The Bahamas lacks proper quarantine facilities to contain the spread of Severe Acute Respiratory Syndrome by infected persons, Dr Perry Gomez said Sunday.
Chief of Internal Medicine and Infectious Diseases at the Princess Margaret Hospital, Dr Gomez was a special guest on the Island 102.9 FM Parliament Street talk show, hosted by journalist Jessica Robertson and lawyer Fayne Thompson.
Being an airborne disease, SARS is even more potentially hazardous than AIDS, he said.
If a resident becomes infected with SARS, Dr Gomez said, the Public Health system can “manage” to quarantine the person at home in the case of a mild illness, but the biggest challenge is providing hospitalization to patients who need to be hospitalized
According to the Centers for Disease Control website, prevention of new SARS cases depends on individuals avoiding close contact with infected persons, and individuals suspected of being infected, promptly evaluated and confined to a hospital, with no exposure to outside contacts.
“To properly manage a SARS patient in hospital, he needs a special isolation room. Not just a room with the doors closed. It is a negative pressure room and we don’t have any of those in the country,” said Dr. Gomez.
According to Dr. Gomez, when a SARS patient is being treated, there needs to be an area where there is very good air exchange, not with the use of an air conditioner, but an open room where there is good air flow and cross ventilation. “It has to be much like the wards that were built in the old days for tuberculosis (TB) where there was a lot of fresh air,” he said.
Dr. Gomez said that as no hospital in the country presently has these negative pressure rooms, trained individuals now have to find a way to produce such rooms. “You not only need a negative pressure room, but you need it in the intensive care area where all other ventilation equipment is found. It is a burden for countries with limited resources, because these things are not cheap,” said Dr. Gomez.
Dr. Gomez said that SARS is potentially more serious an infection than Acquired Immune Deficiency Syndrome (AIDS), as it is an airborne disease.
“I am sure that at the end of the day, there are going to be people who got an infection but never had any symptoms,” he said, adding that infection control precautions should be put in place and medical practitioners should wear gloves, goggles, gowns and the right kind of masks when dealing with SARS patients.
Dr. Gomez further explained that because people are the vectors of SARS, it is not surprising that it is spreading around the world. He said that what has really increased suspicions and fear about SARS, are the reported number of deaths. He said that SARS is a flu-like syndrome and five out of 100 people may die from the virus.
“SARS is a stomach virus from the family called Corona viruses that are small-rounded and very tardy. This means that it may live in a room for a few hours on a surface. This particular virus is airborne and it is either spread through a cough or a sneeze, saliva and faeces,” he said.
Since the virus has been isolated, medical professionals are now working on tests for its diagnosis, he said.
According to Dr. Gomez, the SARS groups of viruses were initially known to cause flu-like illnesses, but not death. He stated however, that this class of virus has been examined for sometime now and medical officials have predicted that it may one day cause a lethal infection because of some of its characteristics.
“It is a promiscuous virus, and it frequently recombines. They speculated that if the virus recombines with a protein from an odd source, it may lead to a lethal virus and this is what has happened in SARS,” said Dr. Gomez, who added that some form of the SARS virus is expected to be around for a very long time.
After a female patient with SARS-like symptoms reportedly sought treatment at the Princess Margaret Hospital on Sunday April 6, Dr. Gomez said, he spoke to the doctor who saw her at the PMH, who said that the person, a visitor, was taken to a walk-in clinic, where it was suspected that she had contracted SARS, but the speculation was later disproved.
He said that persons who had visited SARS-infected zones, were required to declare such visits; any known contact with a SARS patient; and whether they themselves had a high fever and cough.
“This tourist came directly from the United Kingdom and I don’t think the U.K. has reported a case yet,” he said. “When you look at it carefully, it should not have been considered a case because the patient did not meet the criteria.”
The person had a shortness of breath and was also asthmatic, he said.
“Because of this shortness of breath, the patient needed to be at the hospital and they could not just send them him. The doctor at PMH said that they would come to the clinic to see the patient, and I thought this was laudable. She examined the lady and agreed that she needed to go to the hospital,” said Dr. Gomez, who added that it was then that “pandemonium” broke out.
“This was good for us all that we had a dry run a week ago. Since the time, we have had in-service education for various categories of staff that is on-going and we hope that this sort of situation would not recur,” he said.
The incubation period between exposure to infection and the development of symptoms appears to range from 2-7 days.
As of Saturday April 12, the World Health Organization reported a total of 2,960 SARS cases, with 119 deaths reported from 19 countries. This represents an increase of 70 cases and 3 deaths when compared with Friday April 11. The three new deaths were reported in Hong Kong.
New cases were reported in Canada (3), Hong Kong (49), Taiwan, China (2), Singapore (14), Thailand (1), and the United Kingdom (1).
By Tamara McKenzie, The Nassau Guardian
