Sars Tracker

2003-06-27T03:17:00.000-07:00

Singapore has but three cases of SARS left in hospital now. Our epidemic is over. Not so in my homeland! But that's another story and not mine to tell.

Therefore my updates are coming to an end. The excel file has some very interesting analysis and I'll try to keep it updated on a weekly basis.

But no more cool graphs!

If this event has captured your imagination, please remember that AIDS kills more people daily than have been killed by the entire SARS epidemic. Imagine if we put the same resources into stopping AIDS as we did into stopping SARS!

Thanks for giving me the soap box.

2003-06-27T03:10:00.000-07:00

The Excel Datasheet has been updated with 26 June WHO figures.

2003-06-12T20:47:00.000-07:00

The Excel Datasheet has been updated with 12 June WHO figures.

I was away for a week doing a marathon bike ride (well 950 butt breaking kilometres) raising money for AIDS (which kills way more people than SARS by the way).

So what happend while I was gone?!!! Canada has had more SARS cases in the past 10 days than China - IS THIS POSSIBLE? What the hell are those canucks doing? OK I will reserve further comment until my passport renewal is processed.

SHILS - So Happy I Live In Singapore!

2003-05-29T19:06:00.000-07:00

Please note that I'm away for the next week raising money for Action For AIDS on their bi-annual Riding For Life charity drive. 900Km of cycling in 38C heat! Wish me luck!

2003-05-29T19:04:00.000-07:00

The Excel Datasheet has been updated with 29th May WHO figures.

Taiwan has finally surpassed China as having the highest SARS risk! What a mess. See the file for details.

2003-05-25T18:12:00.000-07:00

Is Hong Kong really safe?
The Excel Datasheet has been updated with 24th May WHO figures.

According to my risk ranking - no (see below for definition).

The indicators of risk are the number of new cases in the last 10 days and the number of sick people still in the system. Until Hong Kong drops below a raitng of "6" I think that they are far from all clear. The fact the WHO has taken them off their list of worst affected countries seems to indicate a change in criteria.

Just for your info, here's the list of the highest number of cases reported during any 10 day period for various countries...

2003-05-22T23:12:00.000-07:00

2003-05-22T21:03:00.000-07:00

More on the young deaths...

This is the same graph as the one below with Hong Kong data added in. Hong Kong appears in the middle between SGP and TO. The HK data is "smoother" because there are more data points (ie more deaths). I've also added some transparency to the HK data so you can see that at the top end, there are more HK cases than Canadian cases (ie more cases over the age of 80).

Because of the number of cases, the HK data probably paints a more accurate depiction of the death toll of SARS.

Yet again, the Singapore numbers are alarmingly "young" giving rise to many questions: Is there a different virus in Singapore (a different strain)? Is the pattern of transmission different? Is treatment in Singapore less effective or inappropriate for younger victims?

The data does suggest that if you get SARS then Canada is the best place to be to get proper care... unless of course they simply had an unusual number of old people getting the virus.

One thought that pops to mind: has Singaporean's overuse of antibiotics had some negative effect on their immune systems such that they cannot cope as well with this virus? At least one of the young fatalities was not a Singapore national (a Philippino nurse) so this might nto be the answer...

2003-05-22T20:13:00.000-07:00

The Excel Datasheet has been updated with 22nd May WHO figures.

2003-05-21T21:22:00.000-07:00

Why are so many young people dying in Singapore?
Here's a graph of the deaths in Singapore and Toronto with Singapore in the foreground. Age is on the left axis. Blue & pink represent male and female victims.

The average age of deaths in Singapore is significantly younger... WHY? Yesterday the 5th person under the age of 30 died of SARS in Singapore. Yet in Canada there is only one case under the age of 40. This is very worrying.

2003-05-21T20:34:00.000-07:00

The Excel Datasheet has been updated with 21st May WHO figures.

2003-05-20T19:36:00.000-07:00

The Excel Datasheet has been updated with 20th May WHO figures.

2003-05-19T18:38:00.000-07:00

The Excel Datasheet has been updated with 19th May WHO figures.

Who's Bucking the trend?

2003-05-15T22:59:00.000-07:00

The Excel Datasheet has been updated with 15th May WHO figures.

2003-05-07T02:12:00.000-07:00

Rest for the Wicked
I'm going on holiday and I won't say where in case the authorities want to quarantine me at the border. So the SARS Tracker will not be updated until May 16 by which time I'm counting on the local authorities to have this epidemic eradicated!

2003-05-06T19:10:00.000-07:00

The Excel Datasheet has been updated with 6th May WHO figures.

Well the patriarch of the walkabout family died yesterday. He was the 72 year old vegetable seller who is the grandfather of the 4 kids who were diagnosed with SARS after the "hawker center visitation" episode that drew national condemnation. It was the family's second bereavement in a month with their grandmother having died from SARS on the 15th of April. As reported below by a family member, the details of the incident were not fairly represented by the media. Also, given the early death of the grandmother, it is more likely she cought the bug from a 45 year old PPWC worker who went to the same GP clinic as she did rather than from her husband who didn't get ill until a week after her death.

2003-05-05T18:30:00.000-07:00

The Excel Datasheet has been updated with 5th May WHO figures.

There has been an extraordinary drop off in the number of suspected cases in Singapore yesterday as shown in the graph below:

This has to do with a change in definition of suspect case.

The MOH elaborates in yesterday's report: "The Ministry will from today, adopt the new WHO case definitions for suspect and probable SARS. In patients where the initial clinical presentation and contact history is not sufficient to classify a patient as a suspect or probable case, such cases will be listed under a new category "observation for SARS", until the evolution of the clinical picture and the results of laboratory investigations clarify their status. As these may take several days, contact tracing and the issuance of home quarantine orders, where necessary, will continue to be carried out for such cases."

Note that they did not report the number of cases "under observation for SARS" in their report.

When the WHO revised their case definitions on 1st May, they stated categorically "Clinicians are advised that patients should not have their case definition category downgraded while awaiting results of laboratory testing or on the bases of negative results." This suggests that the WHO does not count on the reliability of such tests at this stage.

On Survival of the Virus
The MOH made a useful clafication about how long the virus can survive exposed. They did not say how long but pointed out that the key method of transmission is through droplets and that viruses lying on exposed surfaces may not present a large enough dose to cause illness.

2003-05-05T02:00:00.000-07:00

SARS Danger Ratings
The graph below depicts SARS danger ratings. This is my own "lies, damn lies and statistical anlaysis" proprietary formula equal to:

LN (Total Active Cases) + LN (New Cases in last 10 days)

2003-05-04T21:23:00.000-07:00

Society For The Uniformity of SARS Controls
I have a new pet peeve: SARS controls one-upmanship.

Everyone seems to be doing their own thing. I have one friend who gets her temperature taken at her office once a day, another gets it twice a day, in my office we don't do it at all.

Another friend is not allowed, by company policy, to meet people working on other floors of her firm in order to avoid cross contamination. So now she has to coordinate with colleagues who are at her church in order that they don't attend the same service.

A friend of mine recenlty arrived from Canada. She has a health cert stating she is fine and the authorities did not stop her at the airport so effectively immigration has said she is welcome to roam around Singapore.

