, however, has consistently told people they will close the school if even one case shows up. Everywhere, people are wearing masks, and everywhere they are disinfecting.

What is disinfecting? Key to understanding this is to understand two things about Chinese society: their ideas of germs and their ideas about work. ALthough the Chinese are clean, they are clean according to the understanding they have. In the countryside--almost everywhere, and even somewhat in the big cities--they do not understand germs very well. They believe things are clean when rinsed with water, never cover their mouths when coughing or sneezing, spit and blow their nose into public places and all manner of similar things. So, trying get them to understand these new ideas about cleanliness is difficult, to say the least, and especially among the older folks.

The second part--their ideas about work--also play into this. Most large entities or businesses hire far more people then are really essential to the operation of that business. This is because there are so many people--to provide enough jobs there have to be a lot of "make-work" jobs. IN Beijing, for example, in order to benefit smaller provinces, all schools and businesses are required to hire 24's worth hour guards from poor provinces and the countryside. Those guards work many hours a day, live in a shack on the business property, have their meals provided at the canteen, along with their uniform, and anywhere from 1-10RMB a day. (That's about $.12 to $1.24). It's not much, but then, many of these folks do no actual work. So, at a business of any kind you will find not only guards, but a separate person for each job--there is no "secretary" that does many things. There is one man who only makes copies. Another that only types headings on papers. Another that only drives the company car, etc.

So, when you hear that everything is being "disinfected," you have to bear in mind that what is happening is that people who normal spent the vast majority of the working day either smoking, sleeping, chatting or reading the newspaper, are now being ordered to spend all day disinfecting things. HUman nature being what it is, who would want to increase their work load 100% for 0% increase in pay? The result is a haphazd job in many places. Not knowing much about hygiene, many "disinfectors" only spray down the floors of a place with bleach water. They don't wipe anytthing, they don't spray doors, windows that are opened and closed, handles, faucets or knobs. Unless people are licking the floors with their tongues, the current method of disinfecting in this area is pretty much useless. I've heard similar comments from many other foreign friends throughout the country.

In Wuhan, there are one or two admitted cases, but the situation is almost assuredly much worse. Aty least one of the universities has stopped classes for now, and many people are leaving the city. A Chinese friend of mine who studies there says that she knows 40 people have died there from SARS. Of course, that might be panic on her part, and where there is little information, people will always assume the worst because that's the only way to keep safe. This has caused a lot of people to leave Wuhan for their surrounding countryside, ensuriing that there will be more spread.

Foreigners here in this province are not being specifically urged to go, but are being given every help if they wish to do so.

LIAONING PROVINCE:

In Dalian, the vacation retreat for China's elite, a friend working at a school there has let me know the situation at that college. The students claim there are cases at that very school, and have many of them stopped coming to class. Those who do are masked and ready. However, the school officials are telling their foreign teachers that not only are their no cases at the school, but not even any in the whole province. At the same time, constant disinfection is being done on the campus, and they are also being told they are not allowed to leave the school unaccompanied, to travel anywhere in China, or to have guests in their homes. They are also being told they are not free to go home--and that they will be accused of breach of contract if they try.

One of the foreign teachers has a relative back home is quite ill with cancer. The teacher had planned to go home for the May 1 holiday and see him. When the holiday was cancelled, this teacher continued with the plan--the tickets were already bought. The teacher was called in and the school tried to force the teacher to remain in China and teach through the holiday. When the teacher put up a big enough stink, they relented, but saved face by calling the teacher into the president's office, specially, so that he could inform them that they, "in their kindness, had decided that the teacher would be allowed to go home."

This is just one example of how a "policy" handed down by the central government, is ignored, mutated, accepted or turned to personal benefit by the different provincial and local governments and businesses. Down in my province, where there "is no SARS" the students and everyone has holiday from May 1 to May 5, regardless of the directive, because that is what people want. In Liaoning, which also "has no SARS," this school is working straight through, without even one day off on May 1, undoubtedly so they can get more work out of their teachers and more money from their students. (private schools here are a real racket).

