SARS - Blown out of fucking proportion

The BBQ Pit
1

I’ve been reading more and more about SARS and I’m starting to think - big fucking deal.

CNN had this article - New SARS outbreak fears - which says “SARS has infected at least 928 people in Hong Kong, killing 25, out of a total of more than 2,600 cases worldwide that have claimed at least 104 deaths.” This disease has now become public enemy number one. Heck, yesterday at lunch a coworker asked us “What would you do if somebody gave you an all expense paid trip to Hong Kong?” I said I would go in a second (well, assuming I really cared to go to Hong Kong). They were surprised I would go. I said “well, are you scared about the flu?” They weren’t.

Well, why are they scared about SARS but not the flu? According to the CDC - Influenza: The Disease - “An average of about 36,000 people per year in the United States die from influenza, and 114,000 per year have to be admitted to the hospital as a result of influenza.”

So, I say: People (not you personally, but to ‘them’), SARS sucks but BIG FUCKING DEAL!!! What the fuck is with all the panic? Go duct tape yourself in your safe room with the plastic sheathing. [obligatory Bush rant] And fuck you Bush Jr. for adding to the fear in America with this - Bush order allows SARS quarantine [/obligatory Bush rant]

Gee. I hope I haven’t added to the hysteria by talking about the flu. :smack:

2

I think the biggest fear about it is that it doesn’t readily respond to current treatments. That and the “super carrier” thing. Christ! That one woman killed both her parents, a sibling, a priest, and an aunt or something. I don’t think it would stop me from travelling to the far East, though. I’d go if I had to.

3

So you don’t believe an incurable, extremely infectious new disease with the same death rate (both in the 3-5% range) as the WW1-end flu pandemic which killed 20 million people is of concern?

Let’s all be thankful that the world’s health experts don’t share your complacency.

4

I understand Fin’s frustration. I think it’s a little misplaced but I understand it.

Yes, this is being made a huge deal because it’s a great story and no media outlet wants to be caught on the wrong foot when the next huge killer epidemic races across the world. Combine that with the massively beaten drum of biological warfare and you’ve got overexposure.

But it is worth noting that a new disease (or possible unidentified variant of an existing one) has emerged and has started to burn its way through the population.

Certainly the CDC and WHO should be paying attention. I think Fin’s real question (and rant) is ‘Should the media outlets being giving us infection-by-infection coverage of it?’

And that a valid rant.

5

(From the CDC article):

“Millions of people in the United States — about 10% to 20% of U.S. residents — will get influenza each year. An average of about 36,000 people per year in the United States die from influenza, and 114,000 per year have to be admitted to the hospital as a result of influenza.”

That’s a mortality rate of less than a tenth of a percent, and mostly young children and peopld over 65. SARS so far is showing a much higher rate, around 3%, and has killed otherwise healthy people in the prime of life. The WHO doctor who identified it as a new disease, Dr. Carlo Urbini, died of it. (That’s always a big red flag to me, when doctors start dying of a previously-unknown disease.)

It appears to spread as easily as the common cold. So imagine if the cold killed about 3% of the people who got it.

We’ve been spoiled in the U.S., these past couple of generations, by not having any old-fashioned lethal epidemics. We have AIDS, but that kills very slowly. We haven’t had the kind of epidemic where hospitals are overrun by panicked people, and there isn’t enough morgue space for the bodies, not for quite a while. There’s no reason it couldn’t happen again, though.

6

Incurable?? If it is inurable, how do you explain that out of the more than 2,600 cases, about 104 died? What happened to the other 2,496 or so people? So, it’s not incurable.

Complacency, maybe. World-ending panic, hell no. Sure, the WHO and CDC should be working on SARS (which they are). But the media is (in my opinion) hyping the fuck out of this thing. To that, I am ranting - although not really clear in the OP.

and after previewing

Jonathan Chance - Amen my brother.

Baldwin - True, most of the flu deaths are either very young or very old. I have yet to find a SARS article that specifies the ages (or pre-SARS health condition) of those killed.

7

This is an example of the hysteria that Fin_man is complaining about. There are 2600 cases, 104 deaths, out of a world population of what, about 6 billion? This is not “burning;” it’s barely a glowing ember. Could it flare up into something worse? Perhaps, but if this disease were highly infectious, we’d have tens or hundreds of thousands of cases by now, not 2600. Hong Kong, for example, is a very crowded place; something easily transmitted would go through there like a dose of salts.

8

Fin_man: INCURABLE is, I believe, the correct word.

You do not ‘cure’ a viral infection - how many cases of 'flu do hear about being ‘cured’?

