Mayor: SARS Overwhelms Beijing Hospitals

[tonado]

Wednesday April 30, 6:48 PM

Mayor: SARS Overwhelms Beijing Hospitals

 

Beijing's SARS outbreak "remains severe" and hospitals handling the disease don't have room for all suspected cases, the city's new mayor said Wednesday, adding that the first 195 patients were being moved into a new isolation unit.

 

In hard-hit Hong Kong, health authorities said some SARS patients have suffered relapses days after doctors declared them recovered _ a development one official said had her "very concerned."

 

Authorities there reported seven more SARS deaths Wednesday, bringing Hong Kong's total to 157, but said there were only 17 new infections, reflecting a reduced transmission rate. China reported 11 new SARS fatalities _ eight in Beijing _ bringing its death toll to 157. It has said 3,460 reported infections.

 

The global death toll from severe acute respiratory syndrome stood at 373, with at least 5,400 cases reported in more than 20 countries.

 

Chinese authorities, previously accused of covering up the extent of SARS, are now battling rumors that they are ready to impose sweeping authoritarian measures to control the illness.

 

Beijing Mayor Wang Qishan _ appointed last week following the resignation of his predecessor, who was accused of mishandling the crisis _ denied that the city of 13 million people would soon be closed off from the rest of the world or dusted with anti-SARS medications by aircraft at night.

 

"We haven't made any such decisions," he told reporters. "There is no issue of sealing off the city, according to the present situation."

 

Fears that Beijing might be isolated and martial law declared spread last week after police set up roadblocks to check people in vehicles for SARS symptoms.

 

In a rare public admission by a senior Chinese official, Wang said the outbreak had overwhelmed 21 Beijing hospitals that have been designated for SARS treatment and there were not enough beds.

 

"Due to a shortage of berths at designated hospitals, not all suspected SARS patients can be hospitalized there in a timely manner," he said in a written statement distributed at a news conference.

 

"The situation in Beijing remains severe for SARS prevention and treatment," he said, adding the coming week would be "of critical importance" in tracking the disease's development.

 

The city has designated 21 hospitals to handle SARS cases, Wang's statement said. It didn't say how the suspected cases that weren't hospitalized were being handled.

 

A special 1,000-bed SARS isolation unit is under construction north of the city, and Wang said the first 195 patients were to be moved in on Wednesday.

 

Beijing has reported 1,448 SARS cases and 8,924 people quarantined.

 

Hong Kong reported that a small number of people who had previously been diagnosed as having recovered from SARS had been stricken again.

 

University of Hong Kong microbiologist Malik Peiris said relapses are "not a good thing," but they weren't surprising given how little is known about the virus that causes SARS.

 

A Hospital Authority spokeswoman said on condition of anonymity that less than 10 patients have relapsed. Officials were "very concerned" about the cases and were studying them.

 

In Canada, Toronto tried to get back to normal after the World Health Organization lifted a travel advisory that had been prompted by that city's SARS outbreak.

 

Its Blue Jays baseball team sold out a game against the Texas Rangers on Tuesday night by pricing about 34,000 tickets at 1 Canadian dollar, or 69 U.S. cents.

 

"This is an opportunity to say 'Look we're all right, we're a vibrant, safe and healthy city,'" Blue Jays president Paul Godfrey said.

 

In Asia, the virus has stifled tourism, disrupted shipments and crippled other businesses. In New Zealand, a study of business confidence released Wednesday showed 42 percent of executives expect conditions to deteriorate in the coming year.

 

Singapore said its unemployment rate for the first quarter was 4.5 percent, up 0.3 percent from the previous quarter, and Prime Minister Goh Chok Tong told the city-state's people to brace for more job losses "as the full impact of SARS makes itself felt."

[owenkrout]

I had two meetings today. One with the school officials and one at the American Consulate in Shenyang. Neither very encouraging.

 

Our school is to limit the students to the campus starting tomorrow. The holiday is completely canceled so we will be teaching as usual. Our school admits to having about 20 students under quarantine on campus. From looking in the windows of the building as I walk by, (it is right next to the building where I teach and up-wind!), it looks like there are more than 20 people in there.

 

Class attendence is quite low for all teachers. No comment on that from the administration.

 

Other colleges instituted various versions of a lock-down today.

 

Prices of food and essentials have jumped dramaticly and the consulate told us that there may be some shortages of particular things that are imported into Shenyang.

 

Shenyang and Liaoning Province are both attempting to isolate themselves from other areas of China. Check points are currently set up all around Shenyang and all traffic must stop for a medical check and scrutiny of ones papers. Those who are not Shenyang residents or who come from "infected areas" are turned back. Those showing any symptoms are hustled off to a quarantine. At one major highway entry point into Shenyang (what would be called Shenyang County in the US) there was an six lane wide eight kilometer long traffic que. Many bus routes have been discontinued entirely. The consulate said that they have had trouble with movement for official diplomatic business even as many local governments are taking the same steps to isolate themselves despite Beijing's orders not to do so.