But some of my friends won't meet with her or their companies will force them to take 10 days leave.

In one friend's office, they meet every two days in order to discuss new SARS controlling ideas. This is one of those wonderful little forums where people get 60 minutes away from thier regular job and tell others to press lift buttons using their keys and chastise colleagues for threatening national welfare by going over to JB on the weekend.

At one such meeting, the guy serving coffee hadn't checked his temperature that morning even though he felt unwell. As it turned out, later that day he was taken by ambulance to TTSH as a potential suspect.

Penny wise, pound foolish.

People are wasting a lot of time on stupid ideas and unecessary controls while at the same time overlooking basic common sense.

The government should set a national standard and then we should all stick by it: nothing more, nothing less. There is no point me wrapping myself in rubber for the public good if the next person is running around coughing all over the place.

Would somebody on high please detail the bottom line on what they expect from the business community and individuals then let us PLEASE get on with our lives?

2003-05-04T21:01:00.000-07:00

Patient Database
For compiled details on all cases until 30th April - see here.

2003-05-04T20:54:00.000-07:00

The Excel Datasheet has been updated with 3rd May WHO figures.

Post-Mortem
The SGP MOH reported that "Post mortem investigations on the 65 year old male inpatient of the SGH Ward 57/58 cluster who was diagnosed as a probable SARS on 7 April 03 and died on 12 April 03 have shown that he died from a non-SARS cause. The post-mortem showed that he died from multi-organ failure due to an abdominal abscess from an infected gall bladder. Postmortem tissues were tested for coronavirus by 2 different PCR tests, both of which were negative."

This is the same patient who was operated on by the infected doctor raising questions as to whether or not she had infected him. This issue seems to have now been resolved.

The chart above clearly shows the Singapore sees the light at the end of the tunnel.

Before you start opening the champagne
Note that several of the last cases have been infections which occured outside the hospital system - friends of friends so to speak or even more random encounters like the deceased cab driver. There remain some cases, like the woman who showed up at Mount Avernia with SARS, which don't appear to have been traced to a source. So there remains the possibility that SARS is still incubating in the community. Another few weeks of vigilence is necessary for the all clear.

Who is under quarantine?

The MOH site lists the following quarantine numbers:

Discharged patients under home quarantine		349
PPWC Quarantine		1,999
Contacts under home quarantine		686
Total under home quarantine orders		3,034

But there is another group not listed: those held hostage in hospital.

A friend of a friend reports that she went in to SGH for an MRI about 14 days ago and was not allowed to leave. She has been put on a 20 day quarantine at hosptial expense "as a matter of policy." She has not been informed that she was in contact with any SARS patient. Unless the hospital is generally unsafe, this cannot be the case: either this is a specific incident of a SARS encounter or everyone should avoid SGH as a general policy. Are things really that bad there?

Post script: I just learned this person is being discharged today. Apparently, SGH has changed its 20 days ruling. If no fever for 72 hours and stool test is SARS negative, you can be discharged.

2003-05-01T18:31:00.000-07:00

The Excel Datasheet has been updated with 1st May WHO figures.

2003-05-01T18:28:00.000-07:00

click for lassen model

2003-04-29T19:33:00.000-07:00

Personal Opinion
The Canadian government threw a fit when the WHO announced a travel advisory for Toronto and have stated publically that they disagree with it completely. YET, their own travel advisory says to avoid even transiting Singapore and Hanoi - the latter hasn't had a case of SARS in over 20 days and even the WHO has given it a clean bill of health. Talk about the pot calling the kettle black. Some have suggested they resent been grouped in with a bunch of "third world countries." I'm Canadian and am very disappointed to watch their behaviour from the other side of the world. Debate - yes. But if Toronto is clean then surely Hanoi and Singapore are as well if not Hong Kong.

2003-04-29T18:49:00.000-07:00

Health Canada Rescinds Routine Access to Ribavirin
Health Canada will no longer provide routine access to ribavirin for the treatment of SARS. This decision stems from a recommendation by a working group advising Health Canada, comprised of health experts and clinicians from across Canada and representatives from the Centers for Disease Control and Prevention in the United States. After reviewing the existing anecdotal clinical experience with ribavirin, negative results from in vitro testing with ribavirin against SARS related coronavirus, and knowledge of reports of serious and unexpected adverse drug reactions, the working group reached a consensus that there is no data to support the continued use of ribavirin outside of clinical trials at this time. Physicians currently treating patients with ribavirin are also strongly advised to critically re-examine the risk/benefit for each patient before continuing treatment.

2003-04-29T18:40:00.000-07:00

ADVISORY - Health Canada Advisory
OTTAWA, April 29 - Health Canada is advising the public that there are no proven home remedies, treatments or preventives for SARS, and that consumers should be cautious of products being advertised for the prevention or treatment of the disease. There have been reports in the media and on the Internet of home remedies and over the counter products being effective in the prevention and/or treatment of Severe Acute Respiratory Syndrome (SARS). Recent examples of products with unsubstantiated SARS-related claims include Vitamin C, colloidal silver, belladonna, and other herbal or homeopathic products. It is important consumers are aware that these claims have not been proven to be effective in the prevention or treatment of SARS.

2003-04-29T18:09:00.000-07:00

'Welcome to Sars central'
Paul Caulford is a doctor at the Scarborough hospital, epicentre of Toronto's Sar's outbreak. This is his diary of the six-week battle against a relentless virus 'with a large appetite for people'

Bizarre SARS Fatalities

Philippines - a man named Jing Tattoo killed a fisherman for sneezing near him. The victim, reportedly suffering from flu, was walking to get noodles at 3am when he bumped into his killer. A witness said that Jing got irked when the sick mans neezed in front of him. He told not to sneeze with other people around since he might carrying SARS virus. A fistfight ensued which was ended by Jing's knife. A manhunt is now on for the murderer.

Taiwian - a man in quarantine in Tapei hung himself because he incorrectly thought his wife had the SARS virus. The nurse who went to advise him that he was mistaken arrived too late. By the time she returned to tell him the news, he had already hung himself. He was 48.

Free and Clear
Although Vietnam has been delisted as a SARS affected area by the WHO, one of the new SARS cases in Taiwan is a Vietnamese national who travelled from Hanoi to Taipei on a Vietnam Airlines flight on April 19.

Death Rate
One statistician estimates death from SARS is as high as 63% for those over 65 and 94% for those over 75%. Children under the age of 15 appear to only suffer mild symptoms with no fatalities.