There are some antiviral drugs that help with some diseases, but none of them are a ‘cure’ and, last I heard, they often have some very unsavory side effects. Antibiotics don’t touch a virus. People survive viruses because their immune systems manage to eventually overpower the invaders. The only real treatment is supportive care - fluids to prevent dehydration and provide nutrition, medications and treatments to relieve some of the symptoms - like oxygen for those who no longer have enough lung function to filter enough from the air, and meds to keep temps at a safe level; in some diseases anti-diarrheals and/or anti-emetics may be necessary.

This is why immuno-compromised individuals - the elderly, the very young, diabetics, people undergoing chemotherapy, AIDS patients, etc. - are usually the hardest-hit populations.

One thing I think many of you are overlooking is that the fatality rate is not the only factor here - most of the infected people seem to have required rather extensive hospitalization. The hospitals in HK are already severely overloaded, and the fact that many health care workers have been infected only exacerbates the problem.

Another concern - I’m not familiar with human corona viruses, but I’m pretty familiar with feline corona virus, and it mutates like crazy and even recombines with canine corona virus. If human corona viruses are just as prone to mutation, SARS could potentially become very serious. (IF the causative agent is, indeed, a corona virus).

Many of the locales most concerned about this (besides HK) - Singapore, Malaysia, Vietnam, Thailand, etc. - undoubtedly do not have the resources to deal with a major outbreak of this disease, especially if their containment efforts fail and it begins spreading through the general population.

The media is misreporting and encouraging hysteria, like they always do - the ProMED list quit posting 99% of the news reports because of their unreliability, staying primarily with WHO and CDC reports, as well as info submitted by medical professionals that have intimate knowledge of events. However, the WHO, the CDC, and hundreds, maybe thousands, of medical professionals and other biological scientists don’t agree to global alerts, quarantine recommendations, etc. because they need a little ego boost, especially when there is already a war underway.

9

If you do not understand the difference between cure and recovery in calculating the lethality of a disease you really are not qualified to pass comment on the matter and certainly not with the arrogant certainty you displayed.

10

Extremely infectious… Yup, I can see that it has to be an incredably infectious pathogen to infect less than 700 people in hongkong since NOVEMBER.

11

The cats out of the bag. They’re not sure how it spreads. It’s very contagious. Hell, I think the media is under reporting it.

She infected two friends, and then they infected two friends. and so on, and so on, and so on…

12

Even though the Media is frying up a big hype about SARS doesn’t means that it is not a valid threat.

It is dangerous, yes. It is blown out of porportion, I personally feel yes. To say it’s a " big ~~~~ deal"? No.

  1. Doctors have no ways to identify the virus acucrately yet. According to the latest WHO reports, they have kits which work if the patients are infected for 20 or more days

  2. SARS cases are appearing every day, despite strict measures and containment. I wonder how it will be like if the government didn’t give a big deal about it.

  3. In Singapore, last week, the government believed that the SARS outbreak was under control. Then suddenly patients and doctors in a hospital who does not treat SARS patient suddenly fell sick. Seven or more has been identified with SARS.

The worrying thing is for all SARS cases, it could be tracked to a ‘super infector’ which could quickly spread disease. For the new series of outbreak, they have no idea how those patients got SARS, and who infected them because they weren’t in close physical contact with any SARS patient.

  1. It is quite evident that ‘super-infectors’ could spread the virus very quickly.

  2. There are speculation that there are people with SARS but are not sick with it, but could still spread it.
    I am quite sick of people saying “SARS would be uncontrollable” or “SARS mean the end of the world”, and I am not saying that the OP is completely wrong, but I would beg to people fed-up with over-hype media reports that there are people really sick with SARS and countries affected with it are suffering, whether the folks have it or not.

My mother has been over-reacting, telling me not to go out, forcing me to drink coke with onion and filling my room with the aroma of garlic mixed with hot vingear. So, yes, I am quite frustrated over the over-hyping and the frenzy reaction.

But please don’t belittie the effort of the hundreds of health care personnel at the frontline battling this virus (they are the one with the highest chances of contracting SARS), or the suffering of those stricken with it, or the potential of SARS’ deadliness.

Thanks in advance.

13

True, but given that mutations are random, is it not equally probable that the virus will mutate into a form that’s completely harmless to humans? In fact, since a virus that kills its host worsens its chances of spreading, wouldn’t evolution favor virii that don’t cause any ill effects in their hosts? How many of that variety are out there? Would we even know?

On another note, several posters have beaten up on Fin_man for confusing “cure” with “recovery.” Yes, they’re not the same thing. But Fin_man’s point remains: this is not a 100% fatal disease. Using the word “incurable” implies that you’re going to die from the disease, as in “incurable cancer.” If you get SARS, however, the odds are that you’re not going to die from it. The fatality rate is higher than that produced by most garden-variety influenza virii, but it’s a lot lower than smallpox or AIDS.

