Post #92,790
3/29/03 9:30:18 AM
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Third hand scary SARS rumor
Just so that everyone knows. This is my report of discussion that my wife was in in the wards of Bellevue Hospital. This discussion was started by a medical student who was present at the event in question. That makes it word of mouth and third-hand (medical student to my wife to me). Salt the information accordingly.
Bellevue has apparently seen 6 suspected cases of SARS, of which one was an "index patient" - which I believe means considered confirmed and part of the official count of US cases. As you might expect they were put in isolation, etc, and the hospital contacted the NY State department of health about what they should do with these. The instructions that were followed were to send the patients home with instructions to stay inside.
The medical student understood the sense of this instruction. It takes a lot of resources to keep people isolated in a busy hospital environment. What bothered the medical student was that these people were sent back into the general public, presumed infected and without face masks. Some conversation ensued, the details of which I will spare you. (Suffice it to say that sleep deprived and stressed out people - that would be virtually anyone in medicine - tend to become highly irrational and are prone to accept and justify anything which makes their lives easier...including unreasonably concluding from a too small sample size that the US somehow has the luck to have aquired a "more benign strain" of a disease. Gah.)
Ain't it comforting to think that 1 confirmed and 5 suspected cases of SARS may have been released into the general public a 5-10 minute walk from where I live? My uninformed speculation on why they might have done this is ranged from idiots at the department of health to their trying to conserve resources because they think of this as a lost battle...
And that ends this unscheduled episode of first-hand rumor hour...
Ben
"good ideas and bad code build communities, the other three combinations do not"
- [link|http://archives.real-time.com/pipermail/cocoon-devel/2000-October/003023.html|Stefano Mazzocchi]
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Post #92,791
3/29/03 9:52:16 AM
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Further spread in Canada
Yet Another Hospital Closing: another hospital in Toronto has been closed and a couple of thousand people have been added to the quarantine list. There is a sense of some panic beginning to emanate from the top people at the health unit in Toronto; they're beginning to be concerned that the disease has run away in Toronto, I think.
Reports from China are that entire cities are being shut down because of the effect of this, and people are raising serious questions about why the authorities didn't start screaming for help on this back in February when it first came to light in Quandong province. The disease has been reported in Beijing, Shanghai, Hong Kong, and in other major metropolitan centers (the Chinese student that lives in my house is from Beijing, and he's freaking out a bit).
I wonder if the quietude on the issue in the US is because they're concerned about the effect widespread knowledge of this might have on public support for the war effort? Sending them out without face masks would fit with that... if people started seeing people coming out of hospitals in face masks, it would end up in the news, and that could perhaps blow the lid off the issue in the media.
--\n-------------------------------------------------------------------\n* Jack Troughton jake at consultron.ca *\n* [link|http://consultron.ca|http://consultron.ca] [link|irc://irc.ecomstation.ca|irc://irc.ecomstation.ca] *\n* Kingston Ontario Canada [link|news://news.consultron.ca|news://news.consultron.ca] *\n-------------------------------------------------------------------
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Post #92,794
3/29/03 10:15:56 AM
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That is a better theory than any I had
And if that is so then [link|http://www.despair.com/meetings.html|http://www.despair.com/meetings.html] sums of my opinion about the people who thought that gem up. :-(
Ben
"good ideas and bad code build communities, the other three combinations do not"
- [link|http://archives.real-time.com/pipermail/cocoon-devel/2000-October/003023.html|Stefano Mazzocchi]
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Post #92,792
3/29/03 10:05:30 AM
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Man, this is bad
The doctor who first identified the disease (employed by the WHO) has just died of it in Thailand.
Also, the WHO has now added Canada to the list of countries that are sources of SARS, and suggests that we screen outgoing air travellers for the disease. Noises are beginning to be made about invoking the quarantine act for passengers arriving in Canada from Hong Kong; that would mean quarantining incoming travellers for (I think) 20 days: twice the known incubation period. They're talking about invoking that if a new wave of cases happens in Hong Kong. There are also rumblings about bringing out the big guns of disease containment, and enforcing quarantines by force if necessary.
Ben, I know it could be financially ruinous for you, but perhaps you and your family should consider getting out and heading for the hinterland, esp. if the health authorities are either ignoring it or have already given up on the idea of containing the disease and are simply trying to minimise panic.
