Why the hysteria over SARS

Factual Questions
21

Considering the disaster several cruise lines suffered as a result of the Norwalk virus that’s not surprising. Remember, the Norwalk virus was similalry preventable by dilligent handwashing etc. (intead of “droplets infecting through mucous organs like the eyes and nose” it was “ingestion of fecal material” – I don’t know which disgusts me more.)

Lissla as far as I know, Toronto residents may travel if they are not infected – if they were known to be infected they would be quarantined and going nowhere for a couple of weeks.

22

Diligent handwashing, etc. may not prevent SARS. I find that scary, as a health care worker. Norwalk hurt the cruise companies, and your good point is well taken. But I don’t think companies banned people from taking a cruise because of Norwalk; the prices just fell a lot.

23

The current Toronto fatality rate is 6%.

About 20% of people admitted to hospital in Toronto with a diagnosis of SARS wind up in the ICU undergoing mechanical ventilation. Of the three quarters of these who survive, no-one yet knows the long term consequences. As a minimum, one can expect some effect on lung function.

Despite vigilant precautions, and certainly much more than a lay person could undertake, doctors and other health-care professionals providing care for SARS patients are contracting the disease at an alarming rate.

Increasing evidence suggests that the SARS virus can survive on inanimate objects for up to 24 hours.

Believe me, you do not want this in your community.

24

No fever, and no known exposure- they’re being pretty careful about exposure right now. They’ve quarantined whole trainfuls of people for exposure. Well, parts of trainfuls, anyway.

No coughs, headache, or breathing difficulties. Looks like we’re good to go.

Ugh. I had Norwalk. Most miserable 24 hours of my life, just about. Fecal matter? Yuck, yuck, yuck…

25

There’s a day by day record of the number of cases, deaths and recoveries, but I didn’t notice any falality rate indicated on this site.

From the figures given, the death rate would be between 6% at best (deaths/total number of cases), and 11% at worst(deaths/deaths+recoveries). In any case, it’s significantly higher than 1-3%…

26

There are tests for it. Right now there are at least an antibody test and a RNA test. Supposedly the CDC is coming out with three more in week or so.

WHO has revised it to 5%, which isn’t all that high in my view.

27

When is hysteria ever in proportion?

28

Maybe not as a percentage, but in absolute numbers?

5% of China’s population is what, 5,500,000 people? That’s a lot.

If it goes world-wide that’s about 40,000,000 people. That’s a heck of a lot. That’s bigger than many entire nations

Of course, that assumes a fairly sophisticated medical system. Where that is lacking - or overwhelmed - the death rate will be significantly higher. Those with co-morbidities, such as HIV infection, will probably have a higher death rate.

A worst case sceanario, of course, but certainly one worth avoiding. Even if the death rate was 1%, if the disease is contagious enough and moves fast enough that would be a significant jump in the death rate in absolute numbers in a very short time. It would be quite disruptive and we’d all be going to a lot of funerals in the near term.

On the other hand - no need to panic yet. It’s serious, it should not be taken lightly, and quarantine is no fun but it hasn’t blazed out of control into a pandemic as of today.

29

And this little factoid widely overstates things in Toronto. Not a single, young, healthy person in Toronto has died from SARS.

Every single SARS death in Toronto has been a person who is eldery or has existing medical conditions. The latest victim of SARS in Toronto was a man of 99 years of age.

This virus preys on the old and the sick. The media has turned this into gross hyperbole.

30

The same could be said of West Nile, but it’s cold comfort at the funeral of a friend (and there were several for us) to be told “it only kills the old and infirm”. If the “old and infirm” person is a loved one it hurts just as bad as if they were young and vigorous.

Or do you limit your associations to just young, healthy people?

31

Here, take this 20-chamber revolver and point it at your head. Hey, there’s only one bullet in it! Spin away.

32

The biggest danger about SARS is that it is affecting the health care personnel by the droves. Once the health care people are gone, or the health system is badly taxed, how can the health system cope with SARS and the normal daily health problems the populace has?

Second, the statistics for SARS may not be impressive may be due to the fact that governments are already taking strict measures. It’s like saying the bullet is not deadly because I am wearing a bulletproof vest.

Third, a testing kit for it is currently still in the works. I recalled from CNN that an American kit will be out in “ten days time” (when I read it). I suppose it is not out yet because it is not heralded on CNN or the local newspaper (Singapore being badly hit by SARS). The testing kit designed by Singaporeans has to be re-evaluted again.

Fourth, the fear and hysteria generated from SARS is more damaging than SARS itself. So it’s the prevention of its spreading and the clean-up work involved. But if we be gung-ho about it and something bad really did happen, who will bear the responsbility? China ‘hushed’ it up and perhaps hoped it will go away, or perhaps want to acknowledge it when the time is right (IIRC, the Communist party don’t want any bad news till the elections are over).

Say a resturant’s employee has SARS. Would anyone want to go there and eat anymore? Being hysteria is one thing, but merely execerising caution is another. Why take the risk? So thought the general populace.

Then countries depending on tourism will suffer. Who will visit the place where an infectious disease, no matter how less infectious? People, in the end, tended to be rule by ‘gut feelings’ and sometimes do irrational stuff. The survival instinct rules strongly.

