How fast is the progress of SARS in a population, who are most at risk in the US, and are there any prophylactic measures to be taken?
I don’t know how fast it spreads. In China, where there are more cases than anywhere else, the pace seems rather slow compared to, say, influenza. More than one person has commented that if SARS spread as fast and as readily as influenza, there’d be millions of cases, not thousands.
The only prophylaxis seems to be to use precautions like avoiding people with SARS risk factors who also have fever or respiratory symptoms.
What’s the general atmosphere in the wards/containment areas
It’s actually very professional, very inspiring in a way. People are proud to do this and want to set an example for each other. So, everyone takes precautions and there’s no bravado. Everyone double checks everyone else. I imagine that’s a pretty common mindset for the military or police, but I hadn’t seen this before in my experiences in medicine.
There’s some fear too. And a bit of fatalism. More than once, I’ve heard comments to the effect of “It’s just a matter of time before I get this”.
What precautions are you clinicians taking to keep from getting it?
Very strict restrictions on hospital visitors. In fact, essentially no visitors for a month now. And, anyone, doctor, nurse, CEO, anyone with a fever, flu-like aches, cough does NOT get through the front door.
All patients with fever, cough, etc. are assumed to have SARS (unless there’s an obvious alternative explanation). So, any patient with a fever, cough, etc., is isolated and cared for as we do for a real SARS patient (see below).
For a “confirmed” SARS patient, we do NOT use space suits (believing them to compromise both dexterity and viral protection (!)). Instead, we gown, double glove, goggle, use hair nets, have an additional visor in front of the goggles, and pay meticulous attention to using cleansing soultion between each step as we “de-cloak”. We also remove the parts of our apparel gingerly and in a way to minimize dispersion of virus. The gloves, gowns, goggles, visors, nets are one-time use only. And, of course, all patients are in isolation rooms - in our place so-called “negative pressure” rooms.
I travel fairly regularly abroad. What areas should I be concerned about?
AFAIK, China and Hong Kong are the key worry areas. Things are coming under control in Singapore and Vietnam. This is the type of question you’re better off checking out at W.H.O. or similar.
Does the media-proported mask idea really work? Should I wear one of those dopey, paper-thin masks if I’m working with locals?
Masks are effective but not needed unless there’s SARS rampant in the community (as there MAY be in Hong Kong or China). Any mask will give some protection since the virus is believed to travel in rather large droplets which are stopped by even “cheap” masks. The virus particle itself is only stopped by masks of the N95 or similar type. Such masks are overkill for the general population (IMHO)
I should also point out that there’s some evidence that SARS survives on inanimate surfaces. This consideration makes the use of gloves important so long as the wearer remembers not to touch his face etc with them!
What are the initial signs/symptoms? Is there anything specific I should look out for? Anything different from say, the common influenza virus?
Great question. In most cases the first symptoms are some combination of fever, muscle aches, or sense of unwellness. Pretty non-specific. Sometimes there’s just a headache or a bit of diarrhea or a sore throat. A runny nose is rare and seems to essentially rule out SARS. Breathing trouble and cough tend to be later manifestations.