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Sunday, October 02, 2005

Say It's Not So, Toronto!

The news from Toronto is interesting. As of yesterday, there were 15 patients hospitalized from a nursing home outbreak of some sort of respiratory illness. Four had died, but I believe these four were residents and not health-care workers, so they would likely be susceptible to disease. The youngest deceased was in her or his 50's. The total affected was 68 residents and five health-care workers. The first symptoms were seen Tuesday of last week. Obviously it is acutely infectious.

The authorities gave a press conference yesterday (video here), during which they first announced it wasn't SARS or influenza, and later admitted that they didn't have tests back yet:
Dr. Alison McGeer, in the video [my bolding]: "we know, from the testing that's been done so far, that this is NOT influenza, we know this is NOT SARS, we know this is not avian influenza"

McGeer 3 minutes later: "we can certainly reassure people that this is not SARS, um, there is no SARS in the world, at the beginning, the illness that these people have is not compatible with SARS, the epidemiology of the outbreak is not compatible with SARS, so we can be definitive that it's not SARS. We have a number of tests that tell you that it's not avian influenza, and not the regular kind of influenza. Can I give you a guarantee that it's not influenza, at this time not, in a few hours, probably, [...] as the day goes on the public health lab has more and more results. Um, can I give you an ABSOLUTE guarantee that it's not the beginning of the next pandemic? No, there are no guarantees in this world."
The Toronto Sun included the following in its new article:
SARS, the deadly virus that killed 44 people in the GTA in 2003, spawned fear throughout the city. When the World Health Organization slapped a travel ban on Toronto it hobbled the local economy.

The city's lucrative multimillion-dollar tourist and convention industries collapsed overnight.

A KPMG report said that Toronto tourism expenditures plunged by more than $519 million, or 26.5%, between the first SARS outbreak in March 2003 and late October 2003.
They said that the hospitals are running normally (there are now three with patients), but it turns out that the nursing home itself is off limits to all visitors and that only patients are allowed in the emergency room of one of the affected hospitals. CurEvents.com has a good thread that is collecting news on the outbreak.

So why Toronto? From The Scotsman, March 31, 2003:
HEALTH officials in Canada closed a second Toronto hospital to new patients at the weekend and said the number of probable or suspected cases of a flu-like illness from Asia continued to increase.

Severe acute respiratory syndrome (SARS) has killed 54 people in 13 countries - including the Italian doctor who first identified the illness in Vietnam.
Scarborough Grace and York Central hospitals, which are now closed to the public, treated initial victims of the illness, all of whom had travelled in Asia, or had close contact with other vicitms.

Despite the dozens of probable and suspected cases in Toronto, authorities said none of the present cases were in critical condition.
Same area in Toronto. One of the possibilities is that this virus emerged from Asia. There is an extremely large ethnic Chinese population in this area, and a lot of Chinese students have just arrived for the fall semester. There have been plenty of reports of a flu-like illness circulating in North America, but it includes gastric symptoms.

It's relatively hard to figure out what virus causes such outbreaks, so it could easily be a week or two before they isolate the cause. It is stories like these that give the lie to the theory that we can lock down a human-to-human (H2H) outbreak when it first emerges. We'll never know in time.

We will know that more people are suddenly dying, so if you want to know what's going on in the US, check the CDC's Mortality report. It is about a week out of date, but it is likely to give you the first indication that you should be worried about flu in general. This is the link for morbidity and this is the link for mortality.

Denial. We're off to a roaring start.

I they were smart, they'd impose travel restrictions- though at this point, that would be of dubious value.
Yes, that chicken flew the coop last weekend, if the first symptoms showed on Tuesday.

They are imposing quarantine. I think this is probably just a bad RSV, which has been killing people in large numbers.

But at the very least it goes to show how ridiculous those computer models purporting to show that we could stop a H2H strain of H5N1 really were.

We're never going to stop viruses. All we can do is limit them.
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