2003-04-29T17:53:00.000-07:00

Trying to Understand Pasir Panjang
SEQUENCE OF EVENTS

April 11 Mrs Chia, 67, is feverish, has a cough and chest pains.
April 13 She goes with granddaughter, 9, to Koh's T&T Clinic at Block 237, Serangoon Avenue 3.
April 14 She is still sick and goes back to the clinic.
April 15 Feeling weak, she needs her 72-year-old husband Chia Gek Soo's aid in going to the toilet. She dies of heart failure on the toilet seat. Their 9-year-old granddaughter complains of a fever. That night, her younger sisters also fall ill.
April 15-19 Friends and relatives attend Mrs Chia's wake at the void deck of Block 225, Serangoon Avenue 4.
April 16 The couple's second daughter, Lay Sea, 41, is sick. The children's parents, who live in Brunei, return for the funeral.
April 18 Mr Chia Gek Soo, who works at the Pasir Panjang Wholesale Centre, is sick with a fever.
April 19 His fifth child, Mr Chia Soo Pheng, who is in the Navy, falls ill. He, his father, sister Lay Sea, his sister-in-law, Mrs Chia Soo Kheng, three nieces and his girlfriend go to a nearby clinic at 10.30 am. They are given masks and told to wait for an ambulance. While waiting, they remove their masks and go to a nearby coffeeshop and a Chinese medical hall, causing 27 people working at these places to be placed on quarantine. The three girls and Ms Chia Lay Sea are now Sars patients while Mr Chia Soo Pheng, his sister-in-law and father are suspects. All could not attend Mrs Chia's funeral that afternoon.
April 21 The three girls' father returns to Brunei where he lives.
April 22 Mr Chia Gek Soo's three other daughters - a lecturer at Ngee Ann Polytechnic; a Hongkong Bank staff, and a third who is a housewife - are all on home quarantine.
April 25 The bank officer's 18-month-old daughter is sick and warded at Tan Tock Seng Hospital as a Sars suspect.

"The group of eight was led by a 72-year-old grandfather. On April 15, four days before the visit to the doctor, the man who worked at the Pasir Panjang Wholesale Centre had seen his wife die suddenly. Two days before her death, she had visited the same private clinic that a 45-year-old man had visited before he was diagnosed with Sars. The cause of her death was diagnosed as cardiac arrest."

" The 45 olds year guy who started the string of infection in PPWC visited this same clinic 3 times!! Than the wife of this 72 year old man visited this same GP subsequently twice but was NOT send to TTSH by the GP. She died of heart attack at home.

In short, this clinic already had 2 SARS patient visitiing it but no action was taken before the family of 8 visited the same clinic again. What was the GP doing???? Noticed also the family wasn't aware that the lady (Mrs Chia) died of SARS until when the news was release to the public SAT nite that she visited the same clinic as the 45 yr old SARS patient. That clinic was still operating that Sat morning hence the family went to visit the GP in the midst of preparing for Mrs Chia's wake on Sat afternoon." - citizen

The Other Side of the Walkabout Story - by Citizen
Hi, about the family of 8 saga, here are some facts you might like to know.

For your info, it was not all 8 of them who wandered around that area as some newspapers mentioned. It is only 1 family member who went to the food centre and another went to the medical hall. It might be their fault for walking around while they might be Sars suspect. However, who in the world would expect this deadly virus to unfortunately fall on so many of them in the family?

They thought they contracted fever was due to lack of sleep for the past few days and being under stress because of their mum's death who passed away suddenly during that same week.

They have gone to the food centre as they had not had their breakfast since that morning. They also could not prepare any food as they were so busy preparing for their mum's funeral and attending to friends and relatives who came for the wake for the past few days.

So that morning, one of the family member went to the nearby food centre to buy a drink and another to the medical hall. The ambulance also took so long to arrive. Moreover, there were 3 kids in this family during that time. Have we ever thought, maybe its the kids who need a drink?

In fact, one thing you may like to know.. this family had chose to seek medical attention immediately when they realise so many of them had contracted fever and not even able to send their beloved mother for her last journey when her body was to be cremate on the same day that afternoon! Do you know how sad this could be?

If they were to be present at the funeral, don't you think more
people might be affected!

I understand PM Goh wants to convey the importance of stopping the
virus from spreading and to punish those people who did not obey
the rules. I totally agree.

The 72 year old man's wife, fell ill and seek medical treatment from a GP 2 days before she passed away. She was running a fever and a cold and chest pain. The GP gave her medication and the old lady was asked to go back and rest. On the second day, she was still feeling unwell, having chest pain like pricking needles and also fever, she went back to the same GP again. The GP did not send her to TTSH immediately and was again asked to go home and rest. The old lady passed away at home in the afternoon the next day.

Having the symtoms so similar to Sars, why has not the GP called for an ambulance and sent the old lady to TTSH immediately, even on the 1st day when she was running a fever? The old lady might be alive today if she was given proper medical treatment and correct judgement earlier.

She was only diagnosed to have died from SARs yesterday but her initial autopsy report said was heart failure. Since the initial diagnosed indicated she did not died from Sars, a 4 days wake was then arranged for her.

If the authorities has suspected the old lady to have died from Sars instead of heart failure, a wake would not have then been arranged. Her body would have been sent for cremation immediately,

8 of the family members in this case, would not have contracted fever one by one during the wake or even during the time when the old lady was sick. They would not have then appeared at the food centre and would not have been criticised by the nation.

But its too late, the virus has already spread in the family and maybe in the wake where many friends and relatives turned up..

Up to date today, this family has 8 confirmed SARs case, the 72 year old man, his daughter, his son and his 4 grandchildren, aged 4, 8, 9 and 18month old. And don't know how many friends and relatives who have attended the wake, fearing the danger of contracting the fearful virus...

This family would have been a happy family today if the GP has given proper attention to the old lady when she was down with fever on her first visit to the clinic?

I felt devastated this family has come to this situation..

I am giving them my moral support and praying for them everyday, hoping those who are still in the hospital to get well soon.

Why? Because I am also part of this family!

(Niece of the 72 year old man, my father's brother)

The SGH controversy
There are many rumours going around that heads at SGH are going to roll. As the story goes, authorities believe the SGH cluster could have been avoided with better controls. They are, however, waiting for the SARS outbreak to die down somewhat before taking action against responsible administrators. This is in order to maintain public confidence.

From CNA Forum
Dear everyone,
Well i would like to take this opportunity and explain the fact that not every1 in sgh is taking sufficient precautions like TTSH...at this point in time all staffnurses in wards are allowed to wear only N95 masks in other wards as protection...in wds 57,58,47,48. staff clinic and A&E the measures taken are equivalent to TTSH...other than these AREAS...all sgh staff only wear masks n take their temperatures...no gloves,no aprons,no caps...MOH should audit sgh and speak to sgh top management level authorities...As much as the public is concerned, people working in sgh are also paranoid re: the increasing trends of cases...but too bad they've got a rice bowl to keep and still have to report for duty amidst all these fears..and are powerless...

2003-04-28T19:03:00.000-07:00

Dragon Boat Races Cancelled
I paddle for the Canadian Dragons of Singapore. This year, the Nationals have been cancelled due to SARS. The reason being that authorities were concerned that with the 20,000-30,000 spectators that come for this event, if there was a SARS outbreak it would be impossible to trace. It is a big let down as teams have been training hard all season. The expat community will nevertheless be holding their own private regatta on June 1st from. This will be a much smaller affair.

This year's regatta would have been the first time that the women's Breast Cancer Survivor Team raced. A team from Vancouver was due to join in the event but they had to cancel beasue of the travel advisory. It is a great disappointment but we are looking forward to resuming paddling life as normal at the December races.

