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Talk:Severe acute respiratory syndrome

Older discussions are in talk:Severe acute respiratory syndrome/archive 1

Something should be done to the "progress of the outbreak" section. Its current size is ok, but at some point (a couple of months from now) we have to either

start deleting older, not-so-relevant-stuff (a bad choice)c
move the section into its own article or
let it bloat into a huge list containing hundreds of small events.

Any ideas before this becomes a problem? --Card 16:05 Apr 10, 2003 (UTC)

I'd take option#2 - create Timeline of SARS outbreak[?] -- kt2

Yes, that makes sense. More tables and plots would be nice, too, e.g. cumulative cases over time. --Eloquence 02:17 Apr 11, 2003 (UTC)

Better would be SARS timeline[?]

I agree that it should be renamed and split up into something resembling the Afghanistan timeline. -- Minesweeper 00:56 Apr 28, 2003 (UTC)

Racial effects

Since no one replied to my request to furnish evidence to substantiate claims of racial effects of the SARS outbreak, I changed the title of the section. I also added a published source who has questioned these claims, since quotable sources were requested. I am taking a Popperian approach here. The null hypothesis is that there are no racial effects of SARS, and to demonstrate that there are such effects we just need some evidence that disproves this null hypothesis. This approach gives us the opportunity to establish with certainty that racism exists. Jfitzg

Although I do prefer the new title and don't have particular objections to the recent edits about race, there are two points to be made here:

Taking a "Popperian approach" is not always acceptable on Wikipedia. There there is far from universal agreement that the only things worth saying are A) not yet falsified by evidence but still B) falsifiable in principle. In addition, people may have different views about what is/isn't falsifiable, and the sorts of evidence that would be relevant for falsification. In light of this, the NPOV policy strongly suggests that being "Popperian" is not a blanket, unproblematic justification for one's edits.

I'm going to be rude and interrupt your comment, becuase the points you make are important (as are everyone's here) and I think it aids clarity to respond to them immediately rather than in some later compendious reply. Anyway, as I have argued below, the hypothesis that SARS has led to racial discrimination is utterly without empirical support. After weeks of these accusations I think it is only reasonable to ask that people who claim that there have been such effects provide some evidence of them. Yes, the hypothesis remains falsifiable; that's the point. It remains falsifiable, but the believers in racial effects of SARS refuse even to try to falsify it (except by fabricating "racial jokes" that were never told). I added the bit about racial slurs and expanded on the quotation from Min Tat Cheung, by the way.Jfitzg

There is no universally acceptable, a priori reason to take "no racial effects" as the null hypothesis, instead of taking, say, "some racial effects", or even "lots of racial effects", as the null hypothesis. You could argue one way or the other based on what seems intuitively plausible, or based on if it's worse to A) say there's racism when there isn't or B) say there isn't racism when there is. But no matter which one you pick, people will disagree with you.

The a priori reason is that the "no effects" hypothesis is falsifiable, and the others not. A non-falsifiable hypothesis does not enable us to reduce uncertainty. No one wants to offer any evidence, anyway. Jfitzg

Again, I'm not currently suggesting any particular changes. I'm just suggesting matters are murkier than they first appear.

--Ryguasu 22:45 Apr 11, 2003 (UTC)

Just my two bits, I don't want to get into this Popperian stuff, or the state null hypothesis, prove otherwise method, because I don't know much about it. Although I do think some of the things that someone recently added, like the fact that Jean Chretien went to a Chinese restaurant, and that "it is close to election" are petty things, which don't really make it any stronger. I mean, wikipedia were actually trying to prove one side or the other, these would be moot points. Wikipedia is NPOV, so it argues for both sides...it which case they are still moot, petty points. I am biased because I personally don't like hearing about the stupid little things that politicians do, and then includes when Chretien invites people to a chinese restaurant, as if he needed to prove he wasn't racist. dave 15:56 Apr 12, 2003 (UTC)

