by Fintan Dunne
SarsTravel.com
April 18, 2003
07:00 GMT

THE END FOR SARS
"A large number of suspect SARS cases turn out,
on further investigation, to have other, common causes."
Last line in WHO Update 32 for 17 April 2003


PART I
POP GOES SARS IN THE USA

Unlike other countries, the US has never identified the 'probable' SARS cases within the large 'suspected' group. Now we know why.

The CDC revealed yesterday that of 208 'suspects' only 35 cases were 'probable' SARS. So now you know. When do severe respiratory symptoms not fulfill the criteria for SARS? When they are not severe at all. Or never were.

The other 173 suspected U.S. cases involved only fever or milder respiratory symptoms, according to Dr. Julie Gerberding, of the US Centers for Disease Control.

"Probable cases are more likely to have the condition," she added.

Thanks for that stunning insight. So, the US CDC has been padding out their SARS statistics with influenza-type conditions for weeks.
Thanks a bunch.

Well, how many of the remaining 35 probable cases are actual SARS?
For example, how many have recovered?

This statistic is now listed by the WHO. As of Thursday, 17th April global recoveries stood at 1,597 of the 3,389 cases. But no statistics are expected to be available anytime soon from the United States, according to CDC press officer Rhonda Smith.

"We're still working to define what SARS is, which makes it difficult to define someone as recovered," she said.

I nearly bust a gut laughing when I read that. OK then, at least tell us how these 35 --possibly recovered, possibly still SARS cases-- are distributed around the USA.

Officials are not saying where the probable cases are.

Right, let's try and figure this out despite the tightlipped CDC stance. The CDC had previously reported that 5 of these 35 patients, all of whom were travelers, had laboratory evidence of recent infection with a novel coronavirus.

Let's make an educated guess that these are the 5 persons with a semblance of something like SARS in the entire USA. Let's make another guess that the reason the US CDC is so coy about the recovery issue is that they already reported those 5 had recovered.

And therefore the mortality from this "deadly" SARS epidemic in the USA out of the existing caseload is likely to be zero.

Big, fat Zero.
Just like SARS itself.

One national public health authority SARS bubble just burst.
Imagine that repeating in other countries.

Meanwhile, in Hong Kong, the sewage just hit the fan.


PART II
SARS: Sewage Acquired Respiratory Syndrome.

"...the Amoy cluster includes a high proportion of cases presenting
with diarrhoea, estimated at about 60%. In most other clusters of cases, diarrhoea has typically been seen in only 2% to 7% of cases."
WHO Update 32 - 17 April 2003

In Hong Kong also on 17th April, Health Secretary Dr. Yeoh Eng-kiong said the mass outbreak at the Amoy Gardens apartment complex began after a SARS-infected man who also had diarrhea visited his brother there between March 14 and March 19.

Most of the 321 infected residents in the Amoy Gardens complex probably picked up the virus in their bathrooms, according to the Secretary for Health. Large amounts of human waste carrying the virus went into the sewage system and leaked into apartments connected by toilet pipes.

A report prepared by Hongkong health authorities said that under-floor U-traps such as those in bathroom floors were dry in most cases. This would have allowed air from decomposing fecal matter to waft into bathrooms.

The moist conditions there allowed water droplets containing the virus to form, the report said. Bathroom extractor fans then spread the virus into the apartments. Most of the SARS cases were in vertically linked flats in a single building, Block E.

Media reports have described Amoy Gardens as a lower middle class housing estate. But the sanitation system rendered it effectively a slum with conditions which rivaled those in Middle Ages.

In other words, the first headline-grabbing high-profile mass-infection so-called SARS incident arose from the oldest disease source known to mankind: exposed human excrement.

Now it gets really interesting. According to the WHO, two-thirds of the building's residents reported diarrhea as one of their initial symptoms of SARS. In most other clusters of SARS cases, diarrhea was typically only 2% to 7% of cases.

Most significantly, the Amoy Gardens residents have been sicker than other SARS patients. Doctors have reported these cases are not responding as well to the anti-viral drugs and steroids that have been effective in around 80 percent of patients.

Conclusion: Amoy Gardens is to the rest of the SARS "epidemic" as
chalk is to cheese.

Much of SARS is arguably atypical pneumonia.
Amoy Gardens was just atypical filth.

But it sure kickstarted the SARS scare, didn't it?

Even though health authorities lumped all the pneumonia's into one grand syndrome, there is more than one type of SARS.

Next stop Canada.

PART III
SLOPPY SCIENCE OF SARS

Dr. Frank Plummer, the head of the Canadian WHO lab investigating SARS was puzzled. He found so few copies of the coronavirus in so many cases that he doubted it was the cause of SARS. Worse still he could only find the alleged causal coronavirus in half of the so-called SARS cases. So what were the rest of the cases? SARS or not?

Here's what I wrote two days ago:

"The virus is not the same as the syndrome.

A syndrome is a collection of symptoms. It's a concept. Whereas the coronavirus is a thing. So, to describe the virus, call it "SARS associated virus." That's not being pedantic --that's being scientific. Sloppy words lead to sloppy thinking and result in sloppy science."

Next, see the flaw in the WHO case definition of the syndrome:

High fever AND cough or breathing difficulty AND either:
a) close contact with a case of SARS;
b) travel to an affected area;
c) residing in an affected area.

A rather loose definition, said Frank Plummer. But let's take it on face value. Cough and fever is SARS if you are anywhere near another SARS case.

And... how do we know the SARS case you were near was a SARS case? Same thing. Cough and fever anywhere near a SARS case.

No wonder the SARS thing mushroomed!
It classified bad influenza or regular pneumonia as SARS cases.
No wonder hospitals began to bulge at the seams.

Have people been dying?
Sure they have. People die of pneumonia all the time in their millions.

But if you stand the Amoy Gardens incident on it's own.
And if you strip out the 50% of cases with no coronavirus.
As 3,000 people die each year in Hong Kong from "regular" pneumonia.

You are left with the natural background incidence of pneumonia, and a possible fecal matter derived pathogen.

We may still have a health problem. And we need to review the cases -more prudently this time. But unless you live in a slum. Or fail to wash your hands after the bathroom.

SARS is not a problem for you.

Best case: Standby for the announcements from health authorities that their hysterical overreaction has saved us all from the deadly SARS epidemic.

Worst: More of the hype machine and further global economic damage, over a spurious syndrome which is a drop in the disease ocean.

* * *

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