2003-04-28T18:19:00.000-07:00

Burried in the detail: A Human Statistic
Singapore reported a 23rd SARS death yesterday. The deceases is a 77 year old man who was in SGH Radiology on 1 April at the same time as the index case of the SGH cluster. He became unwell on 9th April and has been listed as probable SARS since 11 April. His wife, 67, caught SARS from him and was listed as a SARS case since 18 April. She survived only a week and died on April 24th - four days ago. He survived the virus a month but perhaps this last tradgedy precepitated losing the battle.

Don't Sneeze in Malta (if you're Chinese)
A man working in a Chinese restaurant in Malta was thrown into quarantine after he started to sneeze. He is not the only victim of Maltese vigilence. Two people were sent for observation on their return from a trip to Australia after spending two hour in Singapore on transit.

2003-04-28T00:52:00.000-07:00

SARS Symptom Chart: See how SARS is and isn't like some common illnesses.

Vietnam praised for SARS victory
Vietnam has gone 20 days with no new SARS cases. This meets the WHO requirement for eliminateion as an affected are... doesn't it? As of yesterday, Hanoi remained on the list of SARS-dirty cities. Vietnam has closed its northern border with China indefinitely in an effort to stop new cases crossing into the country.

2003-04-27T23:03:00.000-07:00

SARS much more deadly than first estimated
The media is now starting to cotton on to the real death rate of SARS... Don't say you didn't hear it.. about 3 weeks ago!

2003-04-27T18:23:00.000-07:00

Is Singapore Over the Hump?
MOH statistics depicted in the graph below indicate that the virus may once again be in decline. the setback caused by the SGH cluster is evident... Can we avoid another such incident?

2003-04-24T23:18:00.000-07:00

News From SARSnews. To Join Visit HERE.

From: "ken_lassesen" <ken@lassesen.xxx>

I've gone thru the news releases tallying the ages reported. I have also reworked the page so people can verify all of the numbers that
I am using...

http://lassesen.com/sars/deaths_by_age.htm

Short version below

Age Probability of death

30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-99

2.4%
6.7%
4.8%
6.1%
5.4%
7.4%
16.3%
18.5%
39.6%
58.1%
65.6%
82.1%

I understand that the Great Flu pandemic in 1918-1919, killed only 1% of people aged 35-45. SARS appears to be a more fatal
illness.

"The influenza virus had a profound virulence, with a mortality rate at 2.5% compared to the previous influenza epidemics, which were
less than 0.1%." http://www.stanford.edu/group/virus/uda/

*SARSnews : Keeping the Community Informed*
To Subscribe to this group, send an email to:
SARSnews-subscribe@yahoogroups.com

2003-04-24T21:24:00.000-07:00

SARS Mysteries
One of the recent new probable cases is a death reclassified as SARS. The CNA report reads:

"The second case is the 72-year-old grandfather who infected his three grandchildren. The grandfather, a worker at the Pasir Panjang Wholesale Centre, was admitted on 19 April as a suspect case...

The third case is the wife of the 72-year-old grandfather. The 67-year-old wife had died on 15 APRIL of heart failure, after suffering a fever, a bad cough and chest pains."

The 72yo man is famed for being the patriarch of the "reckless" family that did a walkabout in a hawker centre while waiting for their ambulance. He was classified as probable yesterday while his daughter and grandkids became probable on the 21st.

He supposedly got SARS from the Pasir Panjang source (brother of SGH source - aiyah! what a family) who infected at least 9 people both at work and at NUH. But all those infections were reported around 15-19 April by which time the Walkabout family's grandmother was already DEAD.

So my question is this:
Is it feasible that the path of transmission in this case originates from the SGH source/Pasir panjang source or did she acquire the virus earlier and by coincidence Pasir Panjang has been hit by two different sources?

Of course there's a lag between infection and reporting... but is it sufficient enough that one person could drop dead before another even shows symptoms?

Typhoid Bill
It's interesting to note that the 72yo grandfather has FINALLY been moved from suspected to probable even though he infected at least 4 people. The delay was because he hadn't developed any chest condition per x-rays. Is he an example of a "Typhoid Mary"? IE a carrier who remains relatively healthy?

And somebody please tell me how a 72 year old man in the midst of a SARS outbreak stays fit so long. Garlic? Kimchi? Turnip?! Tell me!!!

2003-04-24T20:13:00.000-07:00

We may never get a true picture of the crisis. Many Sars patients cannot get proper medical treatment simply because they do not have the money for health care. When these patients die, their cause of death may not be attributed to Sars. This is especially true in the countryside, where the nearest hospital can be several hundred kilometres away. People in such places may never have heard of Sars, much less been diagnosed with it; 65 per cent of the mainland's population lives in the countryside.
- South China Morning Post

2003-04-24T09:09:00.000-07:00

I have just discovered an odd thing. The updates to this blog cannot be viewed from my home computer which access the web through Magix (Singapore Telecom). At the office there is no problem. I have thoroughly cleaned my cache and refreshed infinitum. I've even rebooted... but on both my browsers (yes I still have a copy of Netscape) I have the same problem. The last entry seen is April 17. Very Odd... If anyone can offer a reasonable explanation for this please let me know by leaving a comment! Thanks.

2003-04-24T01:57:00.000-07:00

YOU know that the scientists scrambling to unravel the mysteries behind Sars are leaving no stone unturned when two have ventured that the virus is actually a cometary microbe. From outer space, in other words. According to the two UK-based astrobiologists, the Sars virus may have entered the earth's atmosphere in the Himalayas - a stone's throw from western China, where it began to wreak havoc.
- Editorial. Business Times, Singapore

2003-04-24T01:00:00.000-07:00

SARSTRACKER ANAYSIS

The table above estimates future deaths from SARS based on historic data. It is based on existing cases ie it forecasts the number of fatalities from current probably cases without making any estimation for future cases. So for Singapoer the graph reads "8 more deaths expected in the next 18 days."

The graph below shows the actual deaths versus the forecast deaths using this method. China has had far more deaths than predicted whereas Canada has done relatively well. I suspect teh Chinese poor performance is as a result of being more accountable for the real toll from SARS.

Actual deaths less predicted deaths

2003-04-24T00:59:00.000-07:00

let your fingers do the walking

2003-04-24T00:15:00.000-07:00

Virus Is Mutating Rapidly
Washington Post Foreign Service - Yang Huanming, one of China's best-known geneticists, said the work has shown significant differences between virus samples from patients in Guangzhou and in Beijing, indicating that the virus is mutating rapidly. He said samples already sequenced in the United States and Canada were similar to the Guangzhou samples because the American and Canadian samples came from people who caught the disease in southern China. But when researchers did sequencing of samples collected in Beijing, about 1,200 miles to the north, they detected significant differences from the southern strain.

2003-04-23T20:47:00.000-07:00

Total Cases

2003-04-23T18:58:00.000-07:00

SARS Treatment May Be Killing Some Patients
The Standard - Secretary for Health, Medical experts are now examining whether the drug cocktail of ribavirin and steroids was responsible for some of the coronavirus pneumonia deaths in Hong Kong. The probe was ordered after autopsies on seven people who died of the killer disease revealed that, apart from severe lung damage, other organs like the heart and kidneys were also affected. Medical experts are now studying whether the side effects from the current treatment had caused the failure of the patients' organs, or whether it triggered their deaths. In their analysis using the treatment records of 138 SARS patients at Prince of Wales Hospital, experts found 18 of them had also suffered from a bacterial infection as the steroids had depressed their immune systems. These 18 patients are still under intensive care.