--\n-------------------------------------------------------------------\n* Jack Troughton jake at consultron.ca *\n* [link|http://consultron.ca|http://consultron.ca] [link|irc://irc.ecomstation.ca|irc://irc.ecomstation.ca] *\n* Kingston Ontario Canada [link|news://news.consultron.ca|news://news.consultron.ca] *\n-------------------------------------------------------------------
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Post #92,793
3/29/03 10:06:34 AM
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I've been told it's in Windsor as well
Many of my co-workers live there...
Regards,
-scott anderson
"Welcome to Rivendell, Mr. Anderson..."
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Post #92,796
3/29/03 10:55:54 AM
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We haven't heard that up here
That's not to say that it's not there, though.
--\r\n-------------------------------------------------------------------\r\n* Jack Troughton jake at consultron.ca *\r\n* [link|http://consultron.ca|http://consultron.ca] [link|irc://irc.ecomstation.ca|irc://irc.ecomstation.ca] *\r\n* Kingston Ontario Canada [link|news://news.consultron.ca|news://news.consultron.ca] *\r\n-------------------------------------------------------------------
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Post #92,795
3/29/03 10:51:35 AM
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It would be financially ruinous
And if public health policy fails, then I don't know where it is possible to go where you can reasonably avoid it. :-(
Therefore the best that I can think of to do is pass the tip onto a couple of reporters who I think might be interested. This I have done, but I don't know if either of them will take the tip...
Cheers,
Ben
"good ideas and bad code build communities, the other three combinations do not"
- [link|http://archives.real-time.com/pipermail/cocoon-devel/2000-October/003023.html|Stefano Mazzocchi]
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Post #92,797
3/29/03 10:57:38 AM
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Might not be a bad idea to prep yourself
for either bailing out or and extended in-home stay, though. You might have a very different view of the cost/benefit ratio after a few more weeks have passed... nothing wrong with hoping for the best and preparing for the worst.
--\r\n-------------------------------------------------------------------\r\n* Jack Troughton jake at consultron.ca *\r\n* [link|http://consultron.ca|http://consultron.ca] [link|irc://irc.ecomstation.ca|irc://irc.ecomstation.ca] *\r\n* Kingston Ontario Canada [link|news://news.consultron.ca|news://news.consultron.ca] *\r\n-------------------------------------------------------------------
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Post #92,805
3/29/03 11:34:20 AM
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I like avoiding unproductive panic
Where I can see constructive things to do which improve my personal situation or the world, I will. But where I don't, I won't take action just for the sake of feeling like I am doing something.
Right now the immediate risk is low. The situation ticks me off, but I am not in imminent danger. It won't keep me from going about my normal business. Yet.
In a few weeks I will cheerfully don a surgical mask with the rest of them. And will then restrict how much I move around. And yes, I will take advantage of opportunities not to have to stay in this population center as they arise...
Cheers,
Ben
"good ideas and bad code build communities, the other three combinations do not"
- [link|http://archives.real-time.com/pipermail/cocoon-devel/2000-October/003023.html|Stefano Mazzocchi]
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Post #92,861
3/29/03 3:17:27 PM
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Sounds like a good time to update PHP though...
PHP:
n.
1. Acronym: Public Health Pantry. A place for storing personal items, mostly food, in case of public health disasters. I just restocked mine with a month's worth of food, usually cheap and canned, with expiration dates over a year and a half from now. Plus a bottle of Vitamin C; I have a multi-vitamin on the shelf already. Might as well buy those things now. It was about $40. As the expiration dates approach, consume and restock. Good blend of panic and forethought. :)
Many fears are born of stupidity and ignorance -
Which you should be feeding with rumour and generalisation.
BOfH, 2002 "Episode" 10
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Post #92,811
3/29/03 12:10:15 PM
3/29/03 12:43:51 PM
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The story has been mentioned in mainstream media
[link|http://www.newsday.com/news/health/ny-hsmyst293196741mar29,0,3674550.story?coll=ny-health-headlines|http://www.newsday.c...-health-headlines]
Obviously without my commentary, and without the obvious questions being asked.
The only way that I can square this with what I heard directly is if the reported figure only includes the "index patient" and not the other 5 questionable cases.
From what my wife was saying, I have little confidence that they really have any way to identify what is or is not SARS at this point. Which makes me seriously wonder about the official statistics that I have seen so far...