 

Some schools in China have been closed and the foreign teachers where left without the airfare or their last pay check on the excuse that they had not completed the contract. The American consulate here said that they have been sucessful in using their connections with local authorities to get the airfare and last paycheck for Americans in that situation.

 

Stores in our local neighborhood are out of certain items, but so far nothing really essential.

 

At the consulate we were told that the CDC has told China that the chemicals that they are spraying indiscriminately everywhere as "disinfectant medicine" is not effective and probably causes more health problems than it prevents.

 

The students are being told that SARS did not begin in China. That there will be a new drug that will cure it in about a month. That there will be a vaccine very soon.

[tparrent]

I've said it before: the reaction to SARS will kill more people than the virus.

 

Also, I hope all of you are taking EVERY word from the Chinese government AND the media with a HUGE grain of salt. After all, if you believe what you read then you should also believe:

 

"The students are being told that SARS did not begin in China. That there will be a new drug that will cure it in about a month. That there will be a vaccine very soon. "

 

Understand that I don't doubt that students are, in fact, being told that. I just question everything else.

 

I walked through the markets in Bangkok that were reprted to be "eerily quiet" "empty" and "like a ghost town". Blatant lies. The markets were absolutely jammed with people. The media, at best, simply didn't check the facts. At worst, they intentionally misled readers.

 

I saw a pciture from CNN today of Chang An Avenue in Beijing. It was nearly empty of cars. I also saw the sun just peeking above the horizon in the picture. It was obviously about 5:30 AM when it was taken. More manipulation.

 

I hope that the fear mongers are happy with the very real effects they have created. Remember, panic did this, not a disease.

[Guest Long_strider]

An interesting read on the media fueled focus about SARS.

 

 

http://slate.msn.com/id/2082308/

[owenkrout]

Sorry tparrent if you don't want to believe it, but what I reported is only what I have actually seen or experienced myself and what the Consul General Mr. Mark Kennon personally told us last night. He also indicated that these were not rumors or repeating what the Chinese government said but rather the actual observations of him and his staff.

 

I will add that he did say that "large numbers" of dependents have departed for the US from the US missions but no staff from Shenyang and only a few staff from Beijing and Guangzhou.

 

He did say that the CDC had recommended to the Chinese government that they "screen" travel from affected areas and that the Chinese government had initially said it was not needed and now have "inserted prohibit in place of screen" and instituted the current draconian measures. He told us that the police are using a list of over 100 "infected areas" in their decision of when to turn back even Shenyang citizens.

[tparrent]

Sorry if you misunderstood me Owen. I never doubted the truth of what you reprted. Rather I was commenting on the build up of the panic that has created the current situation.

[tonado]

Even if SARS is not so serious, it is affecting life in China and here too. My gal can't fly out of Guilin Airport (closed) until June 1 (the travel agent told her). Then there are check points in China and some travellings are restricted. If your gal has a cough a small fever, then they might lock her up who know where. Also, many countries are screening for people coming out of China and some even require them to be quarantine for 10 days. So we must follow the SARS news.

[Myles]

Aloha from Hawaii,

It is very easy to say that SARS is not a problem if you are not there.

You can cite low percentages and say it is not a problem. For you it is

not a problem if you do not know anyone who is sick or dead.

 

Our apartment in Beijing is in the Haidian district. It is in the center of

this outbreak. When the family across the hall reported two deaths in

his work place my wife decided it was time to leave town. Keep in mind

this was when the reported number of deaths was only 4. The government

was and still is not telling the truth.

 

My wife and her son are now in Shenzhen. I feel better now. Keep in mind

that you should not focus only on the relatively low announced death rete.

It is not fun to have a life threatening disease. It is also something that is

added to other risks that you have. Your risk in China is not just 3% but

3% added to other risks.

 

Myles aka Annakuen'GG

[tonado]

Beijing is also reporting 100 new cases a day.

--------------------------------------------------------------

Villagers barricade roads near Beijing as city prepares to open hastily built SARS hospital

By Christopher Bodeen, Associated Press, 5/1/2003 06:38

 

BEIJING (AP) Nervous villagers around China's capital blocked roads with dirt and stones to keep out people with SARS, as authorities prepared to open a new 1,000-bed hospital north of Beijing for patients with the illness.

 

Millions, meanwhile, stayed home for the May Day holiday after officials cut short a week-long vacation in a bid to curb the spread of the disease. Travel agencies were told not to take people out of their home provinces.

 

At a half-dozen farm villages visited by an Associated Press reporter on Beijing's northern outskirts, barricades lay across roads into the communities. Signs told outsiders to stay away. Residents were allowed to leave, but volunteer guards sprayed their vehicles with disinfectant when they returned.