More:
Most Sars patients take well to Ribavirin

While most patients respond positively to this treatment — first recommended for usage by Hong Kong — some may suffer from an array of side effects such as nausea, anaemia and damage to foetuses and kidneys.

2003-04-23T18:38:00.000-07:00

Has Your Cabbie Been Checked?

In addition to regular temperature checks, cab drivers in Singapore have to drive with the window rolled down from today...

Singapore's prime minister has vowed to jail people who violate quarantine orders imposed to contain the spread of SARS, and lashed at "irresponsible" citizens ignoring dangers posed by the epidemic.

2003-04-23T02:06:00.000-07:00

Stupidity Accentuated & Revealed Syndrome
Telegraph India A Severe Acute Respiratory Syndrome (SARS) patient rushed out of a Pune hospital last evening, got married and came back to the isolation ward, with her brand-new husband and 30 invitees.

SARS Family Put 77 in Quarantine
CNA Four of the eight family members who ignored a doctor’s advice to wait for an ambulance are now down with Sars.The doctor had given them masks to wear and told them to wait for an ambulance to take them to Tan Tock Seng Hospital. Instead, they removed their masks and, over the next four hours, went to S11, a coffee shop in Serangoon North, as well as Hock Hua Ginseng at Serangoon Central Drive. Now, a total of 77 people including other family members and people from the clinic, ginseng shop and coffee shop are under home quarantine.

So where was the ambulance for FOUR HOURS?

2003-04-22T20:44:00.000-07:00

Corona Not Responsible
Times UK Scientists searching for a cure for severe acute respiratory syndrome (Sars) have suffered a setback after finding that the virus blamed for the potentially fatal disease was not present in most patients taken ill. “Only 40 per cent of the people with what we call Sars have the corona virus. We have found no other virus but the connection between Sars and corona is actually very weak,” said Dr Frank Plummer, scientific director of the Canadian National Microbiology Laboratory in Winnipeg.

Too bad we made all those monkeys sick.

2003-04-22T02:17:00.000-07:00

SARS SMS
AP - Hong Kong With a few button punches on their handset keypads, subscribers can request a text message that lists all the SARS-affected buildings within a kilometer (0.62 mile) of the calling location....

2003-04-22T02:05:00.000-07:00

Thermal Imaging in Singapore

Profiting from Fear

Are people being misled about
protection afforded by
anti-SARS products?

2003-04-21T19:01:00.000-07:00

The Equal Opportunity Germ
"One key reason for the view that SARS may be positive impetus for change is that it is not confined to the developing world, where infectious disease has for years been a major killer. This is an equal opportunity germ. Hong Kong, one of Asia's most affluent cities, has been the hardest hit of any single locale, and victims come from all walks of life."
- Far Eastern Economic Review, 24 April

2003-04-21T03:21:00.000-07:00

Where The Bug Bites: Sunday Straits Times Compilation
Data shows risk of infection in general comunity remains very low.

SARS Infections in Singapore as of 18 April

Place of Infection	Healthcare Workers	Patients	Visitors	Others	TOTAL
TTSH	49	9	30		88
SGH	21	11	13		45
Other Healthcare Centre	13	1	1		15
Outside Healthcare System				24	24
TOTAL	83	21	44	24	173
%	48%	12%	26%	14%	100%

Infections outside of the healthcare system include:

SIA stewardess on the NY-Frankfurt flight carrying Singapore doctor infected with SARS
Man infected at Pasir Panjang Market
Two Taxi drivers who may have caught the bug from passengers

2003-04-21T00:04:00.000-07:00

Man Infected with SARS was at large for 1 week
The MOH detailed the movements of one of the latest SARS cases in their 20 April report. He contracted the virus at Between 8-16 april he visited his GP twice, Hougang Polyclinic and 2 or 3 Chinese Sinseh before being warded at TTSH. This incredible walkabout will keep the virus tracers busy for some time.

In the meantime, those who visited Pasir Panjang Wholesale Market during these times are asked to contact authorities if illness develops:

Monday: 5 April 03 from 1 am - 11 am
Wednesday: 7 April 03 from 7 am - 9 am
Thrusday: 8 April 03 from 6 am - 9 am.

Pasir Panjang Wholesale Market, the source of 75% of fresh produce in Singapore, is now closed for 3 days and wokers at the market under quarantine for 10 days so the market is effectiely closed until April 29. Panic buying has been seen in some places though price increases have been minimal.

It's probably adviseable for Singapore residents to start keeping a diary of their movements in order to cross check against backdated "hot periods" for SARS...!

2003-04-20T20:08:00.000-07:00

Hong Kong publishes Death Stats by Age
Following is a list of Clinical SARS Cases and Deaths as at April 15, 2003:

Age (years)	Number of cases	Number of deaths	Age-specific death rate
0-14	72	0	0.0 per cent
15-34	467	2	0.4 per cent
35-54	476	17	3.6 per cent
55-64	92	6	6.5 per cent
65-74	90	17	18.9 per cent
Over 75	56	16	28.6 per cent
Overall	1253	58	4.6 per cent

Overall 68 per cent of all deaths have co-existing illnesses.

It's being suggested that the low rate of SARS amongst young people could be because they do not display severe symptoms (eg they might have a low grade fever instead of high grade and are thus not suspected of having SARS). This means they could be undetected CARRIERS of the virus.

2003-04-19T03:38:00.000-07:00

Death Takes a Holiday
As many statisticians take the long holiday weekend away from SARS reporting, the WHO's collation of death stats should dip. This blogger is also taking some time off! Check back Monday.

Tought Bug: Has the Virus Mutated?
Health officials have reported that SARS patients who live in Amoy Gardens are coming down with particularly virulent cases of the disease, as are health-care workers who have caught the virus from those patients. Twenty percent of Amoy victims needed intensive care, compared with about 10 percent of other SARS patients in Hong Kong. The symptoms of Amoy Gardens patients differ from the symptoms of other SARS patients in that a large percentage of Amoy Gardens patients developed intestinal problems. As in Hong Kong, the virus in Canada, has been more virulent than in the United States and is also characterised by more intestinal problems.

2003-04-17T03:10:00.000-07:00

SARSTRACKER ORIGINAL ANAYSIS

Close but No Cigar
The Chart below compiles Singapore MOH stats to show how close they came to containing the virus before the "SGH cluster" set them back....

2003-04-16T23:02:00.000-07:00

SARSTRACKER ORIGINAL ANAYSIS

And Now for the good news
10 recoveries in yesterday's Canadian stats mean their "real death rate" (see below) has dropped significantly (from 32.5% to 26%).

