Severe Acute Respiritory Syndrome (SARS)
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Respiratory Syndrome, SARS Spreading, SARS: Genetic Sequence,
Talking on SARS, SARS in Toronto
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On 25/3/2003, Paul
Williams posted:
Just been away staying with a friend from AQIS, so am immersed in
microbiological things at the moment.
(Also re-reading Laurie Garrett's brilliant "The Coming Plague")
The information below is a few days old but still holds as far as I
know. One of the greatest boons of the internet appears to be in
epidemiology.
Regards
Paul
SEVERE ACUTE RESPIRATORY SYNDROME - WORLDWIDE (08)
**************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Date: 18 Mar 2003
From: "Henry L Niman, PhD" <henry_niman@hms.harvard.edu>
Source: Hong Kong Standard 19 Mar 2003 02:16 AM [edited]
<http://www.thestandard.com.hk/thestandard/topstory.cfm>
Killer virus identified
-----------------------
A team from the Prince of Wales Hospital and Chinese University of Hong
Kong have identified the virus that has caused the recent outbreak of
severe acute respiratory syndrome worldwide, confirming that the
current anti-viral treatment applied to patients has been the right
choice.
Identifying the virus as a member of the Paramyxoviridae family,
Professor John Tam of the department of microbiology of the Chinese
University said it was detected by electron microscopy. The finding,
announced late last night, was further confirmed by a molecular
technique that revealed the nucleic acid sequence of the virus.
Asked if the virus was curable, Tam reiterated that the finding last
night had indicated that the current treatment applied to patients
suffering from the syndrome, more commonly known as atypical
pneumonia, had been the right choice. But he added that they still
needed to monitor individual patients' reactions before they could
conclude that the virus was curable.
Lo Wing-lok, Medical Association president and legislator, said the
Paramyxoviridae family incorporated different viruses that could affect
humans and, as such, further studies were needed to establish whether
it was a new virus. Earlier it was revealed that at least 6 patients
were responsible for spreading the pneumonia in Hong Kong. Health
chief Yeoh Eng-kiong also said that a mainland professor who died in
[Hong Kong] SAR on 4 Mar 2003 was a victim of the atypical pneumonia.
The new information from officials indicated the disease had been more
widespread in the SAR than originally believed. Yeoh said the
pneumonia and suspected cases had now been isolated into 6
"clusters". Yeoh again stressed the government was not hiding
anything. He insisted there was no sign of an outbreak at the community
level.
[byline: Matthew Lee and Georgina Lee]
--
Henry L Niman, PhD
Department of Bioengineering
Shriners' Burn Center
51 Blossom Street, Room 422
Boston, MA 02114 USA
<henry_niman@hms.harvard.edu>
[This is the second identification of a paramyovirus-like organism from
a patient with SARS (see ProMED-mail posting Severe acute respiratory
syndrome - worldwide (06) 20030318.0677). The first identification
was made by investigators in Frankfurt am Main and Hamburg from
specimens taken from a physician from Singapore who had treated some
of the earlier cases seen in Singapore and was admitted to hospital
in Frankfurt, Germany en route back to Singapore over the weekend.
As mentioned in our earlier posting, it is important to confirm these
findings and to identify a similar agent from other cases of SARS
before it can be concluded that this agent is the cause of SARS. That
being said, this second identification of a paramxovirus-like organism
from patients with SARS offers hope that the etiology of this outbreak
may be identified soon. - Mod.MPP]
http://www.promedmail.org/pls/askus/f?p=2400:1000
Zero
Sum responded:
<http://www.theage.com.au/articles/2003/03/25/1048354582099.html>
appears to
contradict it. Worryingly.
This might
be more important than Iraq. If that spreads in a "cold" like fashion, then it
is lightly to become endemic everywhere. Could we take the losses?
Peter Macinnis added:
Didn't Frank Fenner say as much last weekend?
I endorse Paul's views on "The Coming Plague" -- it is an excellent
analysis of how a disease waits its time until the ecology is right.
Paul
Williams replied:
Yes, the original etiology appears to be incorrect.
It does now appear to be a Coronavirus - from a family which includes
infectious upper respiratory viruses.
There is a tremendous ammount of work being done worldwide at the
moment.
It is suggested that using standard specific medical treatment
sufferers are recovering.
I guess that we will know more in the coming weeks.
Transcript from the Centre for Disease Control press conference:
http://www.cdc.gov/od/oc/media/transcripts/t030324.htm
W.H.O. site:
http://www.who.int/csr/sars/en/
Peter Macinnis commented :
(<sarcasm>)*
We all had it wrong.
GE-Free NZ campaigner Claire Bleakley believes that there may be a link
between food derived from GE products and the Severe Acute Respiratory
Syndrome (SARS)!
So now you know.
(</sarcasm>)*
{editorial addition, for those unfamiliar with his style}
Zero
Sum responded:
If it is coronavirus (and it looks like it is) then we are in trouble.
