Comprehensive coverage

China: If Sars reaches the villages we will not be able to stop it

Singapore: We need 10 days without new cases to officially declare the end of the epidemic; 18 more deaths in Asia * China: Mortality rate estimated at 19.9%

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The Prime Minister of China, Wen Jiabao, said yesterday (Wednesday) that if the atypical pneumonia (SARS) spreads to the rural areas of the country, the health system will not be able to stop it. According to Wen, the health services outside the big cities are not suitable for dealing with SARS. The BBC correspondent in Beijing reports today that there are signs of the spread of the epidemic outside the capital. Beijing is the city with the largest number of SARS cases in the world. China announced today five more deaths from the disease, and 159 new infections.

Singapore announced this morning that ten more days are needed before it can confirm that it has managed to control the spread of the atypical pneumonia epidemic (SARS) in the country. Singapore is the country that suffered the third highest number of victims in the world from the disease (37 dead), after China and Hong Kong. "If in the next ten days there are no new cases - that is, for two incubation periods of the virus - we can declare that the epidemic in Singapore is under control," said Choo Suk Kai, who is in charge of infectious diseases at the Ministry of Health of Singapore. He added that the last case of SARS in Singapore was reported on April 27. The United States announced yesterday that it had removed the small state city from the list of areas affected by Sars.

Hong Kong reported 11 more deaths from the disease, and 8 new cases of infection. She also reported that 26 other patients recovered from the disease.
Taiwan announced two more deaths this morning as a result of SARS. This increases the number of deaths from the disease on the island to 13. The number of patients with the disease on the island increased by five, from 120 to 125. Doctors from the World Health Organization are visiting Taiwan these days, helping in the treatment of the epidemic. Despite the two deaths, Taiwan issued a statement today, in which it expresses hope that by the end of May the disease will be fully under control.

The World Health Organization yesterday praised China, and especially Hong Kong, for their aggressive and "heroic" moves to limit the spread of the epidemic. The organization stood by its announcement about the proven effectiveness of the strict tests at the airports and at the borders as a tool to prevent the spread of the disease. However, it was said in the organization's statement, at least in China, it seems that the peak of the spread of the disease has not yet been reached. The organization announced that tomorrow it will send a team to the Bai District, north of Beijing, where the number of SARS cases has increased sharply in the past week.


Research: The rate of deaths from SARS is higher than estimated and may reach 20 percent

This morning, the "New York Times" publishes the results of the first comprehensive epidemiological study conducted on SARS, in Hong Kong. The study states that the mortality rate among SARS patients is 19.9% ​​(55% among people over the age of 60 and 13.2% among younger people). These data are higher than the mortality rate estimated so far - between 5% and 10%. The results are based on a statistical analysis of 1,425 people who were hospitalized for fear of SARS in hospitals in Hong Kong between February 20 and April 15.

The most comprehensive study done so far on SARS estimates that the death rate from the disease may be significantly higher than the experts have estimated so far: according to one of the calculations made in the new study, the death rate from the disease may reach up to 55% in those aged 60 and over, and up to 13.2% in younger people. In total, the mortality rate may reach 20% on average - a figure that, if adjusted, may make SARS one of the deadliest epidemics known today.

So far, the World Health Organization has reported mortality rates from SARS ranging from 2% to 7.2%.

The new study is based on a statistical analysis of data collected from 1,425 people who were hospitalized in Hong Kong until April 28 this year. The study was led by two researchers from King's College London, and included researchers from the University of Hong Kong, the Chinese University of Hong Kong and the Department of Health in Hong Kong. Their findings were published in the British medical journal Lancet.

Calculating the death rates of new epidemics is a very difficult task, especially when there is no unequivocal test to identify the disease - as in the case of the Sars virus. Therefore, the results obtained in the study are only conditional, and are expected to change with the accumulation of additional data in the future. In addition, the researchers used two different calculation methods, and in each of them different data were obtained: according to one method, the death rate over the age of 60 is 43.3%, and the death rate in younger people is 13.2%; According to the second method, the death rate over the age of 60 is 55%, while the death rate for younger people is only 6.8%.

Another important finding of the researchers is the length of the "incubation" period of the disease, that is, how much time passes from the moment a person is exposed to the virus until the moment symptoms of the disease are detected. The researchers estimate that the incubation period is an average of 6.4 days. But according to another statistical calculation they made, which was based on a smaller number of patients, the incubation period could be extended up to 14.22 days.

Estimating the incubation period is important because public health officials use it to determine how long people who have been exposed to the virus should be quarantined. So far it has been estimated that the incubation period may reach up to 10 days; To be safe, double the incubation period, and determine that an infected area has been cleared of SARS if the signs of the disease have not appeared in it for 20 days. Now, following the strict estimate of 14.22 days that the new study came up with, the quarantine period may also be extended.

According to the study, the average length of time between the appearance of symptoms in a patient and his hospitalization is three to five days. According to the researchers, the length of time that passes until hospitalization does not change the results of the disease, but it is important to hospitalize people suspected of having SARS as quickly as possible, in order to reduce the risk they pose to the entire population.


El Al suspends its flights to Hong Kong and Beijing

Zohar Blumenkranz adds: The national airline "El-Al" announced yesterday that it is suspending its flights to Hong Kong and Beijing in China from May 10 to June 6 due to the spread of SARS. The company said that those who want to go to Hong Kong and Beijing will be able to fly with the company to Bangkok.

Yadan who follows the Sars epidemic

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