Judas H. Priest, I’m Astonished!

Earlier Wednesday, Mr. Clement said the government will cover the cost of doubling pay for health-care workers on SARS duty at four Toronto hospitals.

Mr. Clement said the government supports the move to increase compensation for front-line workers but did not endorse requests from other health workers in hospitals dealing with SARS that they get more money as well.

Mr. Clement said the four hospitals, which have formed an alliance to combat the SARS outbreak, are a “special case.”

“That has to be recognized as such and that has to be remunerated as such.”

Nurses combating SARS have been particularly unhappy that agency temps brought in to help in the fight are being paid at a premium.

The new hospital deal would pay nurses at the top end of the salary scale about $66 an hour, roughly what the temporary nurses are being paid.

X-ray technicians and other staff who work with SARS patients or in SARS screening are also getting the premium.

From the Globe and Mail.

Intermixed with this is the usual union whining. Nurses at other hospitals want the pay increase. Everyone’s bitching about more safety gear like you’d know how to use it if you had it, eh?. Look here for how well these folks used the correct equipment they had.

Health officials announced that the five cases being investigated for SARS at Rouge Valley Health System’s Centenary site in east Toronto have been cleared of having the disease; the quarantine period is over for staff and students at Father Michael McGivney Catholic Academy in Markham, with no new cases reported; the two cases being investigated at West Parry Sound Health Centre and a nurse in isolation in Ottawa have also been cleared.

“These latest results confirm the fact that there has been no community exposure,” Colin D’Cunha, Ontario’s Commissioner of Public Health said in a news release.

Now that’s good news. Especially for the high school kids.

More than 6,400 people, including 2,000 from the school, are now in quarantine in greater Toronto after Severe Acute Respiratory Syndrome resurfaced six days ago.

Before then, Toronto had thought it had beaten the disease — no new cases were reported from mid-April to mid-May.

Health officials said a student at the school, located just north of Toronto, appeared to have symptoms of SARS, and that prompted the quarantine call. One of the student’s parents worked at Toronto’s North York General Hospital, epicenter of the latest outbreak.

“The risk of getting SARS in this kind of setting (a school) is very low,” said Dr. Murray McQuigge, a physician in the region where the high school is located.

“We are not aware of any other student in this school who is symptomatic right now.”

The Toronto area is the only place outside Asia where people have died of SARS. There have been 27 deaths around Toronto and there are 12 probable cases now.

Doctors say six patients are in critical condition and they are monitoring about 30 more people for infection.

“In retrospect, we think we let our guard down too early,” said Dr. Donald Low, chief of microbiology at Mount Sinai Hospital, one of the leaders in Toronto’s fight against SARS.

Doctors think the virus lingered in hospital wards for weeks and infected nurses, patients and visitors after the authorities eased rules on wearing masks and gloves.

Nurses this week said they had noticed patients with SARS-like symptoms after the rules were relaxed, but doctors and hospital administrators did not listen.

“Unfortunately, they were not taken seriously,” Doris Grinspun, executive director of the Registered Nurses Association of Ontario, told Reuters, describing it as “ridiculous” that no one paid attention.

From Yahoo News

Let’s see. In a city that just was recovering from a SARS scare and multiple shutdowns of hospitals and thousands of people quarantined… an elderly person lay in a hospital being treated for a respiratory problem and the thought of SARS occurred to no one. The problem spread to several other hospitals, and the index patient (very elderly and frail, died.

If it were smallpox, wouldn’t every rash be first evaluated as smallpox before going on to another diagnosis? How come respiratory problems in populations known to be easily infected with SARS weren’t looked at for SARS? Dumb, dumb, dumb!

From the Times of London

MEDICAL staff sought to hoodwink World Health Organisation (WHO) officials during emergency inspections of hospitals outside Beijing yesterday, amid concern over the spread of Sars among 700 million poorly protected peasants.

China has promised full co-operation with the WHO after the country’s early attempts to hide the epidemic were exposed. But, despite a propaganda campaign calling for greater transparency, many officials continue to attempt cover-ups.