2003-04-16T02:17:00.000-07:00

Three SARS babies delivered by Caesarean: One mother dies
The babies were delivered by Caesarean section to avoid complications from medicines used to treat Sars and because the mothers were seriously ill, Dr Hon Kam-lun told The Associated Press by telephone. All three tested negative for the coronavirus – the likely cause of Sars - but Kam-lun said the babies "increasingly resemble" Sars cases. On Tuesday it was reported that one of the mothers, a 34-year-old, had died. The other two young mothers are still alive. All three mothers were taking the anti-viral drug ribavirin, Kam-lun said, and doctors had been worried about side effects in pregnant women.

2003-04-16T00:46:00.000-07:00

Experiments on Monkeys Zero in on SARS Cause
NEW YORK TIMES, April 15 — Monkeys experimentally infected with a new coronavirus have developed an illness similar to the mysterious human respiratory disease SARS, and it is now almost certain that the coronavirus causes the disease, a World Health Organization official said here today.Experiments on animals are necessary because the lack of an effective treatment for SARS and the relatively high death rate make it unethical to conduct such experiments on humans.

Nine patients in Hong Kong died of SARS on Tuesday, setting a new single-day record for such fatalities. Five of those who died were younger than 45 and included a pregnant woman and four patients with no underlying illnesses.

SARSTRACKER ORIGINAL ANAYSIS

How to read the chart above:
We can estimate the real death rate by Total Deaths / Resolved Cases (Deaths + Recoveries). Applying this rate to total cases gives the estimated total deaths given the existing number of cases.

Lag: You can also determine the average time for cases to "resolve" - this is the difference between today's date, and the date when the existing number of cases was the same as today's total resolved cases. Based on this lag, you can further estimate how long it will take for present cases to resolve thus estimating the daily average deaths between now and then.

Note: this does NOT estimate total deaths from SARS as no assumption is made about the growths in cases. this simply estimates deaths from existing cases to date.

2003-04-15T19:31:00.000-07:00

High-speed test for Sars launched
Telegraph UK - Hamburg-based Artus said its test can detect the presence of Sars in two hours, whereas traditional tests for antibodies take more than 10 days.

More: Singapore to Unveil It's Own Test

Exposure to SARS in Toronto Raises Chance of Its Spread
New York Times TORONTO, April 15 - The possibility that severe acute respiratory syndrome could be spreading to the Toronto population at large increased significantly with the news that 500 members of a Roman Catholic church group had been exposed to the disease March 28 and may have passed it to others.

At least one member was infected at the Scarborough Grace Hospital, where the initial outbreak in Toronto began last month. That person later attended a Mass where hundreds had gathered. The following day many in the group also attended a retreat.

In early April, several members of the church group attended the funeral of a person who was later determined to have died of SARS. Health officials now know that some people who attended the funeral had the disease at the time. Within the religious group, 29 probable and suspected cases have been identified. One doctor who was treating the group was also infected.

2003-04-14T21:54:00.000-07:00

SARSTRACKER ORIGINAL ANAYSIS

How Bad Is It Really???

Death / ( Death + Recoveries ) = Real Death Rate

Those still ill should be excluded from calculations as some will die; including them assumes all will recover which is FALSE. Are health authorities understating the death rate to help prevent panic???

Korean Claims Kimchi Prevents SARS
SEOUL Financial Times - The South Korean Rural Development Agency said the large amount of garlic in kimchi might explain why none of the country's 48m people had yet succumbed to Sars.

Beijingers turn to turnips as SARS cure
BEIJING Reuters - Turnip prices have jumped in Beijing after the vegetable was touted as a key ingredient in a potion to fight the deadly virus that causes Severe Acute Respiratory Syndrome, peddlers said.

2003-04-14T21:42:00.000-07:00

The SARS Arts toll...
8 Apr: Santana 'Shaman' World Tour 2003 - Postponed till further notice
8 Apr: RJC Chamber Ensemble: A La Carte - Cancelled
9 Apr: Tchaikovsky Symphony Orchestra Of Moscow Radio - Cancelled
19 Apr: UBS Private Banking & SNYO Music Mentor Programme 'Inaugural Concert' - Cancelled
19 Apr: Jacky Wu 'The Best One' Concert 2003 - Postponed till 28 Jun
23-27 Apr: The Royal Hunt of the Sun - Postponed till further notice
26 Apr: Sally Yeh & George Lam World Tour 2003 - Postponed till 24 May
26 & 27 Apr: Singapore Sevens - Postponed till further notice
26 & 27 Apr: 'Hansel And Gretel' By Engelbert Humperdinck - Postponed till further notice
29 Apr: NAFA Arts Festival 2003 Music Gala Concert with Yu Chun Yee - Cancelled
30 Apr: David Gray Live in Concert - Cancelled

Excellent: Interactive Presentation

2003-04-14T21:03:00.000-07:00

German Firm Distributes First SARS Test Worldwide
BERLIN Reuters - Hamburg-based Artus GmbH said it had developed the test for the virus causing Severe Acute Respiratory Syndrome (SARS) with the nearby Bernhard-Nocht-Institute (BNI) for Tropical Medicine in just two weeks and had begun distributing it free. They said classical tests for antibodies typically took 10 to 20 days after infection.

2003-04-14T20:29:00.000-07:00

Messages of Support to Health Workers at MRT Station

No Kissing Allowed:
Malaysians have been told not to kiss the cross this Easter in order to prevent the spread of SARS

2003-04-14T18:07:00.000-07:00

The Lassen Model: Click the image for some math on transmission rates...

2003-04-14T03:22:00.000-07:00

ESP - Electronic Sars Protection
We know what you're thinking... OK no we don't! But we know where you are! Close Circuit TV and Electronic tagging are now protection Singapore from potential quarantine busters. From ERP to ESP...What Next?!

2003-04-14T02:16:00.000-07:00

Evidence shows children may escape worst of SARS virus
Reuters - Doctors are trying to explain why a virus that moves with relative ease through the adult population, so far infecting 3,000 worldwide with more than 100 dead, has come up against something of an immunological wall when it comes to youngsters.

2003-04-13T23:15:00.000-07:00

Singapore's containment weakens
As per the chart above, from 30th March to 8 April, Singapore had the best success with containing the growth of SARS. However, over recent days, this record has been lost. The week-on-week growth figure grew to 46% as of April 12th. This compares poorly to 39% for Hong Kong and 36% for Canada. As per the article below, this deterioriation is blamed on the late isolation of a super-spreader...

2003-04-13T22:59:00.000-07:00

"People buying them so they feel comfortable riding the subway doesn't make a lot of sense. We're just not going to encourage silliness because we don't want to see a shortage of masks."
- Dick Thompson, a spokesman for the World Health Organization, noted a run on masks could cause a shortage for those who do need them - the sick and those treating them. source

2003-04-13T22:24:00.000-07:00

A few SARS stories from Toronto...
Recent increases in the numbers of SARS cases were expected as the containment team became aware of a few incidents where people who came down with the virus exposed others.

In one case, several members of a family became ill shortly after attending a wake at a funeral home. It was later discovered the deceased had died of SARS.

In another case, an employee of a Hewlett-Packard plant in Markham, Ont., who was supposed to be quarantined, went to work anyway while suffering SARS symptoms. He is currently in hospital, in serious condition, with the disease. One colleague is a suspect SARS case and 196 other colleagues are in quarantine

And One from Singapore...
...The woman doctor had aching muscles on March 29 but carried on working even on March 31 when she had a fever. She operated on the patient that Monday. She is now seriously ill at TTSH. Like Dr Ong Hok Su who died last week, she took off her oxygen mask to go to the bathroom and almost collapsed.

