X-Message-Number: 21430 From: Date: Wed, 19 Mar 2003 20:30:56 EST Subject: Re: CryoNet #21417 - #21424 In a message dated 3/19/03 2:00:54 AM Pacific Standard Time, owner-Tim Freeman writes: > Mike Darwin said in Cryonet message 21416: > > >2) SARS is *extremely* infectious; those physicians treating it in Hong > Kong > >report that it is about as infectious as influenza. > > In contrast, > http://www.rferl.org/nca/features/2003/03/18032003162937.asp quotes > Iain Simpson of the World Health Organization's communicable disease > section as saying: > > >"It's not clear how contagious this infection is. What is clear is > >that this is not like the flu, where you can just pick it up by being > >in a room with someone or by being on a bus with someone. To catch > >this infection, it's quite clear that you have to have close contact > >with someone who is infected and that, even then, you won't > >necessarily become sick yourself," Simpson said, adding, "This is > >nowhere near as infectious as a cold." > > -- > Tim Freeman I stand by what I said. I am in direct and indirect contact with physicians at the center of the outbreak in Hong Kong. Below is an update from Dr. Buckley as posted to the international critical care medicine forum (CCM-L). *Please note that two of the currently ill hospital staff in Hong Kong became ill after exposure consisting only of passing within 5-10 feet of the Index Patient!* That is very infectious by any standards you care to apply. Several people from Cryonet have asked for some simple precautions they can take. Two health care providers on the front line (in ICU or Respiratory Therapy in large hospitals) have asked for specific suggestions. I'll address these in separate post. Mike Darwin -------------- Date: Tue, 18 Mar 2003 11:30:01 +0800 From: Tom Buckley <> Subject: Re: Hong Kong update Dear Les, We are all wearing gowns, N95 masks, hats, and gloves and additional masks with visors for any bed side procedure. I have purchased HKs total supply of N100 masks (7) to try them out and have requested our safety officer to investigate suppliers of space suits. I cannot believe HK does not have a supply of these somewhere. I suspect that even if we contain this pneumonia then there will be further outbreaks in the future. No nebulizers nor BiPAP. All windows closed and airconditioning on. While CDC says there is airborne transmission we (infection control team) do not think so based on the the index patient using a nebuliser in a very enclosed space. See most recent post and Colin McArthur can describe the general ward set up We have four negative pressure rooms only but 16 patients. Staff morale - near panic stations when it was learnt that two nurses were off sick with this pneumonia. This was the first time I was scared. I had literally just spent 30 minutes being as open and honest with 20 nurses as I can. Walked out of the room and immediately had to trouble shoot (for want of a better word) both nurses. One nurse had visited the index patient's ward two weeks previously and the other while not being excluded had limited patient contact with a very short history between contact (1 day) and symptoms. While she has some CXR signs she is afebrile and WCC is normal. She looked well so I suggested she go home rather than stay on the contaminated ward where she had been admitted to. Jury is out on her but she will be watched very carefully. We have two cardiothoracic surgeons and one cardiologist in ICU who examined a cardiac case 10 feet from the index case!!!!! They would have walked within 4-5 feet of this patient. Staff morale is tense. This is where I plan to spend most of my day. Hospital is aware that if ICU nurses contact this then ........ I won't go there.I am offloading the clinical side. No one has complained but people frequently ask me what I am doing about home. I sleep on the floor in my office. I go home for a shower when the children are in bed. They are not going to school until I can be reassured that this is not more widespread in the community. Jeff Lipman: are you out there? Phone me. I have shaved my beard off because I have had everyone from the Chief Executive to the the Safety Officer in our Department telling me that N95 will not be as effective because of an imperfect seal. If you come to HK next week you may consider shaving yours off. Hope this helps Les Regards Tom Buckley Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=21430