Chances of eliminating this are infinitesimal, chances of
indefinite containment small.
So far we have about seven deaths from 150 cases. A five percent
death rate so far.
What about second infections? For coronavirus there is no
reduction in virulence for the second occurance.
How serious are the consequences of this for humanity as a whole?
Paul Williams replied:
It is very early days.
The most recent WHO figures show 487 cases with 17 deaths. These
figures are a little rubbery. Compared to Ebola (a very
different virus) it doesn't appear to be so virulent. Ebola from
memory has a 50-90% mortality rate. Of course the method of
transmission of SARS is a worry. The consequences for some
isolated groups may be devastating. The gene pool of humanity
seems pretty mixed so I would guess that resistance would be
widespread.
Older people and immuno-suppressed people would be more at risk.
Man has survived virulent diseases for approximately 300,000
years. I don't think that this is "The Andromeda Strain".
Once again I would be more concerned with Ebola - mainly because it
appears to be threatening the very existence of our 'cousin' the lowland
gorilla.
http://news.bbc.co.uk/1/hi/sci/tech/2872421.stm
Recent WHO SARS figures:
http://www.who.int/csr/sarscountry/2003_03_25/en/
Ian
Musgrave, replying to a post by Ray:
At
05:17 26/03/03 +1100, Ray wrote:
>As
a part of our training to write a scientific work report over the year,
>research skills include a study of ethics.
>
>We were given a few examples of historic fraud/error, some of which
will be
>familiar to many, some not so.
[snip]
>
>AAHL -Australian Animal Health Laboratory research into viruses not
present
>in Australia. (stopped fortunately)
So when
those viruses inevitably reach Australia (like fire ants, small hive
beetle,the killer seaweed that we have here in SA), we will have no
research with which to combat them. This is the use of the word
"fortunately" with which I was previously unaccustomed.
Ray replied:
>>So when
those viruses inevitably reach Australia (like fire ants, small
hive beetle,the killer seaweed that we have here in SA), we will have
no
research with which to combat them. This is the use of the word
"fortunately" with which I was previously unaccustomed.
Personally (note: an opinion) Ian, I would prefer to see any research
upon exotic diseases which are not yet present in Australia, done where
they are already endemic or indigenous, rather that find that they got
here because a bushfire (as a for instance) or a human or systematic
error, which accidentally let them loose.
Especially when long isolated marsupials have immunity to imported bugs
similar to that which Indigenous people had for European diseases.
Same reason I'd rather CDC of Atlanta kept their bottles of virus.
AAHL, continues I believe, with scaled down operations. A
bit like the animal pathogen equivalent of nuclear science's Lucas
Heights?
So yeah, I think its
fortunate they weren't operating at Stromlo.
Ian
Musgrave responded:
>Personally
(note: an opinion) Ian, I would prefer to see any research upon
>exotic diseases which are not yet present in Australia, done where
they are
>already endemic or indigenous,
But that
won't give us any idea of what will happen when (note when, not if) they
get here. Australian conditions are not European/American conditions
so we will be at a disadvantage when these diseases arive here.
This is why we do medical research in Australia, rather than
rely on overseas medical research (should we just rely _only_ on
what happens to obese Americans to combat our own obesity problems?)
>rather
that find that they got here because a
>bushfire (as a for instance) or a human or systematic error, which
>accidentally let them loose.
All cases
of undesirable organisms in Australia have been due to quarantine
failure, rather than escape form a secure facility. Human medical
researchers routinely work with really horrible diseases in secure
facilities and there has been no accidental release of these diseases.
Why should veterinary research be any less secure?
>Especially
when long isolated marsupials have immunity to imported bugs
>similar to that which Indigenous people had for European diseases.
You would
rather wait until after the disease got here to find out how
susceptible our native populations are, and how to combat the spread
of these viruses in the native population?
>Same
reason I'd rather CDC of Atlanta kept their bottles of virus.
>
>AAHL, continues I believe, with scaled down operations.
A bit like the
>animal pathogen equivalent of nuclear science's Lucas Heights?
No, more
like any standard human medical virology research centre.
>So
yeah, I think its fortunate they weren't operating at Stromlo.
The Stromlo
fires would have sterilized the labs in the first place (and don't you
think there would be a fire plan in place, what do you think happens
in human medical research centres with horrible viruses in secure labs
when there is a fire?)
Ray answered:
Ian, I reply almost legless.
In short, your pointed argument has greater credibility than does basic
fear.
In reflection upon the quote stated and referenced below (I hope
accurately, I have other things to do beside check... and I'm not
trying to get anything published right now :)), it now appears that
the issue of contention had more to do with the reactionary protest
argued against by your stand point Ian, than it had to do with my own
knee-jerk aversion.
-given the brevity of class time, only Piltdown Man and Thalidomide
were discussed. I think, that had AAHL been discussed,
brainstormed, as it were, I may well have seen a bit more light in
advantages than to have immediately considered the hazard.