 

It wasn't clear whether the barriers were considered a violation of an order by China's central government this week banning local communities from blocking traffic from Beijing and other hard-hit areas. One township official said his government had authorized the barriers.

 

At a cluster of farmhouses within sight of the new, hastily built SARS hospital, set amid cornfields north of Beijing, a chest-high pile of dirt spread beyond the edges of the road. A hand-lettered sign in red on a scrap of plywood said, ''SARS Prevention, No Entry.''

 

''We'll stay here and keep this roadblock up until the threat of SARS passes,'' said a 30-year-old farmer dressed in cloth shoes and a worn military-style jacket who was guarding the roadblock with two neighbors. He would give only his common surname, Xiao.

 

Despite the nearness of the SARS hospital, Xiao said, ''We're not worried about that. They can keep it under control.''

 

The new hospital is part of massive efforts over the past two weeks to stop the spread of severe acute respiratory syndrome in Beijing, where officials Thursday reported seven more deaths, raising the capital's death toll to 82. A total 1,570 cases have been reported in Beijing.

 

The city has shut down schools, sending 1.7 million students home, and ordered cinemas and other entertainment sites to close.

 

Nationwide, the Health Ministry raised the national death toll by 11 to 170 and reported 187 more new cases, bringing the total to 3,647, the ministry said.

 

Among the infected were two Beijing employees at China Central Television, the main government network, said a station official, who would only give her surname, Wang. The official wouldn't provide their job titles.

 

The global death toll from the respiratory disease believed to have emerged from southern China was at least 394. More than 5,400 cases have been reported in about 20 countries.

 

In Hong Kong, five more deaths lifted the toll to 162, but there were only 11 new cases reported on Thursday, the lowest figure since officials began releasing daily statistics in March.

 

The numbers in Hong Kong, which has had 1,600 cases so far, seem to be coming down steadily, experts said.

 

Beijing Mayor Wang Qishan said Wednesday that no SARS cases have been reported in villages around Beijing. But he warned of potential disaster if the virus spreads into poorer areas that lack the capital's health care resources, and said rural households had been issued thermometers and told to check family members every day for fever a key SARS symptom.

 

The rising toll of deaths and infections in Beijing sparked panic last week, with thousands of people fleeing the capital and others stocking up on food for fear the city of 13 million people might be sealed off.

 

The government says the new Beijing hospital, next door to an ostrich farm near the suburban hot spring town of Xiaotangshan, was built in eight days by 7,000 laborers who worked around the clock.

 

Wang, appointed only last week after his predecessor was accused of mishandling the outbreak, said the first 195 patients were ready to move in.

 

Police in Beijing say they have checked drivers and passengers of thousands of vehicles arriving in the capital for SARS symptoms, but haven't found anyone infected.

 

Elsewhere, reports that cities and towns were barring all vehicles from Beijing prompted the order Tuesday by the central government banning such efforts. It said they could jeopardize the movement of medical supplies.

 

Despite that order, an official of the Xiaotangshan township government said Thursday it had authorized roadblocks. He was patrolling the area on a motorcycle and spoke as it was being sprayed with disinfectant at one makeshift barrier.

 

''Prevention comes first,'' said the township official, who wouldn't give his name.

 

At the village of Houniugang, about one mile from the Xiaotangshan hospital, a wheelbarrow blocked the road and a stern-face man with a crewcut and a red armband that said ''Security Patrol'' said no outsiders were allowed. A roadside stand was set up to spray the vehicles of residents with disinfectant.

[tonado]

Thursday May 1, 6:51 PM

U.S. Works to Fight Possible SARS Spread

 

Federal scientists are preparing the first studies of U.S. SARS patients to figure out how long they're contagious and to see if experimental treatments might help.

 

The National Institutes of Health will soon offer some of the 52 people in the United States considered probably infected the option of coming to its acclaimed Bethesda, Md., hospital for the research.

 

"There's an awful lot we don't understand about the pathogenesis of the disease" that requires research in a specialized center, said Dr. Anthony Fauci, director of NIH's National Institute for Allergy and Infectious Diseases.

 

The government is stockpiling ventilators, training health workers and encouraging hospitals to create isolation wards in case the SARS virus spreads here the way it has in China, Canada and elsewhere.

 

Some of these efforts were under way as part of the government's attempt to prepare for a possible bioterrorism attack, while others are a reaction to the global spread of severe acute respiratory syndrome.

 

So far, the country has done a good job preventing the spread of SARS here, but many local officials would not be prepared if the virus took off in their communities, top officials at the Department of Health and Human Services said Wednesday.

 

"I don't think there is any country, including our own, that is right now capable of massive infusion of individuals who are severely ill, requiring intensive care under isolation," said Fauci.

 

Worldwide, there have been more than 5,400 cases of the highly contagious respiratory disease, with at least 375 deaths. Besides the 52 probable U.S. cases, more than 200 other cases here are considered suspicious. No one in the United States has died from SARS.