GUANG DONG PROVINCE

I have friends working in a small city there. They report that where they are there is almost no information concerning what is going on, and that very few wear masks. The next city over has been quarantined (the entire city). But, despite all that has happened, people in the smaller countryside areas seem largely unaware of SARS and its potential

An American group is still planning to continue their summer teaching program in this city. They'll be bringing 18-22 year old college students to Beijing, and then to Guang Dong for about 4 weeks. Nothing we can say will convince them of the idiocy of this plan. They are determined, and we can only hope that the US will stop flights to China for a time.

HEBEI PROVINCE

There is a small village here, called Xuan Hua. If you look for it on the map, you probably can't find it. It is a couple hours from Beijing. It's also home to a lot of the Falun Gong re-education camps. Although there are very few people there, and very little interaction, relatively, with the "outside world," there are 6 cases that my friends know of, personally. There really are no hospitals here--just clinics. What is happening with these patients, what hope they have. Who knows?

[The Mad Monk]

Sars death rate 'higher'

The death rate for Sars could be significantly higher than previously thought, according to an British expert's study into the pneumonia-like virus.
The research by Professor Roy Anderson, due to be published in a medical journal next week, is expected to say the virus could kill between 8% and 15% - or one in seven - of those infected.

The World Health Organization (WHO) had predicted a death rate of 5% to 6% and said the virus could be beaten if countries worked together to stop it spreading.

A WHO spokesman said Professor Anderson was a top class professional and his findings were probably accurate.

Latest figures show Sars has infected an estimated 4,649 people in 26 countries around the world. So far more than 274 people have died, with most sufferers making a full recovery.

Higher death rates

Professor Anderson, of Imperial College, London, who is one of the world's leading authorities on infectious diseases, told the BBC: "If one looks carefully at the WHO figures on mortality and recovery rates, it is running, unfortunately, at 10%."

The new research was based on the study of the 1,400 or so cases in Hong Kong.

It appears to be contained, certainly in developed countries, by very good containment and monitoring practices

Professor Roy Anderson


Sars death toll rises
Prof Anderson analysed the spread of Sars in Hong Kong, where 121 people have died so far.

He calculated that between 8% and 15% of those who contracted Sars would die.

His research also found Sars remained infectious much longer than other viruses.

But Prof Anderson told the BBC that media speculation about Sars had exaggerated the problem facing the world.

He said the higher mortality rate was not the most important issue as so many other health factors could influence a patients' death.

Prof Anderson said: "If this was a highly transmissible agent that was spreading like wildfire then of course there would be huge cause for concern, but it is not.

"It appears to be contained, certainly in developed countries, by very good containment and monitoring practices.

"The concerns lie in the large populous regions of the world: China, India, Indonesia, where the disease reporting systems are limited and it is much less clear to work out what is going on there.

"This just reminds us that we are a globally mixing community and what happens in one corner influences us all."

Working together

On Saturday, **** Thompson, a spokesman for the WHO's communicable disease section, said: "We have not seen the report so we could not comment except to say that this is a top class professional and any figure he commits himself to is likely to be as close as possible to accurate."

KNOWN DEATH TOLL
China: 122
Hong Kong: 121
Singapore: 20
Canada: 19
Vietnam: 5
Thailand: 2
Malaysia: 2
Philippines: 2
Source: WHO/ local health authorities
Map: Global overview
Timeline
WHO executive director of communicable diseases, David Heymann, said on Friday he believed the disease could be stopped if everyone worked together.

"What is important is for all countries to participate and to help prevent it getting in a place where it would be very difficult to stop it," said Dr Heymann.

Of the 26 countries that had seen Sars cases, 23 have contained it well, according to the WHO.

Officials have also taken comfort that it has not spread as easily as other viruses, such as influenza.