SM it appears is an effective arena for brainstorming. Provided
no one takes debate as a personal attack :)
David
Maddern riposted:
Did you mean to say this?
>All
cases of undesirable organisms in Australia have been due to quarantine
>failure, rather than escape form a secure facility.
you have
not met leaches in your breaches {breeches?
the other is too horrible to contemplate! - Barb}
or a funnelweb in your tunnel
or a tick in your reggies
then?
=)
Chris Lawson wrote:
>All cases of
undesirable organisms in Australia have been due to quarantine
>failure, rather than escape form a secure facility. Human medical
>researchers routinely work with really horrible diseases in secure
>facilities and there has been no accidental release of these
diseases.
This is true of Australia,
but not everywhere. There was an outbreak of anthrax in the Soviet Union
because some idiot forgot to put the right air filters in the
ventilation system of a bioweapons research centre. But your essential
point is correct: secure facilities have shown themselves to be
pretty darn secure.
The risk of organisms getting into our local biosystems are, in order
of likelihood, due to
(i) contaminated material entering unnnoticed (eg.,
ships emptying their ballast tanks),
(ii) smuggling (eg., importing rare animals for
private zoos),
(iii) utter stupidity (eg., the introduction of cane
toads against the consensus of the Australian scientific community),
and by a long gap,
(iv) escape from secure facilities.
To determine the value of researching exotic organisms, one has to
balance the risk of escape from the secure facility agains the risk
of being unprepared should one of the other causes of quarantine
failure eventuate. I would submit that in most cases, the benefit
would outweigh the risk, although I certainly wouldn't be keen on
Australia researching Marburg virus...
Gerald
added:
As with the appearance of any new virile {viral?
virulent?} pathogen I suspect initially there will be significant
initial mortality but this will subside to a lower level over time,
still it's tough on those whose immune system is not up to the
challenge.
Peter Macinnis added:
On the news just now, Taiwan and Toronto have been added to infection
centres -- previously Hanoi, Singapore and Guangzhou were on the list.
My guess is Beijing will be on the list within a week. As a
commentator observed in "Science" last week, it puts all the
scaremongering on bioterrorism in perspective. "Mother Nature is by
far the worst terrorist out there", says Marjorie Pollack.
That article, by the way, was canvassing the options of the virus being
a parvovirus or a hantavirus, and mentions that the Chinese had
identified Chlamydia pneumoniae in two of the early deaths, in
Guangdong.
Chris
Lawson replied:
That is yet to be determined. How do we know it *wasn't* a bioterror
event?
Put the challenge to Mr Dembski, as he claims to have the ability to
distinguish artificial from natural sequences :-)
Peter Macinnis responded:
Treating that as a serious question, because it broke out back in
November, in China, and might have gone nowhere, or anywhere, though
I suspect it is reasonable to predict that it would get into North
America.
Besides, nobody has claimed the credit for it, and by now, I think they
would. Of course if some lunatic said the world needed some
breathing space, well you can attribute anything you like to a
hypothetical "mad scientist".
I am not impressed by the chap I saw last night saying it is "not very
infectious". It may not leap down your throat with a roar,
kicking your teeth in as it goes, but it would seem to be quite as
good as any other cold in getting from A to B.
Ian
Musgrave added:
Chris, you're not suggesting Dembski actually test his claims?
I am shocked, I say shocked at the suggestion (:-) for the irony
impaired)
The Science Editor wrote:
The Lab, has posted up a comprehensive guide to this mysterious new
disease SARS (Severe Acute Respiratory Syndrome).
It's called "The facts about SARS" and can be found at
http://www.abc.net.au/science/features/sars/default.htm
Herewith an intro:
The facts about SARS
It was on a farm somewhere in southern China where the mystery
pneumonia we know as SARS probably began. Once in the cities, the
virus spread and - thanks to air ravel - is now a flaring
epidemic in more than a dozen countries. What is Severe Acute
Respiratory Syndrome? How did it originate? What are the symptoms?
And is it treatable?
Ray
re-opened the discussion on 15/4/2003
On a side
issue to genetic sequencing...
The mass
media is currently playing up the 3 billion base pair sequencing of
the human genome whilst offering all kinds of medical miracles and
warning of potential social problems (eg; insurance).
Good and
well. As a first step (well, second step after Crick, Watson
& co), but knowing CCGATTCGTCATGGAACTG... etc is one thing, but
knowing what fragments of sequence do, alone or together with other
sequences is quite another thing.
Maybe we
are even in a position to know which sequences are turned on and which
aren't, and which Operons are the "On" sequences for particular
proteins?
The job has
only just begun, and is certainly nowhere near completion. Just
for the record.
Peter Macinnis, replying to a
post from Paul Williams:
> SARS appears to have about a 2% mortality rate -
about the same as the
> Spanish Flu of 1918 which killed 40 million people.
> 85 years on, we are in a much better position to prevent a similar
pandemic.
> The situation in China is a worry though.