I took out the reference to racial jokes in the media scrum, because I didn't hear any, and I heard the exchange in question several times. If racial jokes were made, quote them in the piece. As for Wikipedia not having a point of view, that is irrelevant. The accusations are just plain wrong. They are demonstrably wrong. They are false. Some of them -- like the story of the racial jokes in the scrum -- are manufactured. I am sure Wikipedia does not countenance printing falsehood simply because it's someone's point of view. What if someone decided to blame the Jews for SARS? That's a point of view. Jfitzg

I don't want to edit the totals, because I realize there is a system in place here. but the totals in this news story [1] (http://story.news.yahoo.com/news?tmpl=story&u=/nm/20030412/sc_nm/health_pneumonia_canada_dc_1) and in this wiki-article do not align. Kingturtle 03:55 Apr 13, 2003 (UTC)

Turtle, don't worry, just fix it yourself next time. This is a high traffic article anyways, if you typed in 14 by accident or if they news changed tomorrow, it would be fixed. dave 06:08 Apr 13, 2003 (UTC)

Sorry to bring this up again, and I appreciate those who update the totals, but the current totals are confusing -- does the China entry represent a sum of numbers in the mainland plus those from Hong Kong and Taiwan?

By the way, there is lots of talk in Taipei Times (http://www.taipeitimes.com/) and elsewhere about Taiwan, WHO, SARS and China. Anyone willing to write it up?

Kaihsu 18:20 Apr 14, 2003 (UTC)

The China entry does not represent a total. The "problem" is that the WHO classifies Hong Kong and Taiwan as regions of China and alphabetizes them on the list as if they began with "C". I've yet to find some way to name these regions without stepping on someone's toes. There was some discussion of this here (/w/wiki.phtml?title=Talk:Severe_acute_respiratory_syndrome&oldid=798287). -º¡º

I don't like the alphabetical order of the external links. I think it should be arranged in the reversed order of significance. I would put WHO website first, CDC's next (due to their authority in the medical field, then Hong Kong's, Canada's and then Taiwan based on number of cases affecting the countries. Just my two cents.

User:Kowloonese 23:08 Apr 14, 2003 (PDT)

Rewrote section on China. IMHO the CNN article was a very bad summary of what was actually said at the press conference. If you go to www.xinhua.org, you see this page on SARS

http://news.xinhuanet.com/ziliao/2003-04/15/content_832545.htm

and even if you can't read Chinese there is enough there to make it clear that the official media is no longer an official blackout on the story. One of the links on the page is a transcript of the press conference covered by CNN, and IMHO the CNN story was quite a bad summary of what the Chinese officials actually said.

Here is a link to the press conference that CNN covered.

http://www.xinhuanet.com/zhibo/20030410/zhibo.htm

Changed the paragraph to describe exactly what China did and remove speculation about why China did it. My experience has been that most speculation on why Chinese officials do certain things tends to be extremely uninformed.

--- User:Roadrunner

I haven't kept track of who keeps doing it, but frequently the Western criticism about China suppressing news of the outbreak gets deleted from the article.

It's actually me. User:Roadrunner

Why would anyone want to omit from the article the fact that people outside China accused the regime of a cover-up?

Changed the wording some more. The way that it was worded makes is read like it has been established that Chinese officials were intentionally covering up information about SARS.

The problem is that the wording misrepresents the Chinese governments position on what happened. I don't have any objections to a charge that the Chinese government has had a coverup provided that there an an accurate statement of what the Chinese governments response is. Thus far, the allegations have completely misrepresented the Chinese governments response to charges of a coverup.

The other point is that the paragraph makes is sound like that Chinese government *still* is surpressing information about SARS, when that is clearly not the case if you the Chinese media. It's been the top story for the past several days.

This encyclopedia isn't endorsing those charges -- merely reporting them. Moreover, if a delay in reporting the outbreak within China itself turns out to have aided the spread of the disease, I think this would be a significant revelation.

Apparently China has both (A) denied covering up the outbreak and (B) apologized for not telling people about it....

--Uncle Ed 18:59 Apr 15, 2003 (UTC)

The position of the Chinese government is that they mishandled the early stages of the disease, but they are trying to do the right thing now.

Thanks for clearing that up, Roadrunner. Perhaps we need a subsection (or separate article) on the cover-up issue.

