View Full Version : Do Gas Masks work against SARS?

04-27-03, 08:31 AM
• What are the symptoms?
• How does the illness spread?
• What causes it?
• How fast does it spread?
• How is SARS treated?
• How deadly is SARS?
• Is it safe to travel?
• Where have SARS cases been reported?
• What if I have SARS symptoms?
• SARS computer virus
• How did SARS begin?
• Do does white cloth covers really help?
• How about gas masks?
• What about sex? Is it spread that way?
• Roger wants to know if taking Viagra pills prevents SARS?

None of those questions are really answered in the story below, but what the heck, do you really want to live forever?

U.S. hospitals on the alert for SARS

Emergency rooms aim to quickly isolate cases

By Rob Stein

April 27 — Nurses and doctors in emergency rooms across the United States are subjecting patients to increasingly intensive scrutiny in an urgent effort to prevent the kind of SARS outbreaks that have exploded in Beijing, Hong Kong and Toronto.

THE EMERGENCY STAFF intercepts patients to test for telltale fevers, coughs and other symptoms, and grill any suspicious cases about their family, friends, work and travel in the hope of isolating people carrying the SARS virus before they can infect health care workers or other patients. Anyone with the slightest possibility of harboring severe acute respiratory syndrome (SARS) is immediately segregated in a specially ventilated room, and no one is permitted near him or her without wearing a mask, goggles, gloves and a gown.

The aggressive measures are a reflection of the crucial role hospital emergency rooms are playing in the nation’s attempt to keep SARS from becoming a major health problem in the United States. Hospitals have been the focal points of outbreaks everywhere the new lung infection has been a major problem. Sick patients have spread the virus to hundreds of hospital workers and other patients, who have then spread it further.
“We’re the canary in the coal mine of medicine,” said Brian Keaton, an Akron, Ohio, emergency room doctor who serves on the board of the American College of Emergency Medicine. “If we have SARS here, it’s going to be people showing up in the emergency department.”

Until scientists develop a reliable test, vaccine or treatment for SARS, doctors have none of the most potent weapons that modern medicine uses to fight disease. Instead, they must resort to the most primitive of public health measures: finding and isolating carriers before they can infect others. “We are very concerned about that,” Julie Gerberding, director of the federal Centers for Disease Control and Prevention in Atlanta, said in a telephone interview. “We have tried-and-true infection control methods, and we have to use them.”
So far, the measures have prevented the kind of catastrophes in the Washington area or anywhere else in the United States that have occurred in other countries. But health officials are worried that the level of vigilance varies widely from one hospital to another, and that infected patients could slip through even the tightest safety net, especially in overburdened emergency rooms.
“That workforce has been stretched very thin in the last several years. We’ve been asking those professionals to do more and more with less and less,” Gerberding said. “It just takes that one combination of a highly infectious person and an unprotected exposure to start a chain of transmission.”
Private doctors and sick people are being urged to alert emergency rooms before suspected SARS patients arrive. That way they can be intercepted with masks and gloves and whisked into isolation rooms before coming into contact with any unprotected staff or patients.
“This is a little bit like looking for a needle in a haystack right now because, of the millions of people who are seen in emergency rooms, only a small number of them are going to fall into a category where they would be suspected of SARS,” Gerberding said.

Many hospitals have posted prominent signs advising patients to alert staff if they have any SARS symptoms or risk factors. Others have placed boxes of surgical masks at the door so patients can put them on as they walk in.
“Our goal is to not allow patients to get into a patient-care area without being detected as a possible SARS candidate,” said Ellen Weber, clinical director of the University of California at San Francisco Medical Center. “If they get in, that’s too late really. Too many people have been exposed to the person.”

All of these efforts are an attempt to avoid the mistakes made elsewhere. “We’ve benefited from those who have been in the front lines in Asia or Canada. Whether that means we will do it better, I’m not sure,” said Michael T. Osterholm of the University of Minnesota.
In fact, the first American to carry the infection into the country from Toronto offers a telling glimpse into how well hospitals are responding more than four weeks after the World Health Organization issued a global alert about SARS.
The 52-year-old Pennsylvania man attended a March 28-30 religious conference. More than two dozen members of the Toronto chapter of the group sponsoring the meeting had gotten infected with SARS when the virus slipped out of a hospital.
After driving back to Pennsylvania, the American started to feel ill and went to a local emergency room, where he was given antibiotics and sent home because no one realized he had SARS.

Several days later, when he started getting worse, he went to the Lehigh Valley Hospital emergency room in Bethlehem, Pa. When nurses recognized he might have SARS, they rushed him into a room with special ventilation and quickly made sure no one came near him without wearing a mask and gloves.
“We didn’t want to see the spread here that we’ve seen in Toronto,” said Thong Le, an infectious-disease specialist on duty. “I could see a scenario where this guy could have been admitted for pneumonia, and no one would be aware of it. There was enough awareness that that didn’t happen.”
Still, the April 14 incident was hardly reassuring. The man sat in the emergency room for more than two hours before anyone realized he had SARS. Twenty-three people were exposed before he was isolated. A half-dozen nurses were forced into a 10-day furlough, taking their temperatures twice a day to make sure they had not become infected.
State health officials had to track down 20 more people to begin monitoring them for symptoms. And the CDC had to dispatch a team to Pennsylvania to make sure any outbreak was quashed and study how it was handled.