Fifth, from my limited understanding, the Eloba virus seems to be deadly, much more deadlier than SARS - but the spread of it seems to be confined to one area? I never heard of SARS here (but ‘here’ being a puny rock of an island), or in Asia, or in US…SARS somehow becomes ‘global’. I guess we’ll be dead by now if Eloba is as widely-travelled as SARS.

33

SARS does not just prey on the weak and sick alone. A 22 year old lady designer and a 30 year old doctor died here.

However, it is accurate to say most of the fatalities are the old and weak. It just that untreated, SARS is likely fatal and while you are treating it, you are likely to get it, and so the cycle goes.

34

Here is what I said:

Since when do the facts overstate anything? Every point in my post was 100% accurate.

You are wrong and misguided.

Do you have a clue what it means to be on a ventilator? Do you know the cost in terms of health? In terms of dollars?

35

>> This virus preys on the old and the sick

As well s those who wear white lab coats and work in hospitals.

36

Unless you’re in HK. Another youngish person (39) died today with no prior medical conditions. :frowning:

37

People are terrible at risk assessment. Ask the average person, and they will tell you they worry about the plane crashing when they are more likely to be killed in the car drive over to the air port. I remember the sniper in DC/VA/MD a few months back. People were petrified, didn’t want to go out of the house, were constantly on the lookout, etc. But the sniper only killed a dozen people (albiet it was a horrible thing to do and I take nothing away from the victims and their families). In the Washington DC metro area, more people died driving to work in that same period (I read this statistic somewhere but don’t have a cite so take it with a grain of salt). The point being people seem to worry about things that have a lesser chance to kill or hurt them, while ignoring things that have a greater. I think that it has to do with our sense of ‘control’ of the situation.

Same with diseases. People worry about SARS, when they are more likely to be killed by Influenza (which still kills thousands a year, even in industrial nations). People die in the hundreds of thousands from heart disease and cancer due to smoking each year. It probably has to do with fear of the unknown. SARS is new and scary (and has tons of media hype atm), where as people catch the flu (and cancer and heart disease, etc) all the time. Some times you just have to shake your head… :confused:

-XT

38

Maybe we shall let the SARS virus run unhindered for a few months, and then instead of risk assessment, do a damage assessment. Do we want to find out how much damage SARS could do before taking action against it?

SARS is not like the lone sniper in DC. That sniper did not train and get more snipers. SARS multipes and passes from people to people.

And behold the manpower that DC utilises to hunt down the snipers! <sarcasm> It’s just one or two sniper! There’s million of people in DC. Less than 0.0005% are killed by this sniper. It’s no big deal!</sarcasm>

People die from heart diseases, but they don’t suddenly die within the span of ten days. People with heart disease do not spread heart disease. People with SARS do spread SARS.

Influenza can kill more people than SARS, but right now SARS is doing the killing, not influenza, so maybe that’s why the governments are concerned about it. Wonder why the spotlight are not on influzena instead…

I do heard that influenza is easier to spread than SARS, though

Pardon my ignorance (since this board is dedicated to the fighting of it), are there still active hotspots where influenza is spreading and causing a lot of deaths? (Never took biology in schools)

Just my opinions.

39

Not to flog a dead horse, or anything. As head of an emergency department, I might even know more than Urban Ranger about the practicalities of dealing with this. I wouldn’t know as much as KarlGauss, though.

There is no test. If someone walks into my emergency room now, I cannot tell if they have SARS. I cannot test for it. A number of companies have said they may have tests in the future. So far, these tests (based on coronavirus) would be completely useless – 40% of people in the community with mild bronchitis are testing positive on preliminary tests, and the test is missing about half of the cases of SARS. I’m not going to dwell on specificity, but a good test has to be right (either tell me the patient does or does not SARS) at least 95% of the time, and no one is close.

There is also a big difference between cure and treatment of symptoms. I think you asserted in another thread that SARS can be treated, but that seems to mean far more to you than it does to me. Intubating and ventilating a patient is not the same as giving them a medicine that helps fight the illness itself, and rivabarin probably isn’t cutting it.

I think Public Health has done a good job of making the dangers known and reacted appropriately. I think governement and emdia have done a terrible job of reassuring the public and that this failure has many needless economic consequences, which are still a small price to pay compared to those that would have been suffered if the epidemic was worse. (Slaughtering a few mad cows is better than slaughtering many healthy cows).

40

Wearing masks. My understanding is, that a virus is small enough to pass through most grades of mask, but the droplets produced while talking, coughing, sneezing are big enough to be stopped, probably even by homemade cloth masks. Only as the droplets evaporate do the viruses stand alone.

So Subject A wearing a mask cuts way back on Subject A giving SARS to Subjects B-Z, and the more of the population wearing masks, the fewer new cases are created.

Is this correct?

Second, Contagion. I read somewhere that if SARS was as contagious as influenza, instead of several thousand cases, there would be a million by now.

That is, SARS is more contagious than leprosy, Ebola, kuru, etc, but less than flu and colds.

Is that correct?