 

No one knows why. Scientists haven't yet found any medications that effectively treat SARS, and supportive care is no better here than in Canada, where 21 people have died.

 

Key to fighting SARS is preventing its spread, yet no one even knows exactly when people are contagious. The NIH has made a priority of studying people who are recovering to find out when they quit transmitting the virus.

 

Fauci also hopes to try a different approach at treatment _ working with patients' immune systems to spur recovery.

 

One option is to cull an immune system cell called immune globulin from the blood of recovering patients. Injecting that substance into the very sick has worked for certain other diseases, and if animal tests proved promising, scientists could try it with SARS.

 

The plans sparked some protest among NIH employees about bringing SARS patients to a hospital that routinely houses cancer patients and others with very weak immune systems. But Fauci noted that immune-weakened patients are in every hospital that will have to treat SARS _ and that the NIH's hospital is upgrading its already strict isolation ward to guard against spread of the virus.

 

Research aside, HHS officials stressed Wednesday that the country must be ready if SARS suddenly spreads here like it did in Toronto.

 

To help, HHS is buying 3,000 ventilators to supplement those now available in the national stockpile. About 100,000 ventilators are operating in the country, with about 80 percent usually in use, and many as 95 to 100 percent taken during the flu season.

 

HHS Secretary Tommy Thompson would not say how many ventilators are now in the stockpile but said the additional 3,000 was a big increase.

 

Many communities do not have enough beds to house a large number of sick people with contagious diseases. By the end of the year, every region is supposed to have beds to house an unexpected surge of 1,000 infectious patients; federal funding for bioterrorism preparedness is helping.

 

And Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, meets with Canadian officials Thursday to learn how they were able to contain the virus.

 

Gerberding said Canadians have taken steps that go beyond what U.S. hospitals are used to in handling infectious diseases: transferring patients from one hospital to another, closing some hospitals, canceling elective surgeries and furloughing health care workers who were exposed to SARS patients.

[Myles]

Aloha from Hawaii,

Thanks Tony for the up dates. We have relatives and friends in Beijing so

information from there is important to me.

Myles aka Annakuen'GG

[tonado]

Saturday May 3, 10:01 PM

More die of SARS but new cases down in HK, Singapore

By Benjamin Kang Lim

 

BEIJING (Reuters) - Hong Kong reported only 10 fresh SARS cases on Saturday, the lowest daily total in the past month and a half, and there were no new infections in Singapore, but authorities warned the disease was not yet under control.

 

China, the nation worst affected by Severe Acute Respiratory Syndrome, tripled the amount of money set aside to combat the disease to six billion yuan ($725 million) as officials reported at least nine more deaths and over 180 new cases.

 

Hong Kong also reported an additional nine fatalities, taking the total worldwide to 436.

 

More than 6,500 people have been infected, including about 4,000 in China, where the disease is believed to have originated last year. SARS first erupted in southern Guangdong province but has since ravaged mostly Beijing, where almost 100 people have died.

 

Although the number of new cases in Hong Kong was the lowest in a single day since March 17, Director of Health Margaret Chan told a local radio station the virus remained unpredictable.

 

"There has been a decreasing trend, new cases have decreased very gradually, but it's like a moving target so we have to be very careful," Chan said on the RTHK network.

 

"There are some patients now who are in a serious condition. Yes, there is a chance that the number of deaths will continue to rise," she added.

 

Hong Kong has reported about 1,600 SARS cases of whom about 900 are still being treated. Of these, about 80 are in serious condition.

 

Chan also said the disease may have come to stay.

 

"Some experts' view is that the virus cannot be destroyed and won't disappear from Hong Kong and other countries," she said.

 

Symptoms of SARS include high fever, cough and pneumonia, and there is no standard treatment. It is mainly passed by droplets through sneezing and coughing.

 

MORE CASES IN CHINA

 

China, with most of its residents closeted at home on the third day of the Labour Day holiday, reported another 181 SARS cases and allocated more resources to containing the disease.

 

There is great worry that SARS could spread to the country's vast provinces, where it could overwhelm the creaky health system. Already, some 1,750 people are infected in Beijing and about 14,000 have been quarantined in the capital.

 

The country has cut short the Labour Day holiday, which usually lasts for a week, to a long weekend this year, and has advised people to stay at home.

 

Finance Minister Jin Renqing said in an interview with state television that an additional four billion yuan would be poured into a two billion yuan SARS fund.

 

The fund would be used to pay for medical bills of impoverished rural and urban residents, stipends for health care workers on the front line battling SARS, purchasing medical equipment in the hinterland and scientific research.

 

"Hospitals should treat patients first and talk about money second," Jin told CCTV's news channel.

 

"For those who don't have health care insurance, we, the Ministry of Finance, will be responsible for them to the end," he added.

 

Singapore said it had made strides in containing new SARS infections by controlling the spread of the disease within hospitals. Most of the victims in the island republic have been hospital visitors, doctors and nurses infected by sufferers.