Near as I can recall, what happened was this:

the West found out about SARS when someone in Hong Kong showed up with the disease early this year. Within about a month, two things happened. Experts traced the disease back to China's Guangdong province, and China officially reported the outbreak to the WHO.
Next, some in the West began complaining that China had been "suppressing" news of the outbreak. They even started suggesting that this alleged "cover up" had aided the spread of the disease and blaming China for this.
In the last week or so, China began to admit that it had been, um, slow (?) in revealing/reporting the outbreak.

Are we pretty much agreed on my three-point summary? I don't want to have an edit war. It's better to hash it out on the talk page, and then edit cooperatively. --Uncle Ed 19:41 Apr 15, 2003 (UTC)

The problem I have with that summary is that it doesn't name exactly alleging a cover-up late last year (meaning that officials knew that they had a problem and intentionally surpressed information about the news). The Reuter articles is not a sufficient source for this since it is just repeating boiler plate. There is a good Washington Post article about this, but all they are accusing the Chinese government of is bureaucratic inertia and rear end covering. They problem here is that unless one is careful one ends up playing a game of telegraph where an original report of bureaucratic inertia becomes a full scale cover-up.

Now there *has* been an accusation that the PRC is covering up cases in military hospitals Beijing, but that is a different issue.

-- User:Roadrunner

Changed the paragraph. There probably wasn't a coverup in Guangzhou, but it appears now that there was a coverup in Beijing.

-- User:Roadrunner

Regarding SARS in Hong Kong,

A poem from all H K Citizens :

 Congratulations, Mr. Tung Chee-hwa,
 What a year you've had so far
 Things have certainly been bizarre
 Starting with Antony Leung's new car (http://uk.news.yahoo.com/030310/80/dv2tm)
 And now we even have a disease named after the HKSAR.

 Oh Mr. Tung, please bring back our glorious past
 When property and stocks would rise far and fast
 And everyone was having such a blast
 Now we're just wondering if you're up to the task
 And asking when can we take off this stupid mask.

Here is a long list of external links on SARS, some may be useful for this article.

Severe acute respiratory syndrome: External links

That post above is cluttering the talk page...delete it? move it? fix the ugly <a class=encyclopedia href= crap? I suggest the original poster should fix the hyperlinks for us.

The WHO is clearly backlogged and they can't verify the deaths to be SARS-related quickly enough. You'd think the the ministry of health in ontario would be quicker. They report 16 deaths (1 is a half-death, the lady caught it in canada and then went to the phillipines and died). All the updates are available here: http://www.health.gov.on.ca

So please don't blindly alter the Canadian death toll and make it lower. If I set it to 13, or 14, or 16, or whatever, it's because I've heard it from the Ontario ministry of health. dave

Hi Dave. I think we just have a failure to agree on our terms. A simple answer is that the table is by definition correct, since it is a list of ONLY those cases reported BY the WHO, and NOT of those reported by national health ministries. But there is an even better answer that cuts to the heart of your question. The WHO is not involved, at all, in "verifying" the deaths of SARS victims. They accept whatever data is sent to them by the national health agencies and report it without modification. So, why does the WHO say 15 why HealthCanada says 16? Simple. If you read the fine print on the Canadian site, it says that one of the deaths was due to a "suspected" case. Since the WHO only reports "probable" cases, the WHO total is one fewer than the Canadian total.-º¡º

Is there a graph that plots the number of cases against the time line? user:kowloonese

I made one a week ago, but it wasn't very interesting so I never bothered posting it. Most of the big jumps have to do with countries "recognizing" and "unrecognizing" cases, and no clear slope was discerned. Feel free to try making your own graph if you think it will be fruitful. -º¡º

--- I've got graphs on world numbers based off WHO data and graphs based on Singapore numbers. They're from Excel but still quite viewable. Should I post them? They'll quickly go out of date ... April 30, 2003 - User:Alex.tan

There is already a graph!!! User:Thomas 04/30/03

Yes, there is already a graph. If you post one of yours, are you going to take the effort to regularly update it? -º¡º

It seems to be up-to-date for the time being.... Actually, I have a macro which is in charge of getting all info from the WHO site to update the graph. Not too much work! User:Thomas 05/01/03

Yes, I noticed that there is a graph, but I don't understand it - what's the big idea of the two Y-axes? Could you explain the left axis and how it goes from negative to 160%? User:Alex.tan 1/5/03

I see, you're right. I'll try to make it easier to understand. User:Thomas 05/01/03

Now that Progress of the SARS outbreak has its own article, shouldn't the duplicate material on the SARS page be removed? -- 241

Sure, why don't you take care of that? -º¡º

Disinfopedia article on SARS outbreak (http://www.disinfopedia.org/wiki.phtml?title=SARS) has information not here, contrasting Chinese and Canadian reaction.