I have just finished entering all of the data from WHO into a
spreadsheet. On the reports to date, mortality varies from 0%
(USA) to 10% (Canada, which was caught early).
As of April 14, 144 dead from 3169, rounds in my spreadsheet to 5%.
I firmly believe that the Chinese are hiding a great deal: the Hong
Kong figures may be accurate, but the mainland stuff does not add up
-- and Vietnam appears to be hiding something as well. Even with
that dilution of the data, the trends are all upwards.
See http://www.who.int/csr/sarscountry/en/
for the data, day by day.
The spreadsheet should be available online today in rough form -- I
will let you know when and how.
and
This spreadsheet is just one
of a large series available for free downloading from www.websterworld.com - go to the site,
find the "Teacher Notes" button on the lower left, click on "For
Teachers", and choose introduction to our new ICT skills support
materials, and choose the link to the Downloads -- or just look
around. The spreadsheet is already there, but there will not be a link
until about 3.30 pm, AEST -- that is, 14 minutes after this message is
sent.
It is called SARS.xls, but you can't FTP it.
Garry
P. Dalrymple posted:
I share your concern but I notice that the defensive frontline against
SARS are the public health institutions, fairly well developed in Hong
Kong, Canada and to a lesser extent China.
My fear is that SARS will enter the large Aids afflicted and immune
suppressed populations of southern China, India, Sub-Saharan Africa
and the poor underclass of US cities where health infrastructure may
be unable to contain it's spread.
Of course a 'co-payment' to prevent 'frivolous' access Australian
health care will do wonders to confine SARS to our own not privately
health insured population.
Viva 'Free Market' health policies and Globalisation, or should that be
'Viral free market' health policies?
Pardon me, but I seen to have a cough (dryly) and is that four horsemen
I can hear?.
Peter Macinnis replied:
My thoughts entirely -- and I have snipped your bit about Oz and the
vicious dismemberment of the medical system by <insert here your
favoured term for coprophagic piranhas>, but endorse that as well.
Not that it matters much -- once health care is overwhelmed,
there won't be enough respirators for the estimated 20% needing them,
and many or most will die. As they pointed out in a 'New England
Journal of Medicine' editorial a week or two back, coronaviruses are
good at swapping stuff around, and if one gets just a LITTLE bit
better at dissemination, or a LITTLE bit better at spreading before
symptoms
appear (harder), it could be away and running.
Let me speculate for a bit.
I would not be surprised to find either that parts of Guangzhou are at
the 20% mortality level now, and that cases and deaths are going
unreported -- or that Guangzhou will reach that level soon. If
that happened, panic would set in, with flight, and spotting of
infection in new centres, perhaps all the ways across the Eurasian
land mass. I really would like to be proved wrong on this.
Anybody with a compromised immune system will be in trouble . . . I
have just been reading Matossian's excellent analysis of the Black
Death which probably wasn't bubonic plague in any case. This one
suggests that whatever it was, it combined with severely compromised
immune systems, affected by ergoty rye, and so killed large numbers.
Anybody want some elderly aflatoxic peanuts?
and
This is a test transmission of mortality data for
SARS. I have only used the four most affected
unit/nations at this stage.
|
World |
China |
Hong Kong |
Singapore |
Canada |
| 17-Mar-03 |
0.024 |
0.000 |
0.250 |
|
|
| 18-Mar-03 |
0.018 |
0.000 |
0.250 |
|
|
| 19-Mar-03 |
0.034 |
0.000 |
0.250 |
|
|
| 20-Mar-03 |
0.033 |
0.000 |
0.222 |
|
|
| 21-Mar-03 |
0.029 |
0.000 |
0.222 |
|
|
| 22-Mar-03 |
0.028 |
0.000 |
0.222 |
|
|
| 24-Mar-03 |
0.037 |
0.000 |
0.273 |
|
|
| 25-Mar-03 |
0.035 |
0.000 |
0.273 |
|
|
| 26-Mar-03 |
0.037 |
0.039 |
0.032 |
0.014 |
0.158 |
| 27-Mar-03 |
0.038 |
0.042 |
0.027 |
0.026 |
0.107 |
| 28-Mar-03 |
0.036 |
0.042 |
0.024 |
0.023 |
0.103 |
| 29-Mar-03 |
0.035 |
0.042 |
0.021 |
0.022 |
0.081 |
| 31-Mar-03 |
0.036 |
0.042 |
0.025 |
0.022 |
0.091 |
| 1-Apr-03 |
0.034 |
0.042 |
0.023 |
0.033 |
0.075 |
| 2-Apr-03 |
0.035 |
0.039 |
0.023 |
0.042 |
0.103 |
| 3-Apr-03 |
0.035 |
0.039 |
0.023 |
0.041 |
0.097 |
| 4-Apr-03 |
0.036 |
0.040 |
0.022 |
0.050 |
0.101 |
| 5-Apr-03 |
0.037 |
0.040 |
0.025 |
0.059 |
0.095 |
| 7-Apr-03 |
0.038 |
0.042 |
0.026 |
0.057 |
0.100 |
| 8-Apr-03 |
0.039 |
0.041 |
0.027 |
0.071 |
0.110 |
| 9-Apr-03 |
0.039 |
0.041 |
0.028 |
0.076 |
0.106 |
| 10-Apr-03 |
0.040 |
0.043 |
0.030 |
0.071 |
0.103 |
| 11-Apr-03 |
0.040 |
0.044 |
0.030 |
0.068 |
0.102 |
| 12-Apr-03 |
0.040 |
0.044 |
0.032 |
0.061 |
0.099 |
| 14-Apr-03 |
0.045 |
0.045 |
0.039 |
0.076 |
0.130 |
Paul Williams responded:
Yes,
sorry - currently around 5% mortality is correct. I've been
mixing my figures.