 

The city-state enjoyed a reprieve on Saturday with no new reported infections but described SARS as a "virulent" enemy.

 

"SARS is an enemy of an unprecedented nature for Singapore," Deputy Prime Minister Lee Hsien Loong said in a speech.

 

"It cannot be arrested or combated visibly and physically. Yet it is virulent, and will exploit lapses in personal precautions," he said.

 

After breaking out in Guangdong, SARS spread to nearby Hong Kong this year and was then taken around the world by air travellers.

 

In one worrying case reported on Saturday, a flight attendant for Australia's Qantas Airways was hospitalised in Sydney with probable SARS after working on a flight from Singapore.

 

Australia's biggest airline said it was contacting the 341 passengers and 19 crew who were aboard the flight to Sydney as a precautionary measure.

 

Australia has previously reported four probable SARS cases to the World Health Organisation. Those people have recovered.

 

(Reporting by Tay Han Nee in Hong Kong, Benjamin Kang Lim in Beijing and Jason Szep in Singapore)

[tonado]

"Doctors are urging patients to avoid personal contact such as hugging and kissing when they go home. "

 

-----------------------------------------------------------------------------

http://www.msnbc.com/news/885653.asp?vts=050320030835

 

Researchers say SARS is mutating

NBC, MSNBC and news services

 

 

Researchers in Hong Kong said Friday the SARS virus is mutating rapidly into at least two forms, complicating efforts to develop a solid diagnosis and a vaccine. Meanwhile, China agreed Saturday to have World Health Organization experts visit rival Taiwan to study its outbreak, ending a political stalemate that the island said threatened to hurt disease-fighting efforts.

 

"THIS RAPID EVOLUTION is like that of a murderer who is trying to change his fingerprints or even his appearance to try to escape detection," said Dr. Dennis Lo, a chemical pathologist at Chinese University of Hong Kong.

Researchers at the university said that they had determined the genetic sequences of virus samples taken from 11 SARS patients and that by late March there were two forms of the virus in Hong Kong.

 

"We have shown that the SARS coronavirus is undergoing rapid evolution in our population," Lo said. But he said more work was needed before researchers could say whether the virus had become more infectious and lethal.

 

Researchers also need to find out whether people who get SARS from one strain can develop immunity to other strains, he said. If not, finding ways to better diagnose it and develop a vaccine could be more difficult.

 

The WHO says there is no evidence that the mutations have any effect on the disease itself. WHO scientists also say it is not surprising that the SARS bug shows genetic changes, because the coronavirus family is prone to mutations.

 

Hong Kong scientists are also concerned that the virus may survive in an infected person's body for at least a month after recovery. Doctors are urging patients to avoid personal contact such as hugging and kissing when they go home.

 

"The virus still exists in the patients' urine and stool after they were discharged. It will persist for at least another month or maybe even longer," said Dr. Joseph Sung, head of the Department of Medicine at the Chinese University of Hong Kong.

 

PROGRESS IN TAIWAN

Saturday, China took steps to help bring the virus under control in Taiwan, announcing that it had agreed to allow the WHO to send experts to review the SARS situation there.

 

The announcement, reported in a brief dispatch by the official Xinhua news agency, did not say when the experts might go or give other details. It quoted a Health Ministry spokesman as saying he was concerned about the "health and well-being" of people in Taiwan, which China claims as its territory.

 

Taiwan, which announced five new SARS deaths Friday, taking the island's toll to eight, has complained that the WHO has not responded to requests for information and help with SARS. China has blocked its efforts to join the organization.

 

Taiwanese health authorities have complained that WHO failed to respond to their requests for help with severe acute respiratory

 

syndrome, which has killed eight people there. The island's Mainland Affairs Council, which handles relations with Beijing, had

 

no immediate reaction to China's announcement.

 

BEIJING SAYS WORST IS OVER

Liang Wannian, deputy director general of the Beijing Municipal Health Bureau, said at a Friday news conference that the pneumonia-like disease was peaking in the capital.

 

In the recent past, health experts criticized China over its belated and secretive response to the outbreak. But the government has changed its policy and begun fighting very aggressively to contain the disease.

 

Liang said the number of SARS patients in Beijing had remained steady since April 21, based on figures the Health Ministry released Thursday.

 

"My personal judgment is the present high plateau of the number of cases in Beijing will continue for a period of time. Overall, the situation in Beijing is stable, and the upward trend has been effectively checked," he said.

 

Cases of SARS in the capital will likely drop in the next 10 days if the virus does not mutate, he said.

 

Beijing has imposed restrictions on university students leaving the city, requiring health checks and barring them from going to rural or disease-affected areas, a Communist Party official said Friday.

 

Only students who are found to be in good health without fevers or other symptoms of SARS will be allowed to leave the capital for their hometowns, said Cai Fuchao, a spokesman for the city's party committee.