Ben
PS My understanding from the reported conversation at Bellevue is that medical staff would not report anyone without a travel history putting them at risk as having SARS. That makes the official report of "no evidence of transmission within NYC" a self-fulfilling conclusion. Now I really wish that I knew more about why those 5 "non-index" patients are not being counted in the reporting...
"good ideas and bad code build communities, the other three combinations do not"
- [link|http://archives.real-time.com/pipermail/cocoon-devel/2000-October/003023.html|Stefano Mazzocchi]
Edited by ben_tilly
March 29, 2003, 12:43:51 PM EST
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Post #92,822
3/29/03 1:05:30 PM
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They're only reporting index patients?
Oh, that's no good. Index patients (ie- exposed from outside as opposed to catching it here) is perhaps 3% to 5% of all reported cases in Toronto. So, if the ratio is app. the same, five reported cases equals probably about a hundred to a hundred and fifty actually extant... and since all index cases here have been immediately placed into isolation since the health unit in T.O. figured out what was going on, the rate of infection might be higher.
Fortunately, the situation in Vancouver from the initial patient is that they managed to keep it under control, with no new cases reported among hospital staff there. OTOH, fourteen people arriving from Hong Kong were immediately whisked off to isolation from Van's airport yesterday.
In an interview on CBC radio this morning, the chief nurse at Van's big hospital was saying "maybe we had better procedures in place, maybe the patient wasn't as infectious as the person in Toronto, or maybe we just got lucky: I don't know."
Confirmed cases are being put in negative pressure rooms, with staff wearing full protective gear up here. They (er, the health unit folks) don't really know how transmissable it is, but I think they may have seen some evidence that scared the shit out of them on Wed. night or early Thurs. morning because they suddenly went from a soothing "relax, everything's under control" to "we need to quarantine thousands" in less than 24 hours.
Today, there are big full page ads in the Globe and Mail from the health unit telling people what to look for and what to do. I imagine that the ads are in the Toronto Star too.
--\n-------------------------------------------------------------------\n* Jack Troughton jake at consultron.ca *\n* [link|http://consultron.ca|http://consultron.ca] [link|irc://irc.ecomstation.ca|irc://irc.ecomstation.ca] *\n* Kingston Ontario Canada [link|news://news.consultron.ca|news://news.consultron.ca] *\n-------------------------------------------------------------------
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Post #92,828
3/29/03 1:19:03 PM
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So *that* is what an index patient is?
I had been wondering...
As for the ratio between patients and index patients, that is like the ratio between a spark and the fire started. They are unconnected, and therefore there is no reason to believe that the two resemble each other in any way.
However if Bellevue is typical, rather than 5 reported cases in NYC, we probably have more like 30. Most of whom are at home, with family in the home, having pizza delivery guys coming home, etc.
Well, if I had thought that the public health system was not going to contain this before, I am positive now...
Suggested reading: [link|http://www.lauriegarrett.com/index_betrayal.html|http://www.lauriegar...dex_betrayal.html].
Cheers,
Ben
"good ideas and bad code build communities, the other three combinations do not"
- [link|http://archives.real-time.com/pipermail/cocoon-devel/2000-October/003023.html|Stefano Mazzocchi]
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Post #92,914
3/29/03 8:15:19 PM
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What is actually known?
We don't know that much about transmission, and there is some evidence that it may be somewhat easier than initially thought, but the death rate is currently being estimated slightly lower than before (3.5% vs 4%):
[link|http://www.cnn.com/2003/HEALTH/03/29/mystery.illness/index.html|http://www.cnn.com/2...llness/index.html]
[link|http://www.nytimes.com/2003/03/30/health/30INFE.html?ex=1049605200&en=515394677ffb382d&ei=5062&partner=GOOGLE|http://www.nytimes.c...62&partner=GOOGLE]
As for Toronto, what appears to have changed is that there is a public panic. They not only have to deal with the medical problem, but also the panic. If someone thinks that they might have it and you think that they don't, why not just tell them to isolate themselves? No real harm done, and they are out of your hair. A more detailed report describing how they were swamped:
[link|http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_Type1&c=Article&cid=1035780018110&call_pageid=968332188492&col=968793972154|http://www.thestar.c...&col=968793972154]
And, speaking of panic, this is a very good time to re-read [link|http://www.vmyths.com/fas/fas1.cfm|http://www.vmyths.com/fas/fas1.cfm], all of it. It talks about a different kind of virus, but the phenomena that it talks about is universal. I also note that mere geographic proximity to an outbreak doesn't actually confer any actual expertise on the topic in question.
