SARS
Very worrying at the moment. My brother has cancelled his trip to HK (phew). And I have been getting updates from a Chinese friend via mail. But it is good to know that everyone everywhere (bar Beijing – SARS: 1.3 billion Chinese left in the dark) are on high alert. Even my local paper show that our regional hospital is preparing an action plan in Limerick.
From a mail forwarded on (All email adresses stripped out :) )... (More info on the Amoy Garden breakout)(April 1st 2003)
We (Police) have confirmed the reason for the spread at Amoy Gardens.
There was a leakage of the sewage pipe from the infected PWH nurse’s home.
So everyone stepped on the sewage water near the main entrance and
brought the virus into their respective houses.
There is no evidence of “Airborne” at this stage.
I just have the briefing about this finding.
F.Y.I.
Neil T.M. CHAN
Date: Sun, 30 Mar 2003 11:09:23 +0800
Dear all,
Hundreds of staff are working with me and they are all facing the same risk
f infection. It is really sad that over last 2-week fight 8% of ourstaff
have been infected despite droplet precaution, probably due topitfalls like
air leak on N95 mask, rubbing eyes/nose after touching the mask, etc.
So you can imagine how contagious this virus is! The outbreak in Amoy Garden
is not surprising to me because this is exactly what has happened in ward
8A. The only difference is that the number of infectious index cases now in
Amoy Garden is 60 times of PWH’s.
We do believe this infection has wide spectrum of clinical presentation
ranging from sorethroat and low grade fever to full blown ARDS/BOOP.
We think the clinical presentation depends partly on the dose of inoculum.
The
ultimate protection against this new virus is our immunity and inevitably
all of us will be infected eventually. The purpose of preventive measure is
to minimize the dose of virus so as to avoid severe complication.
Could you please forward these messages to all your friends and relatives
and ask them to distribute further?
1. Always wear a well-fitted mask (N95 or 3 ply surgical) in escalator, bus,
MTR, train, office, restaurant and shopping mall. Don’t go to cinema.
Push the button in the lift using your key to avoid any direct contact with
your
bare hand. If you can tolerate a latex glove, wear it.
2. Don’t touch your mask, it traps a lot of droplets.
3. All the surfaces within a distance of 5 feet from a patient are highly
infectious because of droplets. Wash your hands frequently. Don’t rub your
eyes, touch your nose or mouth before washing hands.
4. Clean the door handles, furnitures and floor with diluted (1 in 100)
bleaching detergent. Dettol is NOT useful. Wash your clothes immediately
after going home.
5. Patient is highly infectious 2-3 days (in contrast to what EK Yeoh said)
even before developing illness. Treat those without wearing mask potentially
infectious even if they look healthy.
Take care,
Dr. Justin Wu
Message from 2 doctors from Prince of Wales Hospital, Chinese University of
HK
Anthony TC Chan
Chairman and Chief of Service
Department of Clinical Oncology
Prince of Wales Hospital
Chinese University of Hong Kong
Tony Mok
Prince of Wales Hospital
Chinese University of Hong Kong
I AM at Prince of Wales every day, closely involved with all actions and
still in good shape. Let me
clarify the subject matter:
1. There is no evidence that the infection is airborne. Only direct exposure
to respiratory droplet
has been related to infection.
2. The figure released from HA is definitely correct. Even stupid people
should be able to distinguish
between dead person and dying person. In fact, a couple of patients in ICU
has improved and got
better. Look like the dying patient won’t die afterall.
3. A mask (N95) can definitely reduce the risk of infection, even viral
infection. Imaging that we have
to look after the 100 sick people with atypical pneumonia. If the mask is
not effective, all of us will
come down with the illness. The fact is that there is minimal number of new
cases among medical
staffs at Prince of Wales since we install the policy on mask.
4. The current treatment with ribavirin and steroid is definitely helping.
Particularly if the patients
receive treatment early, a good percentage showed good response and
reduction in severity.
Only when the patients presented very late, the treatment would be less
effective.
5. Running nose is NOT a symptom of this illness.(another fact on his/her
ignorance) However,
you should definitely seek medical attention if you have severe headache,
muscle ache and fever
Advice:
1. Wear a mask if you are in contact with anyone with symptoms. Also wear a
mask if you are confined
to a closed atmosphere with no control whom you are with.
2. See doctor when you have any of the symptoms.
3. Stop listening to those stupid rumors.
Tony Mok
Prince of Wales Hospital
Chinese University of Hong Kong
A message from Medi Dept of CUHK:
Yes. There are many “rumours”, “news stories”. But most importantly, the
“facts” need to be disseminated properly:
1. There are likely to be infected people in the community (people who
knowingly/unknowingly contacted patients
when precautions were not taken). They should be identified as soon as
possible and admitted to facilities with
ability to treat them (ie major public hospitals). We have family members
infected because people with clear
symptoms stayed home.
2. The symptoms are fever, shiver, muscle aches, with fever NOT responding
to antibiotics. Other respiratory
symptoms are not specific.
3. N95 or surgical masks should be worn in high risk areas, like hospitals,
when contacting patients(this is what we
all do in public hospitals). Hands must be washed thoroughly after contacts.
4. The early cases in PWH are s erious since treatment was started late, but
the later cases are mostly doing well.
And now with the virus identified by our virologists in CUHK and more
sensitive tests being developed and
verified, there are discussions on the safe time for some treated patients
to be discharged (please be assured
that we will not discharge ANYONE until we are very confident that they are
OK).
5. At this time there is NO evidence that ANY prophylactic drugs have any
effect.
I’m happy for you to send these messages to your friends, but I will not be
available to answer individual enquiries.
They can call the government and HA hotlines.
Anthony TC Chan
Chairman and Chief of Service
Department of Clinical Oncology
Prince of Wales Hospital
Chinese University of Hong Kong