“We’re working hard to make sure that doesn’t happen again,” said Gerberding, who also has dispatched a team to Toronto to help the Canadians contain the disease and try to learn why they have had such difficulty preventing spread. “We’re working very hard to close those gaps.”
Many U.S. emergency rooms are overcrowded and hard-pressed to keep up with the regular onslaught of victims of car accidents, shootings, heart attacks and other diseases, many of which often look deceptively like SARS.
“You never know who’s infected and who isn’t,” Osterholm said. “That’s part of the problem. We won’t necessarily know who really is the SARS case. At least have a head start. But we all know our health system is already stretched to the limit.”
Many hospitals, for example, have only a few “negative pressure” rooms that keep infected air from contagious patients from escaping.

04-27-03, 08:32 AM
The chore is compounded by rising numbers of people arriving in emergency rooms with colds and flus frightened that they may have SARS.
‘We have a lot of the worried well. If they get a cold, they insist on being ruled out as SARS.’
Rochester General Hospital in New York “We’re seeing a lot of people who are worried because they passed through Toronto. We have a lot of the worried well. If they get a cold, they insist on being ruled out as SARS,” said Ghinwa Dumyati, head of infection control at Rochester General Hospital in New York, which is 90 minutes from the Canadian border.
At the same time, patients in waiting rooms are becoming increasingly anxious about other patients near them. “If they’re sitting in a waiting room and someone is coughing, they are concerned that we haven’t identified them,” Weber said.
Many hospitals have benefited from the recent concern about bioterrorism, which has prompted health officials to take steps to help hospitals cope with infectious diseases. Washington area hospitals have developed the capacity to treat several hundred patients in isolation units or wards, according to officials of the Inova hospital system, Johns Hopkins University and the D.C. Hospital association. “This is almost like a fire drill for the bioterrorism systems we’ve put in place,” Keaton said.

“The last thing that we can do at this point in time is relax and say, ‘Well, thank goodness we don’t have very many probable cases in the United States.’”
Centers for Disease Control and Prevention Many hospitals in recent years have linked their computers so that any usual upsurge in diseases could be spotted to get an early warning of a possible bioterrorist attack. That system is being adapted to try to spot any early SARS outbreaks, Keaton said. “If you have that baseline and then all of a sudden you jump, maybe it means nothing, but you should dig a little deeper,” he said.
The U.S. Army Medical Research and Material Command at Fort Detrick, Md., also has heightened the sensitivity of its computerized Global Emerging Infections System, which tracks symptoms reported by military personnel worldwide. Analysts are focused on Pacific rim installations but are scrutinizing data at all U.S. defense installations, a spokeswoman said.
At the same time, health authorities have been meeting all planes, boats and cargo ships from Asia for weeks, removing and isolating sick passengers and warning other passengers to be on the lookout for symptoms. Similar efforts began last week for people arriving by air or land from Toronto, the site of the largest SARS outbreak outside of Asia.
“We must remain vigilant here. The last thing that we can do at this point in time is relax and say, ‘Well, thank goodness we don’t have very many probable cases in the United States,’ ” Gerberding said. “This is exactly the time where we need to continue to do what we’re doing and learn our lessons from what we are observing in the other countries.”

Staff writer Spencer Hsu contributed to this report.

© 2003 The Washington Post Company

04-27-03, 08:58 AM
What I find interesting is when AIDS raised it's ugly head in the U.S. thirty plus years ago.

It ran rampage though the gay community, to the misconception that it ONLY affected gays.

In an attempt to curtail its spread, San Francisco wanted to close all public bath-houses and saunas. This was considered gay bashing and was voted down. In my mind, it would have helped.

ALSO, and more to the point, previous contagious disease carriers were required to name their contacts so they could be notified and tested.

HIV carriers were exempted from this long standing requirement, as it infringed upon their civil rights. As a result, much of the proliferation of AIDS in the U.S. can be attributed to this protection of the civil rights of the affected.

Since SARS is NOT identified as being a sexually transmitted disease, it appears possible to reinstitute the long ignored requirements of quarentine and report of possible contacts.

Mike Farrell
Cagayan de Oro

04-27-03, 08:51 PM
Good points firstsgtmike,

When do our "civil rights" overrule the common good of all?

What if "Joe Studdly" likes to make out with the ladies, (they like it too) and he comes down with SARS?

Is it his civil right to NOT reveil the smooching?

If so, the spread of SARS goes unchecked.

I think that this country has a real problem with the courts interpretation of our rights as individuals.

We continue to watch the burning of our flag, the distruction of property and the harassment of others as freedom of speech.

Got SARS---don't ask, don't tell.