Re
Spanish Flu: - About 2% of the world's then (1918) population of
around 2 billion died.
2% of
the current world population (of about 6 billion) is 120 million.
5%
is, of course, 300 million.
Nevertheless,
we are in a far better position today than we were in 1918 - the
extrapolation to 300 million or even 120 million deaths is not likely
to my mind.
(Best
to work hard at this though).
Peter Macinnis replied:
At 17:35 15/04/03
+1000, Paul wrote:
>Yes, sorry - currently
around 5% mortality is correct.
>I've been mixing my
figures.
Not a problem -- I was also in error, I find, and it has a worrying
side to it.
US mortality 0% from about 160 cases (don't have it here, but a goodly
number of cases with no deaths at all)
Canadian mortality 13% -- 13 dead from 100 cases -- 3 yesterday.
I argue the two nations have similar health systems and honest
reporting: why the difference? Could it be a different and more
virulent strain in Canada? I attributed it to them being snuck
up on at the start of SARS, not treating early cases, but the figures
do not support that . . . the deaths have been uniform.
Combine that with the Dalrymple scenario, and it is NOT good . . .
Paul
responded:
Now that the Canadians have sequenced the virus, comparisons can be
made. Four other labs are close to sequencing the virus. Hypothesis:
Perhaps the Canadian sufferers somehow received a large initial 'dose'
of the virus, overwhelming their immune systems before any sort of
defence could be put up?
I say this taking into account the comments on Carlo Urbani's death by
one of his colleagues:
"Most of those who had died of SARS were old or had some underlying
condition that weakened them, but "he worked with patients for weeks,
and we suspect he got such a massive dose that he didn't have a
chance,"
Dr. Palmer said."
http://www.nytimes.com/2003/04/08/science/sciencespecial/08PROF.html
(This is the same NYT link I supplied previously - registration is
painless and safe)
Peter replied:
> I firmly
believe that the Chinese are hiding a great deal: the Hong
> Kong figures may be accurate, but the mainland stuff does not add
> up -- and Vietnam appears to be hiding something as well.
Even with
> that dilution of the data, the trends are all upwards.
Actually, what I meant is that the Chinese are a pack of terrified
liars, but I was being polite. This is more or less what the ABC
news said this morning. Whether it is cultural or political, the
Chinese authorities are lying. The figures say so.
Adding in the April 15 figures, mainland China and Hong Kong both show
an identical (well, THERE's a surprise, Sir Cyril!) 4.5% mortality,
Singapore shows 8%, Canada still 13%
I cannot believe that Chinese medical care is that much better than
Singaporean and Canadian health care. The dose hypothesis may
account for a few cases, but continuing high levels in Canada and
Singapore cannot be accounted for that way.
David
Allen posted:
* Breakthrough in Sars battle *
Global health chiefs confirm Sars is a new strain of the common cold,
saying the discovery will aid efforts to find a cure.
Full story:
http://news.bbc.co.uk/go/em/-/1/hi/health/2953285.stm
This story carries positive spin but as we have been unable to find a
cure for the common cold is this warranted? Or am I just out of date
and there is a cold cure?
Paul Williams replied:
As far as my limited understanding leads me to believe, there will be
no cure.
I believe that vaccination will eventually be possible.
The problem with this may be how quickly this virus mutates.
The positive spin I put on the appearance of this disease is that we
have never been in a better position knowledge wise and communication
wise to control its spread.
China still remains a worry.
Zero
Sum added:
On
Thu, 17 Apr 2003 20:55, Paul Williams wrote:
> As far as my limited understanding leads me to believe, there will
be no
> cure.
Define
'cure'. Without repirators we would be losing more than 5%...
'Cure' is a magic word with no real meaning. No 'cure' is 100%
efective.
>
I believe that vaccination will eventually be possible.
Why do you
believe this? We have been trying to find a vaccine for the 'common
cold' for a long, long time. Each cold seems different, no
immunty seems to be aquired. And SARS is an 'uncomon cold' is it
not?
>
The problem with this may be how quickly this virus mutates.
As with the
common cold?