I'm confused about the graph. Where did the numbers come from? Like 100%=94 for Canada. Where did you get this? It does not match the WHO table. dave 19:48 Apr 30, 2003 (UTC)

I rather think is that graph really meaningful? -- Taku 02:09 May 2, 2003 (UTC)

and the blue gradient background detracts from the readability of the graph, making it hard to read. I'd also like to see the data sources noted. The curves look much too smooth. The Anome

I also agree that they are too smooth. Ideally I'd like to see a white background, and all the data points shown, scatterplot. And I think a trendline would be better than point-to-point connections. Maybe a moving average is best in this case. There's no way those outliers should be swinging the curve wildly like that. dave 15:16 May 2, 2003 (UTC)

OK OK! Major changes about the graph. Far more easier. Actually the previous one is very useful to get the evolution of every country very fast. This is a more global approach and it doesn't require to think too much. All value are trended (Moving Average of 7 days) and stacked. And easily readable. Any other suggestions? USER:Thomas 05/02/03

This graph seems pretty good! I think we can keep this one. JohnQ[?] 14:56 May 3, 2003 (UTC)

One thing - graphing "currently infected people" does not make sense from a clinical point of view. As SARS is an evolving disease, there is no way to know that "recovered" people are no longer infected. There have already been cases of "relapses". Similarly, there are reports that "recovered" SARS patients are still shedding SARS virus 4 weeks later in their stools. Therefore, I think graphing this is at the very least potentially misleading. Alex.tan 01:24 May 5, 2003 (UTC)

Nice. What is your suggestion then? USER:Thomas 05/05/03

I suggest charting total cases, number recovered and deaths. Graphing a derivative of these numbers is just graphing what you think is appropriate - with the benefit of the retrospectoscope (later, of course) this may or may not turn out to be the right way to have shown things. Having said that, I think WHO should be reporting "number discharged" rather than "recovered". Also, why is your graph showing a mortality of 20% when my numbers suggest that (deaths/(deaths+recovered)) so far amounts to 13.87%? Alex.tan 12:28 May 5, 2003 (UTC)

Your calculation is not good. 13,87 % is the AVERAGE mortality rate since the outbreak of the disease. This is absolutly not relevant to trace it troughout the time. 20% is the mortality rate calculated from the new deaths and new recovered people for the last 10 days. Which is useful to see how the disease is evolving. Taking into consideration total cases, number recovered and deaths doesn't add any information (the mortality rate is a synthesis of these figures). Moreover, it doesn't show that the disease decreases in some countries (Canada, HK) and that China is not able to control the disease. Which are important facts I guess.
USER:Thomas 05/06/03

yes, but your graph didn't initially show that it was tracking the 10 day mortality rate ... your graph initially suggested this 20% was the AVERAGE mortality rate. Please don't show misleading information. Alex.tan May 6, 2003

To have a graph with the average mortality rate doesn't make sense! The figure for tomorrow will contain the figures of today and yesterday. Therefore, you cannot compare variables that are not differentiated. Variables have to be comparable.

AND PLEASE ALEX.TAN ! IT'S NOT BECAUSE YOU ARE TOO STUPID TO UNDERSTAND A GRAPH THAT YOU SHOULD REMOVE IT! I DON'T DAMAGE YOUR WORK, RESPECT MINE. USER:Thomas 05/06/03

I will remove whatever I think is wrong information, misleading information or downright disinformation. I'll agree that your current graph is the best out of all your graphs but many others will agree with me that your first few ones sucked big time. I can't modify your graph to fix the numbers so the best I can do is remove it until you fix it. Alex.tan 13:47 May 12, 2003 (UTC)

(unknown date sometime between March 25 and April 1), an Asian commerce conference was postponed to an undetermined date in autumn. Can anybody verify this claim by supplementing it with a bit more information? This seems far too vague a statement for this entry.