Yes, this disease is a serious public health threat. But when all is said and done, and the corpses are tallied, I am willing to bet that the panic over the disease will cost an order of magnitude more than the disease itself did - with little reduction in the actual long-term spread because of it.
Of course that bet is being made by a moderately informed person armed with no more than a broad general background, decent intelligence, and undue verbal facility. Insert appropriate levels of skepticism...
Cheers,
Ben
PS I actually am finally getting around to reading [link|http://www.lauriegarrett.com/index_betrayal.html|http://www.lauriegar...dex_betrayal.html] and I reiterate my recommendation to read it. It is a very good book that is extremely relevant to the current situation.
PPS If the name Laurie Garrett rings a bell, it is because she is the person who wrote the infamous description of what happened at the WEF...
"good ideas and bad code build communities, the other three combinations do not"
- [link|http://archives.real-time.com/pipermail/cocoon-devel/2000-October/003023.html|Stefano Mazzocchi]
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Post #92,928
3/29/03 9:20:32 PM
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Known SARS cases in T.O. tops 100
At least, so says CBC Newsworld tonight (as in, five minutes ago). The health unit folks say they expect to see more. Also, they've called in the police to start ensuring that quarantines are observed.
I suspect that the reason they went from "it's all OK" to "close hospitals and quarantine" is because they knew that the confirmed cases were about to rise dramatically. As Dr. Cunha put it in today's press conference "the major vectors now are health workers and people in close personal contact with them" which is to say health workers in the two hospitals that have been completely closed and their families.
I've been reading the Garrett stuff too. Very interesting reading, albeit all US history; obviously, the development of public health infrastructure followed a very different path in Canada.
I think it's the very large differences between the two that have led to the different approaches to dealing with SARS on the two sides of the border. It will be very interesting to see how it plays out... there's a paper in there, that's for sure.
--\n-------------------------------------------------------------------\n* Jack Troughton jake at consultron.ca *\n* [link|http://consultron.ca|http://consultron.ca] [link|irc://irc.ecomstation.ca|irc://irc.ecomstation.ca] *\n* Kingston Ontario Canada [link|news://news.consultron.ca|news://news.consultron.ca] *\n-------------------------------------------------------------------
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Post #92,934
3/29/03 9:51:08 PM
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Her book is not all US
As for SARS, an impending rise is a good reason to get more serious. As I said at first, with an untreatable disease either you succeed in confining it at the start, or you have to live with the consequences of failing. If current policy is not containing it, then it is better to go drastic early than to wait.
The more than 100 number is also confirmed at [link|http://www.globeandmail.com/servlet/story/RTGAM.20030329.umask0329/BNStory/National|http://www.globeandm.../BNStory/National].
Ben
"good ideas and bad code build communities, the other three combinations do not"
- [link|http://archives.real-time.com/pipermail/cocoon-devel/2000-October/003023.html|Stefano Mazzocchi]
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Post #92,939
3/29/03 10:23:39 PM
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Well, I'm only reading chapter 4
That's the one she has available online in PDF format, though there may be other parts that I've not found yet. Interesting reading, nonetheless; the recounting of early twentieth century public health advances in New York is fascinating. I'm more familiar with the efforts of the Europeans (Pasteur, Snow, etc) than I am with what happened in the US in the late nineteenth and early twentieth centuries.
As for SARS in T.O., I have to say I'm concerned. Considering that these folks are ones who should know how to minimise risk of infection from their patients, the possibilities for what's going to happen to their immediate families are chilling; they would simply not have been thinking about it most of the time, I'd imagine.
One thought that I had earlier this evening would be the consequences if it got into the homeless population in Toronto. That would be really bad, I think. That possibility underlines the importance of looking at indigency not only as an ethical problem (the suffering of the indigent) but also as a potential public health problem.