>
The positive spin I put on the appearance of this disease is that we
> have never been in a better position knowledge wise and
communication
> wise to control its spread.
Which may
however, be imposible.
>
China still remains a worry.
I'd say the
whole world has a worry. Could we survive if we lost a random
5-10% a year?
Paul responded:
> Define
'cure'. Without repirators we would be losing more than 5%...
> 'Cure' is a magic word with no real meaning. No 'cure' is
100%
efective.
Cure: Treatment which results
in recovery or return to health.
Various anti-viral drugs are being trialled at the moment.
I doubt that any of these will be a 'magic bullet'.
One day we may be able to target specific coronavirus glycoproteins.
> > I
believe that vaccination will eventually be possible.
> Why do you believe
this? We have been trying to find a vaccine for the
> 'common cold' for a long, long time. Each cold seems
different, no
> immunty seems to be aquired. And SARS is an 'uncomon cold'
is it not?
<snip>
There are at least four
different classes of viruses which cause the 'common cold'.
There are at least 100 serologic types of rhinovirus.
There are 3 or 4 of the 30 isolated coronavirus strains which infect
humans (Add one more now)
Echoviruses and coxsackieviruses also cause what we call the common
cold.
This complicates vaccination for the 'common cold' somewhat.
A vaccine against SARS may be complicated by the mutability of the
virus.
Vaccination - SARS:
"Although efforts to develop a vaccine against the new SARS respiratory
disease have already begun, ``several years'' of accelerated research
will be required before one is generally available, the government's
top infectious disease scientist said Monday."
"Dr. Anthony Fauci, director of the National Institute of Allergy and
Infectious Diseases (NIAID), said his agency is at work on the first
steps of vaccine development even before virus samples it received
from the Centers for Disease Control and Prevention have been
confirmed as the cause of the disease. ...He said his agency is
working to develop a vaccine from dead coronavirus and he expects a
``proof of concept'' vaccine to be ready in a year."
http://www.nlm.nih.gov/medlineplus/news/fullstory_12280.html
Zero
Sum replied:
>
Cure: Treatment which results in recovery or return to health.
Look, if I
seem a little sour on this, there is a reason.
Our family was decimated by the influenza at the beginning of the last
century. Quite possibly as we seem to have a genetic basis for
small sinuses.
For my children this is going to be even worse as they have already had
problems with this. It seems their mother has added to or
complicated the problem found in me.
My chance of survival from SARS would be small, and similarly for my
children. All remaining members of my family are old and infirm.
Sufficiently so that I doubt many of them would 'complain' at
the result. They are way past the age of reproduction anyway (and so
am I).
This has the potential for wiping my family from the planet with ease.
Given that the roughly 5% death rate so far is only 5% because of
drastic life support measures, any large numbers are going to totally
overwhelm any medical care we can provide and when that occurs the
death rate will climb to at least 80% (my guestimate only).
We won't have a pollution problem any more. Or any technology
above an axe.
>
Various anti-viral drugs are being trialled at the moment.
> I doubt that any of these will be a 'magic bullet'.
> One day we may be able to target specific coronavirus
glycoproteins.
If this
thing gets a foothold we are _not_ going to be a technological
species within a decade. That 'may' seems very, very remote.
>
There are at least four different classes of viruses which cause the
> 'common cold'.
And there
appears to be little we can do about any of them.
>
A vaccine against SARS may be complicated by the mutability of the
> virus.
We probably
do not have time to find one anyway.
Will someone show me I am wrong for God's sake? Please...
And:
On
Fri, 18 Apr 2003 11:16, Ray wrote:
> >>Could we survive if we lost a random
5-10% a year?
>
Yes. The Bilby has survived with greater attrition.
> Only just, but survive it did.
It isn't a
technological species.
It doesn't need massive industry just to survive.
Once we lose the technology and the industry the death rate is likley
to hit 80% or more.
Ray responded:
Oh
Well, "what doesn't kill you makes you stronger" ..and being one
of the casualties means the problem has also ceased to exist
personally, and I never expected to live forever so I won't be
surprised.
:)
I think the technocracy would survive a biological virus, even if 95%
of the world's air travel services went to the wall...
Zero
Sum replied:
I'm not concerned with my personal survival. I have spent a
number of years battling with 'not wishing to survive' and truthfully,
I would welcome the end of the responsibility.
However, my children face a doom I would not wish on them.
>
I think the technocracy would survive a biological virus, even if 95% of
> the world's air travel services went to the wall...
Hang
fire. I don't think there is a 'technocracy' any more. I
cwertainly would not call Bush, Howard, Blair, Mahatir, Kim, etc.,
etc. technological. I'm not sure I would consider the first
three literate.
This 'technocrat' and family would head for the bush and wait it out,
but I think we would be wainting far longer than any resources I could
mustered (read that as forever).
Ray wrote:
Time Will tell, Zero Sum.
Methinks it is just a bit early to upgrade one's life insurance before
the crash.