14

No offense to your mother, but this is eerily similar-sounding to Middle Agers carrying around sachets and pomander to ward off Plague. Things have not changed too much in 700 years.

I don’t know jack about infectious diseases, but I’m not going to worry too much about this one until the death rate, or at least the infection rate, starts showing something more geometrical than arithmetic. When this story first broke, there were, I think, 9 deaths without another death reported for several days afterwards. This is not Big Plague behavior, I think.

But what do I know. Wouldn’t it be ironic if I caught the thing now?

15

Has anyone figured out if you can be re-infected with SARS after going through it once?

Just wondering. Perhaps the human body could build immunity to it?

16

Ok, we have around 160 days since the SARS outbreak happened.

Lets assume once infected each person infects 2 people in turn. Lets arbitrarially say this happenes once every 10 days. Each infected person only spreads the pathogen for 1 10 day cycle…
Time point 0

1 infected patient

TP 1

2 IPs – 3 total

TP 2

4 – 7

TP 3

8 – 15

TP 4

16 – 31

TP 5

32 – 63

TP 6

64 – 127

TP 7

128 – 155

TP 8

256 – 411

TP 9

512 – 923

TP 10

1024 – 1947

TP 11

2048 – 3995

TP 12

4096 – 8091

TP 13

8192 – 16283

TP 14

16384 – 32667

TP 15

32768 – 65435

So since november assuming we’re dealing with reinfection cycles of 10 days we’d have a total of 65,435 cases in hong kong.

However, the virus has a much shorter incubation cycle than that, so lets call it 5 days.

We now have 30 infection cycles.

Time Point 30

New infections – 1,073,741,824
What’s a MUCH more likely situation is that the pathogen in bodilly fluids and can survive there for a fairly long period of time. In hospitals, it’s fairly easy for an ill patient to get a fair amount of bodilly fluids on bedding, and hospital staff who handle say the bedding with the infected speutum might not think about what else they touch before they change their gloves. Then someone else later comes into the room, comes into contact with the infectuous agent then infects themself. And thus we have someone contracting SARS with no direct contact.
Generally, if a pathogen is easy to transmit you’ll see a more or less exponential explosion in the number of cases. We’re not seeing it here. We are seeing isolated pockets of outbreaks and new infections in people who have occupational exposure to bodilly fluids of infected patients.

From everything I’ve read so far, the media is OVERREPORTING SARS cases. Take Canada’s protocol. Anyone with a fever, cough and fluid in their lungs is automatically called a SARS patient and quarintined. This is a GOOD thing, agressive containment = less spread. However, how many other diseases also cause the same symptoms? Without a reliable detection kit or assay protocol probably a lot of people with pneumonia not caused by SARS are being catagorized as SARS patients.

You start worrying about an outbreak when you see thousands of new cases showing up. When after 6 months there are less than 3,000 cases you make sure you wash your hands more frequently.

17

You generate immunity to EVERY pathogen you are infected with. Viruses infect cells using specific protein markers, these protein markers are what the antibodies your body creates to isolate and kill the virus.

14 days following initial infection you have a systemic immune responce as your body has generated cells producing antibodies specific to the invasive pathogen in your body. Those cells hyperproliferate and exterminate the pathogen.

Memory B cells/plasma cells are believed to remain in your body for decades or longer they can rapidly produce large quantities of antibody if you are reexposed to the same pathogen – same pathogen in this instance referse to serotype, pathogens can mutate and if their surface markers change enough the antibodies won’t work and a new serotype or STRAIN is generated.

This means, once you’re exposed to a specific virus, if you ever encounter it again your immune responce generates an immune reaction MUCH faster and MUCH stronger. Odds are you won’t even feel anything. This happens constantly as we are being exposed to pathogens constantly in our daily lives.

The question dealing with SARS is this: What’s the mutation rate? Pathogens like Rhino Virus and the Flu are unstable – they generate a high number of mutations during the viral lifecycle – the higher the mutation rate the shorter the amount of time between generations of new serotypes. Paramoxyviruses–Mumps–are very stable and don’t mutate noticably and thus you only contract them once in your life. The same goes with small pox, that didn’t mutate with a high frequency either.

18

I’m currently re-reading Stephen King’s The Stand.

And I have the sniffles.

:eek:

19

I love it that we have people like CRorex on these boards, how cool is that. Need an expert WAG? It seems we have an expert for every field represented. Thanks.

20

Thank you Early out. I am going by the definition in my Webster’s II New Riverside University Dictionary of incurable: Not curable: Hopeless. Well, it’s not hopeless. The definiation of curable is Capable of being healed or cured. So, by both definition and implication, incurable SARS is not.

And since this is the Pit, tagos, kindly fuckoff you drippy-dicked fuckwad (wait, that’s a different disease)