2003-04-13T22:16:00.000-07:00

Hong Kong officials launch investigation after SARS kills younger, fitter patients
Star - Health officials said Monday they were trying to figure out why six relatively young SARS patients with no aggravating illnesses have died in recent days. On a radio show Monday, Liu said some of the younger patients came to the hospital when they were already in a serious condition and their conditions worsened even after they received intensive care.

More: Fit victims spark Sars worry

2003-04-13T22:10:00.000-07:00

Death from SARS much higher than reported
See the chart below prepared by this blogger. If you correct for time, the death rate is much higher than we are being told. People don't die from SARS the minute they are reported as a SARS cases. There is a time lag between when they are first admitted to when they die. So if we divide the number of deaths by the number of cases 7 and 14 days earlier, we get a better idea of the real death rate. Presently, the global death rate (excluding China because those figures are highly unreliable) based on deaths / cases 7 & 14 days earlier is 5.1% and 8.2%. The figures for Canada and Singapore and are much higher but Hong Kong is doing relatively well:

	7 day correction	14 day correction
Canada	13.5%	27.0%
Hong Kong	4.4%	7.7%
Singapore	8.9%	10.1%

In the Canadian outbreak, the higher case-fatality ratio appears to be linked to the older age of the patients, who frequently have underlying chronic disease.

2003-04-13T21:45:00.000-07:00

Late Isolation blamed for Rise in Singapore Cases
WHO 12 April - "WHO has collaborated with health authorities in investigations and contact tracing that have linked most cases in the hospital outbreaks to a single “super-spreader.” This patient was treated at Ton Tock Seng Hospital (sic) from 5 to 20 March, where he is thought to have become infected. He was subsequently admitted to Singapore General Hospital on 24 March. The patient showed a very atypical clinical course before being isolated on 2 April. This late isolation is thought to explain, in part, the large number of exposed and infected individuals linked to the single patient."

2003-04-13T21:37:00.000-07:00

Hong Kong Department of Health:
http://www.info.gov.hk/dh/ap.htm

This actually includes lists of buildings with confirmed SARS patients!

2003-04-13T21:30:00.000-07:00

US is Listed as SARS affected area
In their 12 April Summary Report, the WHO stated "On Friday, WHO added Beijing, China to its list of SARS-affected areas. Areas are added to the list following indication that chains of local transmission are occurring." As of 12 April, local transmission in the USA has been acknowledged (see these stats). The finding is not surprising given that the US had over 150 reported cases (albeit subject to their unique definition). - more than Canada, Singapore or Vietnam. They now join London as the newest members of the Affected Areas list.

2003-04-11T21:11:00.000-07:00

What is Herd Immunity?
"Herd" immunity is a theory which purports to explain how an entire group can be protected from disease. It is thought to result in protection of everyone once around 70% of vaccinated or otherwise immune individuals is reached, by preventing transmission of the virus to those who remain "unprotected", either because a vaccine didn't happen to work for them, or was too risky in their case.

In the case of SARS, the human race reaches herd immunity once either (a) there is a vaccine which everyone has access to and takes or (b) the disease has become so widespread that the numbers of people that have built natural immunity is so high that transmission of SARS is virtually stopped.

Unfortunately, the last scenario isn't feasible. Because such a large number of SARS patients require intensive medical treatment, if a significant proportion of the population developped SARS, health systems would break down and global economies would collapse.

The only hope at this stage is that SARS can be contained long enough for a vaccine or cure to be developped before the number of people infected gets out of control.

2003-04-11T09:25:00.000-07:00

Masks Are Useless
MSN - 7 April - Viruses, including the coronavirus that scientists believe may be the cause of SARS, are so tiny that they can easily pass through such barriers. Several studies even have shown that surgical masks fail to prevent transmission of the much larger mycobacterium tuberculosis, which causes TB. While the U.S. Centers for Disease Control and Prevention advises that people who have SARS wear these masks, they do not even recommend them for people in contact with those patients unless the infected person can't wear one. Wearing surgical masks outdoors, where virus-laden particles easily disperse, has even less value.

2003-04-11T08:42:00.000-07:00

The First Major Health Threat of the 21st century
WHO - Although the last decades of the previous century witnessed the emergence of several new diseases, SARS needs to be regarded as a particularly serious threat for several reasons. If the SARS virus maintains its present pathogenicity and transmissibility, SARS could become the first severe new disease of the 21st century with global epidemic potential.

2003-04-10T02:11:00.000-07:00

Another 1268 in quarantine
Toronto Star - Another 1268 people in the Toronto area were ordered into quarantine yesterday because of potential exposure to two cases of Severe Acute Respiratory Syndrome (SARS) one an infected worker at Hewlett Packard Canada Ltd.'s Markham operations who was supposed to be in isolation and the other a student at Stephen Leacock Collegiate Institute in Scarborough.

2003-04-09T23:09:00.000-07:00

China accused over Sars death
BBC News - Hong Kong - Friends of a US citizen who has died from the mystery illness, Sars, claim he was moved to Hong Kong because China's authorities did not want another foreigner to die of the virus on the mainland.

Corona virus: Pretty, isn't it?!

2003-04-09T20:43:00.000-07:00

Officials 'frustrated' by those not isolating themselves after SARS exposure
Canada.com - TORONTO (CP) - Nearly 200 workers at a business north of Toronto were told to go into isolation Wednesday after public health officials learned a SARS-infected employee ignored instructions to stay home.

Doctor alleges Beijing cover-up over SARS crisis
The Scottsman - Beijing - The accusations of a cover-up came from Dr Jiang Yanyong, a retired chief of surgery at a Beijing military hospital. He said doctors and nurses at two other military-run institutions had told him there had been at least seven deaths in their hospitals and claimed there were 106 cases of the disease in Beijing - more than five times the figure given by authorities.

2003-04-09T18:12:00.000-07:00

WHO Daily Report :

Guangdong Healthcare System Praised
The team concluded that the health system in Guangdong responded well to the outbreak. The province has a health system in which every hospital at every level reports any new cases of SARS... However, the team found an urgent need to improve surveillance in the countryside to head off new outbreaks in rural areas. The team was further concerned by an increase in sporadic cases, which could not be linked to a particular transmission chain, as such cases raised questions about the adequacy of contact tracing.

Amoy quarantine Ending
The isolation order placed on Block E, Amory Gardens will expire at midnight, April 9. The Hong Kong Health Department has announced that residents, temporarily housed at camps, may return home after their flats have been disinfected by the Food and Environmental Hygiene Department.

Singapore Super Spreader
The health worker considered to be the index case in [the latest] cluster of cases may be the fourth “super-spreader” identified in Singapore.A “super-spreader” is a source case who has, for as yet unknown reasons, infected a large number of persons. Although transmission patterns of SARS remain incompletely understood, evidence suggests that such “super-spreaders” may have contributed to the evolution of SARS outbreaks around the world.