I believe that SARS is a highly mutable RNA-type virus, and as such the
odds are even at worst that its next mutation might be as harmless as
the sniffles from which it came.
By the toss of a coin do we bet on tomorrow. (or maybe by the roll of a
pair of dice)
Even money are favourite odds.
David
Allen, responding to Zero:
>
Given that the roughly 5% death rate so far is only 5% because of
drastic
> life support measures, any large numbers are going to totally
overwhelm
> any medical care we can provide and when that occurs the death
rate will
> climb to at least 80% (my guestimate only).
<snip>
7:30 report last night had an expert (??) uttering a remarkable
statement which seemed to slip past Maxine's guard.
It related to criticism of published mortality rates by statisticians.
Evidently, mortality is being measured against total cases rather
than 'relevant' cases. i.e. So many in per day vs so many out per day
(or similar). When measured 'properly' mortality is about 20%.
Hopefully, Maxine's interview with the lady concerned will be
transcripted shortly. Can't find it at the moment. Otherwise others
who saw the item may care to confirm, or otherwise, my comprehension.
Meredith wrote:
A professor friend recently visited China, and arrived back here
through a direct flight from Hong Kong to Cairns, then on to Sydney. He
was not checked or tested in Cairns, nor Sydney.
In China and Hong Kong everyone was wearing masks, and his comment was,
"Well, everyone else is wearing masks, so why should I need to wear
one?"
How cautious is our country?
Paul
Williams responded:
If he had shown any symptoms, the guidlines stipulate examination by
healthcare professionals.
>
In China and Hong Kong everyone was wearing masks, and his comment was,
> "Well, everyone else is wearing masks, so why should I need to
wear one?"
The virus
can survive for some time on surfaces. If he touched an infected
surface and then his face he would be at risk. Wearing a mask reminds
one not to touch one's face before washing one's hands.
>
How cautious is our country?
Very. These
are the guidlines regarding airports:
"Health announcements made on all arriving international flights from
SARS-affected areas. The announcement describes SARS, outlines its
symptoms and urges passengers who may have some of the symptoms to
inform the cabin crew.
Pilots of all in-coming international flights are compelled to seek
quarantine clearance before they can land at Australian airports.
Pilots must notify Australian quarantine authorities whether or not
there is an unwell person with symptoms of SARS on board before they
are allowed to land.
Front-line border control staff from the Australian Customs Service and
the Australian Quarantine and Inspection Service are instructed to
report to airport-based health professionals any persons who appear
unwell and showing the symptoms of SARS. These people are then assessed
by the health professionals.
All international passengers arriving at and departing from Australian
airports are given information leaflets about SARS by customs officers.
These leaflets contain information about the symptoms of SARS,
how to protect yourself from infection and when to seek medical
attention. The leaflets are in English, Traditional Chinese, Simplified
Chinese and Vietnamese languages.
All people arriving in Australia from countries where there is local
transmission of SARS will also be screened by health authorities in the
country from which they departed. Anyone who has any visible symptoms
would not be allowed to travel in the first place."
http://www.health.gov.au/sars/sara38.htm
Australia has imported the SARS virus:
"If we did not import the virus for this vital work we would risk
delaying the validation of diagnostic tests for SARS and impair our
national capacity to make a rapid diagnosis of suspected cases."
- Commonwealth Chief Medical Officer Professor Richard Smallwood
The virus will be kept safely at 'The National High Security Quarantine
Laboratory'.
Update on airport assessments regarding SARS:
"In the past 24 hours, a further 17 airline passengers were identified
for assessment for SARS at Australian international airports. None met
the medical criteria for a SARS case and all were cleared. Of those
assessed, eight were at Perth Airport, four at Melbourne Airport, three
at Sydney Airport and one each at Brisbane and Cairns Airport.
Since the introduction of new quarantine clearance arrangements at all
Australian international airports on Friday 4 April, a total of 253
people have been assessed and cleared."
http://www.health.gov.au/sars/sara40.htm
Peter Macinnis added:
Some of you would be aware that I generate material for an encyclopedia
as my day job -- I deal with science, and try to make the content
educationally useful. With that aim, I have created a SARS spreadsheet
that is available for downloading for free. The data are now
beginning to reveal some VERY interesting trends, and make a useful
teaching tool.
F'rinstance: Singapore looks to have it under control, yet the
mortality is rising -- this is natural, because there are no new cases
arising, but a few of the old cases are still to die.
F'rinstance: the Hong Kong mortality rate has doubled, partly from the
above effect, but possibly because reporting is now more honest. I will
not say in public what I think of the data coming out of China.
F'rinstance: the massive drop in US cases once they fell in line with
WHO reporting standards. The use of varying standards was first
attacked by Florence Nightingale, who is less renowned for her
contributions to statistical science than to nursing, but it is still a
problem. (Also, SARS is defined by elimination, so cases drop off
the radar form time to time.)
The spreadsheet has four sub-sheets: one with data by country by day
and totals (cases and deaths), one with background info, one with
mortality data, one with graphs.