--\n-------------------------------------------------------------------\n* Jack Troughton jake at consultron.ca *\n* [link|http://consultron.ca|http://consultron.ca] [link|irc://irc.ecomstation.ca|irc://irc.ecomstation.ca] *\n* Kingston Ontario Canada [link|news://news.consultron.ca|news://news.consultron.ca] *\n-------------------------------------------------------------------
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Post #92,887
3/29/03 5:32:00 PM
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Cosmic ruminations aside..
re. agendas of a series of wars for peace, being inconveniently interrupted..
Ever since long London conversations with the father of a sweetie, himself born within "the sound of Bow Bells" and re. the performance of the Brits under the stress of WW-II.. I have long thought that the USA would be among the last places to want to be - were we to suffer anything resembling major discomfort.
While I am in the boonies, no matter. Our entire food and other- supply depends upon massive coordination, and as has been pointed out years ago (maybe at IWE too) -- our miserly funding for Public Health has steadily eviscerated much chance of a massive, coordinated and effective control of any epidemic; most people can't even spell pandemic. Or recall the Flu of 1918, and how close that came to ...
Face masks? I suspect that hoarding will ensue.. as with the Cyprio: you can never have Too Many when it's My Children\ufffd / Screw Yours. (I have not much of an idea of their effectiveness, or of the 'grades' available - but I'd think that folks in cities might want to find out.)
Luck to all; it's all we have budgeted for.
Ashton
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Post #92,948
3/29/03 11:04:23 PM
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Rumours of it in my general area
A woman came down with symptoms after visiting the Orient. No diagnosis yet, but it was the top headline in the community section of the local paper.
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Post #92,980
3/30/03 12:25:27 AM
3/31/03 5:44:39 PM
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#UPDTE Wife arrived HK last night - here are her stories ...
******************************************
#Update (from Sydney Morning Herald)
- all HK schools now closed
- The people living in one appt block in Kowloon had been ordered to stay inside for 10 days after 318 dwellers were found to have symptoms of flu
- Singapore has nurses at Changi International airpt to inspect *all* incoming passengers from Taiwan, HK, & Mainland
******************************************
That the official death toll in GuangDong province (Canton Province) is 60 but the real toll is close to 600. GuangDong is the province surrounding HK SAR (Special Admin Region). GuangZhou (pron GwongShou) is the capital & where it is worst.
That HK International airport last night (when she got her flight) was like an evacuation zone & flight full of women & children.
That officialy 60 schools have closed but more have done so since.
That people are increasingly wearing face masks in public.
She said she heard one story that plans had been prepared to close Chep Lap Kok (HK International Airport).
HK has set up one hospital as an isolation building for all SARS cases.
Doug M
Spectres from our past: Beware the future when your children & theirs come after you for what you may have been willing to condone today - dsm 2003
Motivational: When performing activities, ask yourself if the person you most want to be would do, or say, it - dsm 2003
Edited by dmarker
March 31, 2003, 05:44:39 PM EST
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Post #93,333
3/31/03 8:12:53 PM
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Best hopes for a healthy imune system..
Am sure you're relieved it didn't take a day longer,
Ashton
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Post #93,353
3/31/03 10:15:56 PM
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Seconding what Ashton said.
My thoughts are with you + yours, hope she's in the clear, and that you are as well.
God does not play dice with the universe: He plays an ineffable game of His own devising, which might be compared, from the perspective of any of the other players [i.e. everybody], to being involved in an obscure and complex variant of poker in a pitch-dark room, with blank cards, for infinite stakes, with a Dealer who won't tell you the rules, and who smiles all the time.
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Post #93,376
3/31/03 11:23:53 PM
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I had been increasingly concerned about her
She has a cold !!!!
We are optomistic it is just a cold because she does not have classic flu symptoms. She has had it for approx 5 days. Had she stayed a day or had worse symptoms, she may not have been allowed out of HK.
Anyway, she is staying with her parents in a self imposed exile for 4 more days.
Cheers
Doug (& many thanks for the kind thoughts)
Spectres from our past: Beware the future when your children & theirs come after you for what you may have been willing to condone today - dsm 2003
Motivational: When performing activities, ask yourself if the person you most want to be would do, or say, it - dsm 2003
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Post #93,378
3/31/03 11:27:45 PM
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Crossing fingers for her, Doug.
Hoping for your wife's quick recovery.
Alex
Men never do evil so completely and cheerfully as when they do it from religious conviction. -- Blaise Pascal (1623-1662)
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