I can't seem to find any information in the article on the transmission vector of the virus (e.g. airborne, water, food, etc.). Does that mean it is still not known? Could someone add that kind of information to the article. -- Ap

It's airborne. That's why people where the masks, and that's why you see politicians going to chinese restaurants on TV (because it's not in food or water). Of course, if someone coughs in your food, that's a different matter. dave 22:24 May 2, 2003 (UTC)

It is not known! It is likely airborne, but probably also infects in other ways, there is big inconsistensys in the ways it have and have not infected. The medics working on it today is not sure.Stefan[?] 03:14 May 4, 2003 (UTC)

Sure, they are not 100% what method it is transmitted by. But what else could it be? There aren't that many options. And obviously if it is in fact airborne, then it is probably in one's saliva as well, and blood as well. Actually I just heard on the radio right now, that it can last up to 24 hours or longer on a plastic surface, you if you touch a surface which someone with SARS coughed on, then put your finger in your mouth (or any other orifices) you'll probably catch it. Also, they said it lasts up to 4 days in excrement. dave

Why does our graph seem to show a 20% mortality rate, when news sources keep reporting a 5-10% mortality rate? For example [2] (http://www.cnn.com/2003/WORLD/asiapcf/east/05/04/sars/index) Rmhermen 02:52 May 5, 2003 (UTC)

I can tell you, the mortality rate is absolutly not 5-10%. These figures are wrong. USER:Thomas 05/06/03

Where does anyone except yourself say that this is the mortality rate? The way the caption looks under the graph it appears that you are claiming that WHO says that this is the mortality rate but as of May 1 they were saying it was 6-10% but liely to go higher [3] (http://www.haaretzdaily.com/hasen/pages/ShArt.jhtml?itemNo=289232&contrassID=1&subContrassID=8&sbSubContrassID=0&listSrc=Y). Is there some more recent news? Rmhermen 19:33 May 5, 2003 (UTC)

Hear, hear. The mortality rate is closer to 15%, not 20% even by the calculation of deaths/(deaths+recovered). I still think the mortality figures should show an overall number rather than the number over the last 10 days. The assumption that all patients take the same amount of time in hospital is false. Some people are out after one week, some after two ... and ... many people in ICU can end up staying in hospital for more than a month.Alex.tan May 6, 2003

We could increase the time span, but not extend it to a global average. This has to be limited in time! Otherwise, this is misleading. (for instance, if the mortality rate sinks the average mortality rate will be far too slow to react). USER:Thomas 05/06/03

Shouldn't the mortality rate be deaths/(deaths+cases)? Just because someone hasn't "recovered" doesn't mean they've died either. Then the mortality rate is closer to 6%. -- Minesweeper 17:43 May 6, 2003 (UTC)

What are you exactly talking about? Current deaths? People dead for the last 2 weeks? New cases? Actual cases? I don't think we can compare people recently dead to actual cases as this would be to compare a state to a flow. USER:Thomas 05/06/03

Just look at the totals in the chart: 6234 cases, 435 deaths, 2702 recovered. The calculation being used is deaths/(deaths+recovered) = 435/(435+2702) = 14%. Now, what about the 3097 who have been ignored? The term "mortality rate" means to me the number of people who have died out of the number of people infected. If 10 people are infected and one dies, it seems that's a 10% mortality rate. For example, what if 10 people are infected, one dies and two recover, leaving seven still "sick"? By the above calculation, we have a 1/(1+2) = 33% mortality rate, even though just 1 out of 10 infected has died. This calculation of mortality rate leaves the thousands who have been infected but have not died out of the equation, inflating the numbers. See this article (http://www.boston.com/dailyglobe2/126/nation/SARS_mortality_rates_are_seen_to_vary+.shtml), which says "WHO and the US Centers for Disease Control and Prevention divide the number of deaths by the number of cases to yield a mortality rate, which yesterday was 7 percent worldwide." This calculation yields 435/6234 = 7%. Are we going to follow the numbers of some PhD, or the WHO and CDC? -- Minesweeper 01:29 May 7, 2003 (UTC)