Mild SARS Spontaneous Remission - Vietnam
... The daughter’s husband, who attended the Hanoi French Hospital with his wife, had a mild febrile illness which was undiagnosed at the time and which resolved spontaneously. It is presumed that he had mild SARS and passed the infection to his father-in-law

No Assymptomacitc Carriers
...WHO epidemiologists maintain the view that asymptomatic transmission does not appear to occur. Nor does this case suggest a longer incubation period than currently assumed (2–7 days, with 10 days considered the rare maximum).

2003-04-09T18:09:00.000-07:00

Superspreaders and asymptomatic carriers:
National Geographic - Experts warn that some people may be so-called "superspreaders," or more prone than others to transmit the virus... One theory suggested by medical investigators is that infected people may carry the disease without suffering extreme symptoms. Healthy carriers of a disease are not unusual, the most famous of whom was Mary Mallon. Popularly known as Typhoid Mary, she spread typhoid fever in the United States without suffering symptoms herself.

Adopted Chinese Children Pose SARS Risk :
Good Housekeeping - Last week, public health officials reported a Massachusetts woman adopted a 15-month-old girl from the city of Guangzhou who later developed SARS. The woman's aunt also became infected with the pneumonia-like illness ...

2003-04-09T02:02:00.000-07:00

SARS can be transmitted before the carrier shows symptoms
Canada.com - 7 Apr 2003 Dr. Allison McGeer, one of Canada's leading infectious disease specialists, contracted the disease from a staff member at the hospital. The health-care worker was not showing symptoms of SARS at the time, but went on to develop the disease.

2003-04-09T01:01:00.000-07:00

2003-04-08T23:39:00.000-07:00

SARS forces Singapore churches to halt confessions
Reuters AlertNet, UK - SINGAPORE, April 9 (Reuters) -The Roman Catholic church has suspended confessions in Singapore due to the spread of the deadly SARS virus and priests will instead forgive all churchgoers for their sins, church officials said on Wednesday. SURELY THIS MEANS DAMNATION!!!

Questions from unofficial contributors:

Has the Pope OK'd this procedure?
Why not Confession by SMS as was used the the Philippines up until recently?
I haven't confessed in 20 years. Is it OK to come now and get in on this special?

2003-04-08T23:32:00.000-07:00

Govt warns of increasing SARS cases
The Jakarta Post, Jakarta - Director General for Communicable Disease Eradication and Environmental Health Umar Fahmi Achmadi toldThe Jakarta Post on Tuesday that SARS appeared to be on the increase in Indonesia despite the declining trend worldwide. According to Umar, the total number of suspected SARS cases rose to 16 on Tuesday, up from 12 on Monday, but only five are still being treated at Sulianti Saroso hospital.

(How come the WHO has no Indonesian stats??? Why are the Indonesian girls below on SARS high alert?)

2003-04-08T20:45:00.000-07:00

My SARS Questions & Observations
See Pic

Today, media in Canada reported, "By yesterday, public health officials said, the number of probable and suspect SARS cases in [Ontario] stood at 188, and totalled 226 nationwide." However the WHO stats only recognise 90 cases in Canada to date. The who stats also indicate the death rate for SARS is unusually high in Canada (11% vs. global average of 3.6%). Do the Canadian SARS stats underestimate who widespread the problem is in Canada?
Likewise, the high death rate in Thailand (27%) and Malaysia (100%) suggest the number of cases are under-reported. Plus how are we to believe that Jakarta, on the main business traffic hub in South East Asia with significant flow from Singapore and Hong Kong, has remained untouched?
The only country where the growth rate of SARS is higher than Canada is the US. They, however, report "suspected cases" to the WHO as opposed to confirmed cases. Yesterday the WHO recorded 148 such cases in the States yet local transmission of the disease has been ruled out. Does that mean that ALL the cases are imported? How is this possible if Singapore has only recorded 6 imported cases and these have led to the local epidemic of 118 cases in total. Are the US authorities taking their eye off the ball?
Why is it that some countries stats seem to drop off the list... and then re-appear as in the case of Spain and Belgium..?
It's worth noting the difference between the charts Probably Cases by Date of Onset vs. Probable Cases by date of Report. This indicates that the epidemic is dying down however the fact that medical authorities have been playing a bit of catch-up when it comes to understanding the situation, things look like they're getting worse when they are not... Is this fair or just a case of lies, damn lies and statistics? The number of observations for the former chart is a mere 362 versus 1402 for the latter (blown out by Chinese numbers of course).
The CDC's travel advisory is as follows:
"CDC has also issued a travel advisory, and health alert notices, which are being distributed at ports of entry to people returning from the three affected regions. CDC advises that people planning elective or nonessential travel to mainland China and Hong Kong; Singapore; and Hanoi, Vietnam may wish to postpone their trips until further notice. Because the epidemiology of SARS in Canada is significantly different with regards to community transmission, CDC is not issuing a specific travel advisory for Canada at this time." Just what does that mean???
- Epidemiology: the sum of the factors controlling the presence or absence of a disease or pathogen
One person suggested to me that this means hygiene in Canada is better than in other affected areas. I find it hard to believe that the standards of hygiene anywhere surpass those of Singapore.... and certainly not Toronto's Chinatown.

It the epidemiology of the disease is so great in Toronto, why are the growth and death rates so alarming??? The WHO's advisory is rather more general: Screen anyone coming from an infected area... including Toronto.

2003-04-08T19:24:00.000-07:00

Study: Test May Determine Likely Fatal SARS Cases
Reuters, UK - WASHINGTON (Reuters) -An enzyme test that detects lung damage could help determine which patients are more likely to die from the respiratory illness SARS

China Still Covering Up SARS, Doctors Say
Reuters, UK -China's government, already under fire for having hidden an epidemic of deadly respiratory illness, is still under-reporting the number of cases, doctors said on Tuesday.

Roach theory on spread of SARS
News Interactive, Australia -Hong Kong deputy health director Leung Pak-yin said investigators were exploring the possibility that cockroaches might have been responsible for infesting Block E of the Amoy Gardens housing estate, where more than 240 residents were quarantined last week after 278 cases of SARS were discovered.

Fear Leads to Racism
Marathon: Rotterdam organisers ask Chinese to withdraw over SARS...
Channel News Asia, Singapore - Organisers of this Sunday's marathon in Rotterdam have asked two Chinese runners to pull out over fears of the deadly Severe Acute Respiratory Syndrome (SARS) which has killed over 100 people worldwide. China, the native country of Sun Yingjie and fellow runner Jin-Li, is believed to be where SARS originated (...and the home of another 1 bn unaffected people).

Available tests to detect Sars not fully reliable, says WHO
Bangkok Post, Thailand - ``The PCR (polymerase chain reaction) molecular test for detecting Sars virus genetic material is useful in the early stages of infection but produces many false negatives, meaning many people who actually carry the virus may not be detected,'' it said.

SARS Is Here to Stay, Hong Kong and Singapore Tell Citizens
New York Times - Health officials in Hong Kong and Singapore warned their citizens today that the agent that causes a mysterious respiratory disease had spread so far in their communities that it would be hard to bring it under control anytime soon, if ever.