A CRITICAL PERIOD IN CHINA

"The next few months will prove crucial in the attempt to contain SARS worldwide, which now greatly depends on whether the disease can be controlled in China," the WHO said in a statement on its.

 

China said on Saturday nine more people had died from SARS and another 181 were infected, taking the death toll to 190 and the number of cases to almost 4,000.

 

The Health Ministry said five of the new deaths were in Beijing, currently the hardest hit place in the world, along with 114 of the latest cases by 10 a.m. local time on Saturday. However, more than 1,400 SARS patients have recovered and been discharged from hospitals, a ministry spokesman told reporters.

 

SARS has killed 190 people in China and infected almost 4,000 since it emerged in the southern province of Guangdong late last year. Worldwide, it has infected more than 6,100 people in 30 countries, killing close to 400 of them.

 

President Hu Jintao called Friday for a "People's War" on the disease during a trip to the industrial city of Tianjing, which experts say is poised to experience an outbreak because of its proximity to Beijing.

 

Movie theaters and other recreational spots have been closed in Beijing, where about 12,000 people are under quarantine orders in the city of 14 million.

 

Xiaotangshan Hospital in a village north of Beijing, boasting at least $11 million worth of medical equipment, opened its doors after more than 7,000 builders rushed to erect the temporary facility for SARS cases in eight days.

 

Some of the 1,200 medical staff due from the military had arrived, and 156 SARS patients from 15 hospitals in urban areas in Beijing were brought to the hospital in ambulances Thursday evening.

 

RELAPSES IN HONG KONG

Scientists in Hong Kong, meanwhile, said they feared that 12 people may have relapsed. The new findings raise questions as to how doctors can tell whether a patient has fully recovered, underscoring the difficulty health authorities face in tackling the new disease.

 

Dr. David Heymann, the WHO's chief of communicable diseases, said that the relapses were disappointing and that it was not clear what caused them. He said he had not heard of similar reports outside Hong Kong.

 

"We don't yet have the data ... as to exactly what has happened, what these people were treated with," Heymann said. He said one theory was that some relapses might have happened because patients stopped taking steroids too quickly. The steroid therapy is being prescribed in Hong Kong.

 

Heymann said that in some other infectious diseases, it was not uncommon to find virus in body excretions after a patient's symptoms were gone.

 

"So it's not a new phenomenon that viruses remain, but certainly a relapse is concerning," he said.

 

FATALITY RATE WORSENING

World health officials continue to follow new cases of the disease, but they said its fatality rate was worsening as patients who had been lingering in hospitals have now begun to die from the disease.

 

The WHO said the death rate may have risen to 10 percent from 6 percent, especially in Canada and Singapore.

 

The WHO said the mortality rate appeared to be higher in places with developed health services, but a WHO official said the reason was a mystery.

 

A possible explanation for a higher fatality rate among infected medical staff, at least, in wealthier countries is that in those countries doctors and nurses tend to get more involved in treatment and general care, the official said.

 

"It may be just that there was much more contact -- and that this happened before [the seriousness] of the disease was known," he said.

 

RELATED DEVELOPMENTS

The Canadian government said Friday that it would set aside $100 million ($70 million U.S.) this year to protect Canadians and visitors. Canada has had 349 probable or suspected cases of SARS and 23 deaths; the Toronto area reported two more cases Friday, both of them in nurses.

 

In Malaysia, 60 more patients and staff were quarantined at two hospitals feared to be sites of a SARS outbreak.

 

Singapore reported two new cases and another death Friday, bringing total deaths to 25, the world's third-highest number. The latest infections were the first new cases in three days, dealing a blow to hopes that the city-state's tough quarantine and screening measures had mostly contained the illness.

 

The United States and Britain have been taken off the WHO's list of "SARS-affected areas," the organization said Friday. Countries are removed after 20 days, twice the incubation period for the disease, unless there is evidence of transmission to additional people. Four countries -- Canada, China (including Hong Kong and Taiwan), Mongolia and Singapore -- remain on the list of countries where national authorities have reported a local chain of transmission. There have been 245 suspected SARS cases reported in the United States, but only 41 are probable cases, and there have been no deaths.

 

Vietnam's state-owned airline slashed fares by 20 percent to attract travelers after the WHO declared that the country was the first to contain SARS.

 

 

 

The Associated Press and Reuters contributed to this report.

[tonado]

"The new data suggest that infection can occur simply from touching a contaminated table or doorknob, the report said."

--------------------------------------------------------------------------------

Monday May 5, 12:52 AM

Mass quarantines continue in China as SARS deaths slow worldwide

 

HONG KONG (AFP) - China took strict measures to contain the SARS outbreak in its capital, placing close to 16,000 people under quarantine as further deaths were recorded in Asia and evidence emerged that the virus can survive on common surfaces for hours.