China has almost 5,000 cases now and, if Sars spreads in the countryside, where modern medical facilities are not available, the epidemic may become impossible to contain.

At the Infectious Disease Hospital in Baoding, in Hebei Province, staff began preparing for a WHO visit yesterday after notification from the Government. Police and security agents were on guard while staff undertook last-minute construction measures.

One entrance had recently been refurbished, covering redbrick walls with white marble and gold letters bearing the hospital’s name. Keen to impress the WHO with their anti-virus efforts, staff spent the morning installing new room dividers and partitions. They also filled the hospital forecourt with brand-new cars and ambulances. Later, hospital workers were instructed to raise a banner over the main entrance saying: “We must be victorious in the hard battle against Sars.”

As the WHO team arrived, staff and police at the main gate donned face masks; staff at the back of the building remained maskless. WHO representatives were asked to have their temperature checked, a procedure afforded nobody else all day.

Hours earlier, dozens of smaller clinics in Baoding were suddenly closed. A doctor at one of the centres said: “The local government gave the order to close all the small clinics the day before.”

The measure may be aimed at preventing the WHO from inspecting less well equipped facilities. Shops along the streets near the seven-storey Infectious Disease Hospital were also closed, possibly to isolate the visiting delegation.

Communist China has tens of thousands of people in quarantine, many hospitals closed for quarantine. Does anyone, anyone, believe the numbers that they are reporting? Add a zero to the right side of every statistic from Communist China and you might be close to reality.

Parts of Communist China are a Fourth World country, as poor as any. Most is Thrid World, and some of the larger cities are Second World. I’m not sure I could characterize any part of the Middle Kingdom as First World, though the ruling elite certainly have the money to live that way, though perhaps not the will.

The most important thing in Communist China is that you not be disgraced by an error or perceived error. The second most important thing is that the rulers of this country suffer from “Middle Kingdom” syndrome, the belief that the world revolves around them and their rule. It’s much like Chiraq’s France, actually.

So what happens is that nothing bad ever gets kicked up the chain of command. And the rulers of the country honestly believe that they deserve their lot in life as an entitlement.

A whole lot of Chinese are going to die before this is over, from SARS, and, yep, from AIDS and whatever else is running around in the population that no one is talking about.

April 22 I blogged that the SARS death rate was about 11%. Finally, May 8 WHO says that, oops, the death rate is closer to 15% than the 4% it had been saying all along.

The death rate as of their May 8, 2003 report is 506/3564, or 14.6%, worldwide.

Yay, me! And shame on the WHO for their fuzzy math.

From a CDC Briefing on 5-7-2003:

DR. GERBERDING: Thank you. With respect to your second question about the situation in Taiwan, what happened there was that initially they did an excellent job of containing the first round of illness that appeared there, but unfortunately a traveler went to the country while ill and initiated a series of chains of transmission in various settings.

And so it’s taken significant detective work to track down those chains of transmissions, and the number of people ultimately exposed, as the story was unfolding, was extremely large.

In addition, transmission was initiated in the health care setting, so that health care providers who were not initially protected acquired SARS and, again, served as potential vectors for transmitting to others. So it’s an example of how quickly a situation can get out of hand if there is not an immediate detection and isolation capacity.

Of course, Taiwan has some marvelous medical facilities and significant capacity to manage a public health emergency, but this is a very large situation for them now, and they have requested technical assistance and other forms of assistance, and WHO and CDC are very happy to contribute what we can.

Interesting stuff.

But I also wanted to end with one reminder; that we are coming into West Nile season, and it’s very, very important that we remind people that there are individual steps that need to be taken to prevent exposure to West Nile. And one of the early steps is to remove the water and the other places where mosquitoes can breed. We’re having a lot of wet weather here, particularly in the South.

And so while it’s not upon us yet, the earlier we get into the mind-frame of fighting against this infectious disease, the better off we’ll be when it is the full-blown summer months, and the mosquitoes are about.

So I just wanted to remind you that emerging infectious diseases are appearing right and left, and we can’t ignore one because of our concentrating on another.