I am now extremely worried. We had a patient attend locally on Easter
Sunday. Just returned from Hong Kong where he had been living in the
building across the road from Amoy and had watched events unfold. He had
developed tiredness, headache, a cough, breathlessness and nausea. He
looked well and was apyrexial but had been pyrexial the day before. I
weas phoned, and came in to see him. He had already seen an assessment
nurse and an SHO both of whom took appropriate precautions. In the
meantime, advice was sought from a microbiologist who told staff to
discharge him. So I arrived to find a set of blood tubes and no patient.
He had not had a chest Xray and had not had any other tests. (Details
disguised but clinical issues accurate)
Public Health locally will keep an eye on him. However, I checked the
PHLS website and found there were considerable discrepancies, so I rang
and spoke to the duty PHLS doctor. Her attitude was remarkable and the
main cause of my concern. She was extremely dismissive of the severity
of SARS, "Nobody has died or gone to ITU in the UK so what is the
problem?" and seemeed to think that HK and Canada were flapping
unnecessarily. I was considerably taken aback by this, and asked why
this attitude was not reflected in the website. She promised to take the
suggestion back.
Why am I worried? Well, this all smacks of the official attitude to foot
and mouth. There was no quarantine until too late and huge numbers of
animals had to be killed eventually to regain control. If my patient did
have SARS, even if his was mild, so little is known of its infectivity
and transmission that he could presumably form a nidus for infection and
others could be infected and be made much more ill. We know very little
about the transmissability and infectivity of this virus, except for
what we see in the news. I therefore ask if the advice to return these
patients to the community needs to be reviewed and reviewed urgently. I
for one do not think that we should stick our heads in the sand - if
only to honour Dr Urbani's death.
Best wishes
Rowley
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