 

China also sacked officials nationwide for failing to implement tough measures to contain the deadly disease as the health ministry reported seven new deaths from the pneumonia-like respiratory illness and 163 new infections. There are now some 197 dead and 4,125 confirmed or probable cases in the world's most populous country.

 

The capital city Beijing has borne the brunt of the epidemic in China, with 100 deaths and at least 1,803 known cases.

 

Health authorities, an estimated 15,873 people had been quarantined in the capital as of Sunday morning -- up 825 from Saturday's figures.

 

Those ordered quarantined are either infected with SARS, suspected of being infected, showing SARS symptoms or having had contact with SARS patients. Authorities also quarantined a third construction site in the capital.

 

China's poorly-funded and overtaxed medical system, particularly in Beijing, a city of 13 million people, has been struggling to cope with the epidemic, which is suspected to have originated in the southern Chinese province of Guangdong and spread globally, infecting 6,407 people and killing at least 449 people.

 

State media reported Sunday that 10 officials in Longnan county, southern Jiangxi province, were sacked or disciplined for failing to implement SARS-related health policies, while five officials in central Anhui's Fuyang city were fired or disciplined for similar violations.

 

An official in Chaoyang city, northeastern Liaoning province, was sacked for failing to implement quarantine measures and monitoring the return of migrant workers from Beijing, while the head of the People's Hospital in Zhumadian city, Henan province was also fired.

 

Even in southern Hainan province, which has not reported any cases of SARS, the province's health bureau chief and several hospital directors were sacked or disciplined for failing to implement SARS-prevention measures.

 

In Hong Kong -- the worst hit location outside of mainland China -- five more SARS fatalities and eight new cases were reported Sunday, pushing the toll there to 184 deaths and 1,629 infections.

 

Officials breathed a sigh of relief when 10 crew members of a Malaysian cargo ship that anchored off the territory after the government received a distress call from the vessel were found not to have SARS.

 

The crew had shown SARS-like symptoms including a cough, fever and aching joints but were later determined not to have Severe Acute Respiratory Syndrome.

 

As global research into the mysterious pneumonia-like illness continued, the Washington Post reported that the SARS virus can survive for hours on common surfaces outside the human body, and up to four days in human waste, evidence that may explain Hong Kong's particularly bad outbreak at a housing estate.

 

Scientific studies found the virus can survive for at least 24 hours on a plastic surface at room temperature, and can live for extended periods in the cold, the studies found.

 

"It's the first time we have hard data on the survival of the virus. Before, we were just speculating," said Klaus Stohr, the top researcher into the mystery virus for the World Health Organization.

 

"These studies are very important for designing strategies for cleaning and disinfecting."

 

The new data suggest that infection can occur simply from touching a contaminated table or doorknob, the report said.

 

They shed light, too, on how the disease may have spread in a 33-storey apartment building in Hong Kong where hundreds were infected.

 

Scientists found that the disease persists in adult faeces for six hours but in human diarrhea for up to four days, and now suspect it was spread at the Amoy Gardens complex by a SARS-infected man with diarrhea, via a crack in a sewage pipe.

 

Outside of China, SARS deaths and infections appear to be stablilising. Singapore and Taiwan reported one new SARS death each on Sunday, bringing their respective death tolls to 26 and eight, though Singaporean officials said they had included one non-SARS related fatality in its toll.

 

In Taiwan, two reporters from Hong Kong Next magazine's Taiwan edition who were placed in quarantine for two weeks after pretending to be SARS patients face a penalty of up to three years in jail for gathering news from a hospital closed because of the SARS epidemic.

 

The two posed as patients at the Taipei Municipal Hospital which was ordered closed due to a SARS outbreak, the Taipei city government said.

 

In India, 23 Australians have been quarantined after two of their fellow travellers were hospitalised as suspected SARS cases.

 

And Malaysia Sunday ruled out a travel ban on its citizens to Singapore and other SARS-affected nations as it reported a seventh probable SARS patient and two new suspected cases.

 

SARS continues to have lingering economic effects in Asia, most specifically in China, where authorities decided Sunday to cancel an international trade fair scheduled for the southwestern province of Sichuan.

 

The cancellation follows a decision at the weekend to move both the world cycling championships and the women's World Cup football tournament from China due to the epidemic, for which there is no known cure or vaccine

[tonado]

washingtonpost.com

SARS Can Live on Common Surfaces

Key to Its Spread Lies in Quantity

 

By Rob Stein

Washington Post Staff Writer

Sunday, May 4, 2003; Page A01

 

 

The SARS virus apparently can survive on common surfaces at room temperature for hours or even days, which could explain how people can catch the deadly lung infection without face-to-face contact with a sick person, scientists have found.

 

New laboratory studies, being released today, have produced the first scientific data on how long the SARS virus can live in various places and conditions, demonstrating for the first time that the microbe can linger outside an infected person's body.