There have been six probable cases of the virus in the UK, but no deaths.

A group of school children from Cheshire returned home early from a cultural exchange visit to Beijing on Saturday.

Two members of staff and 21 youngsters from Knutsford High School in Knutsford, had been due to return from their cultural exchange visit to Beijing on Sunday but came home a day early.

http://news.bbc.co.uk/2/hi/health/2977035.stm

Thanks to Drudge for the link.

[Seeker]

"this school is working straight through, without even one day off on May 1, undoubtedly so they can get more work out of their teachers and more money from their students. (private schools here are a real racket)."


To be fair, that is general thing that happens to foreign English teachers.

We had a **** of a hard time getting three days off for a goddamn funeral.

Even sickness, the contract is a piece of paper to them. You have to be immobile, otherwise show up. Flue, cold, they don't care. One reason is that you're irreplaceable. There is no one who can 'cover' for you and the students can't just be sent home, so if a FLT isn't there the so-called 'system' is thrown into chaos.

Search for "Blacklist Korea" or "Blacklist Hagwon" for some real horror stories....(violence, lies, threats, etc)

[SpencerH]

Originally posted by Seeker
Any biology types want to tell us what this 'hyper-carrier' 'hyper-transmitter' thing some articles are on about is....umm....about?

They seem to say that some infected people are hundreds of times more infectious than normal, so that while it's like a cold for most people, when a 'typhoid mary' walks into a hospital ward, she can potential infect the lot just walking around for a few hours.

We dont know if super-spreaders even exist. The term comes from ideas generated for HIV infections where it looked like one person was able to transmit the infection more succesfully than others. I couldnt find a link so I'm going on memory from our departmental briefings but some of the infections from the HK index case were due to the most casual and short-term contacts.

The phenomena could could be due to variance in the organism, the host, or behavioural/treatment differences. Whether super-spreaders really exist or not is unclear, but its hard to understand the epidemiology of the disease in places such as Singapore without at least considering the possibility of their existance.

[Lancer]

Willem, thanks for the replies. I hope it mutates into something harmless or is totally contained, or both.

[Willem]

Originally posted by Lancer
Willem, thanks for the replies. I hope it mutates into something harmless or is totally contained, or both.

Yes, so do I. I have a feeling that it will blow over fairly quickly, The disease seems to have a fairly fast burn out rate, 10 days and you're in the clear. The important thing is whether we can keep it contained. I read on the Toronto Star site today that the number of people quarantined is down to 30 now, from 80 last week, which is a good sign.

I have to hand it to the people in the medical profession. Even though there's been a few blunders here and there, they've done a great job of identifying and isolating it quickly. I think we're developing a pretty good international system for dealing with infectious diseases. There's still a few kinks to work out, but overall the situation has been handled quite well, I think.

I just hope that people don't start going off the deep end and getting paranoid about it. It has been a fairly limited outbreak so far, and it's looking like it's already fading away, at least here in Canada. China might be a different story though, we'll just have to wait and see.

[SpencerH]

Originally posted by Willem

It has been a fairly limited outbreak so far, and it's looking like it's already fading away, at least here in Canada. China might be a different story though, we'll just have to wait and see.

Thats kinda the point though. The situation in Toronto arose from a single index case. If the Chinese dont deal with it effectively they will be a continuous source of these infections.

[Willem]

Originally posted by SpencerH


Thats kinda the point though. The situation in Toronto arose from a single index case. If the Chinese dont deal with it effectively they will be a continuous source of these infections.

Well it sounds like they're finally trying to get on top of it now though, they've essentially shut down Beijing. And if it's too late to contain it there, at least it will be easier to keep it from spreading around the world, with the disease confined to one particular region. That's much better than having it spread out from a wide number of focal points. I just read that Vietnam has had no new cases for 18 days now so it looks like overall, the containment is working.

[mindseye]

The latest is specualtion that various strains are responsible for the differing mortality rates.