You can get it from http://www.websterworld.com
in two ways: one is quick, the other shows you what else is around for
grabs -- but grab soon, as it will become subscribers-only in the
not-too-distant future.
1. Go to "What's New", and use the link there to open the
spreadsheet (I recommend opening in a new window).
2. Go to Teacher Notes, click on "For Teachers", choose
"introduction to our new ICT skills support materials", choose the link
to "The Downloads" and find the spreadsheet downloads. Again, open in a
new window.
Look around on the front page for background articles on SARS as well.
On
9/5/2003, Chris Forbes-Ewan posted:
>
Welcome back Forbsy. How was your trip?
>
> David Allen
The
trip (to Kingston, Ontario) was very enjoyable, although far too short
at only 10 days (including travel) away from Australia.
I
went via Toronto airport, where a group of about 15 young girls all
wore masks, but hardly anyone else seemed to bother. No-one I could see
on the streets bothered with masks, and I soon found out why--at that
time there hadn't been a new case of SARS among the general Toronto
population (i.e. other than health workers in close contact with SARS
patients) for nearly
two
weeks.
Toronto
was desperate to attract tourists back to the city--so desperate in
fact that $1 air fares were being offered, along with $1 entry to the
Blue Jays baseball games and other high-profile activities.
It
appears that Toronto is not well liked in the remainder of Canada, and
that this situation predates SARS (by decades). A commentator in the
Globe and Mail (a national newspaper) wrote that Canadians would now
flock to Toronto for their holidays ... provided that it continues to
cost only $1 to go there and also for entry to the few worthwhile
activities in Toronto.
I
thought this was a little harsh, however the Mayor of Toronto, Mel
Lastman, added to Toronto's reputation as a laughing stock by giving an
interview to CNN in which he gave woefully inaccurate figures for the
SARS rate in Toronto, confused the (US) Centers for Disease Control
with WHO, and then asked "Who are WHO ... I've never heard of them?"
The late-night comedians
on US television had a field day with this interview!
More about SARS
in Toronto in a later message:
According
to the Globe and Mail (a Canadian national newspaper) Toronto was very
lucky to contain the SARS outbreak as quickly as it did.
Or
more to the point, Toronto had to rely on scientists from other parts
of Canada, because in 2001 the five scientists employed in Toronto for
the purpose of combating any new diseases were made redundant. This was
carried out on the grounds that it was highly unlikely that any new
disease would come to Toronto!
Despite
the fact that these scientists were working on diseases such as
hepatitis C and West Nile, their positions and research were considered
redundant and they were all given the sack. Two years later, health
authorities in Toronto had to bring in (or seek the help of) scientists
from parts of Canada that were more forward-looking, including British
Columbia.
I
intended to keep the newspaper article, but inadvertenly left it on the
plane between Kingston and Ontario, so the above is from memory, but
the gist is reasonably accurate.
Another
salutory lesson to health authorities everywhere--one that they will
never learn, of course.
Sue Wright
responded:
Forbzy, Forbzy,
Forbzy! What are we going to do with you? Now you'll have utterly
paranoid people thinking that SARS is actually an acronym for an evil
underground movement called Scientists Angry at Redundancy Studpidity -
who manufactured and then released a hideous virus just so they could
have those who made the redundancy decision on their knees begging the
evil 5 to come back.
<Snip>
Or more to the point, Toronto had to rely on scientists from other
parts of Canada, because in 2001 the five scientists employed in
Toronto for the purpose of combating any new diseases were made
redundant. This was carried out on the grounds that it was highly
unlikely that any new disease would come to Toronto!
Paul Williams
added:
I tried to
source the original articles that you mentioned but the 'Globe and
Mail' archives only go back so far.
Perhaps this
article may fit the bill?
Globe
and Mail.
Tuesday,
May 6, 2003:
"The Ontario
government cut spending on local public-health units by 17 per cent
over the past four years, despite repeated warnings that the reductions
were leaving the province open to a new epidemic from an infectious
disease."
"Now the SARS
emergency has shown that the cuts went too far because the province
"had to beg and borrow to respond to an emergency," Liberal Leader
Dalton McGuinty told the legislature yesterday."
"...William
Bowie, an infectious-disease specialist from the University of British
Columbia who pitched in early on to help Toronto contain the SARS
outbreak, said last week he was dismayed to find expert analysis teams
not already in place to track the disease. "SARS was an accident
waiting to happen; because of the priorities of the government, the
cost-cutting measures, the conditions were great for SARS to take
hold," Dr. Bowie said."
http://www.globeandmail.com/servlet/ArticleNews/TPStory/LAC/20030506/USARSM//?query=SARS
Chris
replied:
Good job, Paul!
But the article I was referring to was in the Globe and Mail on
Saturday 3 May 03. It referred to five positions that were
disestablished in 2001 because the authorities couldn't conceive of the
possibility that a new infectious disease would threaten Toronto.