OK. It depends what you want to show. The calculation you speak about is a slow one. I mean, if the disease become suddenly very lethal, the graph won't show it at once. Moreover, if the number of people infected rises suddenly, this will decrease the mortality rate, which is clearly misleading. But, as I can understand that not everyone is familiar with all these different calculations and the graph has to reflect the figures in the news to appear consistent, I changed it. (I'm not stubborn! Just feel free to give your opinion I'll do my best to put it into pratice!) USER:Thomas 05/07/03

No, Minesweeper, the mortality rate refers to an individual's prognosis at the onset of the disease. If you were to catch SARS now, how likely would you be to die? The easiest way to examine that is to look at the cases where the disease has run its course; ie. the patient has either died or recovered. If you read the Boston Globe article your change points to, the expert opinion seems to sway on the side of this "known outcomes" calculation method. WHO says they are using the deaths/cases method for consistency, but that's foolish; consistency in these figures is impossible to attain between a new and rapidly spreading disease like SARS and, say, malaria. Thomas is right in that the spread and effects of the disease are better illustrated with the known outcomes approach. For example, there is now statistical evidence showing that the growth rate of the case load is very different from the growth of number of deaths (using the WHO data for the last month, the number of cases is growing at a rate of 40% per 10 days while the death toll is rising 78% in the same time). These kinds of issues are not illustrated by WHO's metrics that are clearly designed to work with more mature diseases. User:Markonen 05/07/03

Okay, understood. I felt that the lower number should at least not be ignored, which it now isn't. I think both numbers are somewhat misleading, but since both are quoted and explained, I'm happy. -- Minesweeper 10:24 May 8, 2003 (UTC)

The visual presentation of the graph is much better: but please can you remove the soft-shadow effect in the corner that obscures the latest details? The Anome

Sure. Thomas 05/08/03

In this new article we see WHO adopt a new mortality rate computation system [4] (http://story.news.yahoo.com/news?tmpl=story&u=/ap/20030508/ap_on_he_me/sars_virus_319). This one is apparently based on the likelihood of dying for each week you are sick. Their new rate is 15%. v Rmhermen 13:25 May 8, 2003 (UTC)

15%! And the average mortality rate calculated on the graph is...15%!!! Ha! WHO should come here to read this page. Thomas 05/08/03

This should be of use to those working on this article [5] (http://story.news.yahoo.com/news?tmpl=story&cid=541&ncid=1624&e=3&u=/ap/20030523/ap_on_he_me/sars_virus_521)
Is this of use? [6] (http://story.news.yahoo.com/news?tmpl=story&cid=1508&ncid=1624&e=25&u=/afp/20030522/hl_afp/health_disease_sars_030522234921)

Kingturtle 17:30 23 May 2003 (UTC)

In the news yesterday: SARS from space? http://edition.cnn.com/2003/TECH/space/05/23/sars.fromspace/

Heh, I was just checking in here to add mention of that "SARS from space" story myself. Think it should go in the main article? -- John Owens 20:31 24 May 2003 (UTC)

And what of the lowly civet cat[?]? (Much maligned, much eaten, and an ingredient in perfume...) <G> -- Someone else 20:37 24 May 2003 (UTC)

on the BBC the guy was described as (I think) an astrobiologist. checking if we have an article on astrobiology... they gave a huge amount which they say is biomatter that falls to earth each day. seemed enormous -- Tarquin 20:48 24 May 2003 (UTC)

Hmm, it might be worth it, if only to include this one quote from a WHO spokesman: "I find it hard to believe that it came from outer space. We won't be sending a WHO team to investigate." -- John Owens 21:10 24 May 2003 (UTC)

What is the average mortality line on the graph and why does it never change? Rmhermen 18:35 15 Jun 2003 (UTC)

This is the GLOBAL average mortality rate. When the disease will be over, this will be the mortality rate of the illness. Thomas 05:47 24 Jun 2003 (UTC)

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