 

One study showed the virus survived for at least 24 hours on a plastic surface at room temperature, which suggests it might be possible to become infected from touching a tabletop, doorknob or other object. Another found the microbe remained viable for as long as four days in human waste, a crucial finding that could clarify how the virus can spread through apartment buildings, hospitals and other facilities.

 

German scientists found a common detergent failed to kill the virus, indicating that some efforts to sterilize contaminated areas may be ineffective. An experiment conducted in Japan concluded that the virus could live for extended periods in the cold, suggesting it could survive the winter.

 

The long-awaited findings should be crucial for containing the epidemic, and they could solve one of the most important mysteries about the new disease: how the virus spreads without direct exposure to infected individuals.

 

"It's the first time we have hard data on the survival of the virus. Before, we were just speculating," Klaus Stohr, the World Health Organization's top SARS scientist, said yesterday. "There has been a lot of speculation that the touching of objects could be involved. This shows that transmission by contaminated hands or contaminated objects in the environment can play a role."

 

In addition, the findings will help researchers develop better tests for the virus and possible treatments. Now that they know what temperatures kill the virus, researchers can purify serum from sick people for use in calibrating tests and possibly to give other patients as a therapy. Serum contains antibodies that are measured by tests. In addition, the antibodies could work as a treatment if they can neutralize the virus.

 

The new data come as the number of cases continues to increase. An additional 191 cases and 18 deaths were reported yesterday, bringing the toll to 6,234 cases in 27 countries, and 435 deaths, according to WHO. Outbreaks appeared to be under control in Hanoi, Hong Kong, Singapore and Toronto, but the disease was still spreading in many parts of China, and Taiwan has experienced a sharp jump in cases in the past week.

 

U.S. health officials are investigating 54 probable cases in this country, including three in Virginia, and are monitoring an additional 237 suspected cases.

 

The results were produced by laboratories in Hong Kong, Japan, Germany and Beijing that are part of a scientific network organized by WHO to study the previously unknown virus. The findings were compiled and analyzed over the past few days and were to be posted on WHO's Web site today so public health workers around the world can begin using them to keep the virus from spreading, said Stohr, who described the findings in a telephone interview.

 

"These studies are very important for designing strategies for cleaning and disinfecting," Stohr said.

 

Stohr stressed that a key unknown is how much virus is necessary for someone to become infected. So even though the virus can survive in the environment, it remains unknown whether it can survive in sufficient quantities to be dangerous, he said.

 

"What we're seeing is that this virus certainly has the capacity to stay in the environment. What we don't know is the infectious dose," he said.

 

Stohr also emphasized that, by far, the primary mode of transmission was through droplets that spray out when an infected person sneezes or coughs.

 

But researchers had become increasingly suspicious that there were alternative transmission routes because of incidents in which people became infected without close personal contact with a sick person.

 

The most disturbing case involved a 33-story apartment tower in the Amoy Gardens complex in Hong Kong. Hundreds of people living in the building were infected, forcing authorities to evacuate the residents to quarantine camps.

 

An intensive investigation concluded that the outbreak may have been caused by a man who caught SARS, developed diarrhea and used his brother's bathroom in the building. Investigators found a small crack in a sewage pipe in the building and speculated that the virus spread through the building in droplets that became airborne from the leak.

 

"There has been a lot of speculation about how the Amoy Gardens got infected. No one knew whether the hypothesis would hold. This would support the theory that . . . sewage coming out from that crack could have contaminated the air," Stohr said.

 

In the new research, scientists in Hong Kong added the virus to normal human adult feces and diarrhea, as well as to feces from a 6-month-old baby. The virus survived in the baby's feces for three hours, in normal feces for six hours and in diarrhea for four days. The difference appears to be linked to acidity -- the virus survives longer as the acidity decreases, Stohr said.

 

"This is important, because traces of stool could occur on surfaces in hospitals. So this is very important to know in sterilizing those environments," Stohr said.

 

In another set of studies, scientists in Japan examined how well the virus weathered extreme temperatures. The virus died at 98.6 degrees Fahrenheit and above, started to deteriorate at 40 degrees but seemed to remain viable indefinitely when temperatures dropped to 32 degrees. Scientists in Beijing produced similar results.

 

"This means that if the virus is being kept at lower temperatures, we have to think about next winter," Stohr said.

 

German researchers, meanwhile, placed the virus on a plastic surface at room temperature and found it could survive as long as 24 hours. "It survived easily," Stohr said. Another team in Hong Kong produced similar results.

 

The German scientists also found that a commonly used detergent appeared to have little effect on the virus. The U.S. Environmental Protection Agency is planning a large-scale study to test a large number of disinfectants against the virus, Stohr said.

 

Other teams in Singapore and Hong Kong have also been testing the virus's ability to survive in various temperatures and levels of humidity; in blood; and on metals, plastics, paper and cotton. Those results could come within days, Stohr said.

 

"We're beginning to understand how this virus can survive in the environment," he said.

 

 

 

© 2003 The Washington Post Company