Signs Of SARS - Bay Area
Man Quarantined
After Violating Voluntary Isolation Order

By Sabin Russell
Chronicle Medical Writer

Two other unidentified county residents who had close contact with the man are being sought, to place them on fever watch as well. Morrow said that none of the contacts posed a health risk to anyone unless they were to become ill. The point of the monitoring is to assure that, if they become ill, they can be quickly isolated.
As a recent traveler to Taiwan who came down with a fever and respiratory symptoms, the patient is automatically classified as a "suspect" SARS case, under the definition adopted by the e "negative pressure" isolation cells in the county jail to confine inmates with respiratory illness. The rooms, like those in a hospital, are designed to prevent air surrounding the patient from circulating in the rest of the building. Morrow said that, in light of the recent experience, the county would now routinely issue an enforceable isolation order to SARS patients as soon as they are diagnosed as a suspect case.
"If you want to be able to have some teeth, orders are the way to go," Morrow said. Although SARS has apparently spared the United States thus far, the disease has shown the potential for explosive spread in hospital environments. "We don't went to have an experience like Taiwan or Toronto, where tens of thousands of people are quarantined," Morrow said. In San Francisco Wednesday, Centers for Disease Control and Prevention Director Dr. Julie Gerberding commented that SARS "is the most infectious disease in a health care setting I have ever seen." In three months since the world health organization...
For rest of the story: 6/06/BA141838.DTL
From Astraea Kelly
Dear Sabin,
I really liked your article in SF Chronicle on the San Mateo forced isolation.
Some of MY questions then coming off this opening are as follows:
1) There are several other hospitals in the Bay Area and South Bay and North Bay that have known and reported SARS isolation units in operation and have reported some of their suspects to public health officials.
2)  If those same hospitals then start to see "pneumonia" patients in large numbers, with fever, hypoxia, respiratory distress, ARDS, and diarrhea........those would indicate SARS symptoms by CDC criteria, would they not?
Those then same hospitals would also fall under the criteria of being a "known SARS contact" area........would they not?
They have SARS suspects in isolations and reported.
3) So why are staff with SARS symptoms in those same reported and acknowledged hospitals allowed to run around without being in isolation or monitored?  I am one of those types of situations.  In fact, I am being "forced" to go to back to work in the hospital next week, even though I am not well yet, and lab tests or procedures for checking my illness progression of a "virus syndrome" are not completed.  I am certainly not 10 days past well. 
I have worked in a known SARS isolation hospital, with patients in and out of isolations, some who died of similar symptoms and are being investigated.  And yet, I am not instructed or monitored in the least bit for my community contacts.
In fact, I have repeatedly been told to take off my mask in public, as I don't need one ( I didn't travel outside of the U.S.). I just work where their are SARS isolation patients and I have just found where I might have been exposed to such a SARS suspect BEFORE they were placed in an isolation room and before they were diagnosed as "isolation potential" and I treated them intimately in contact without isolation procedures. I then became sick with my first SARS symptoms and was screened on April 7th by the SARS team. I was ruled as "regular flu" and told to go home and do whatever I do for the flu.  I became ill again on May 5th with viral syndromes matching my patients symptoms and I have been given a "confidential diagnosis" with only the screening physician's name for my diagnosis on May 10. I was then processed for workers comp and am under occupational medicine and my internist for continued follow up.  I was told this past week by my internist that I have a "viral syndrome" and yes, it can affect the kidneys.  I am now having a problem with my right kidney and am still going through tests for it.  However, neither the SARS team nor I realized at that point, on April 7th, that I had been in contact with an isolation patient, before they went into isolation.
4) This repeated in-fighting and delay in my workers comp processing even though all my physicians have signed that I am a workers comp situation, has left me without any income or pay for five weeks.  I have had to borrow money from family and friends just to have food.  There is no one to run my errands for me, and no one has followed up on my patient contacts or who I have been around for 5 weeks with my "viral syndrome"(that I am aware of).   I have voluntarily self isolated myself at home, as much as I can, without any instructions or monitoring on any daily basis by public health or my hospital.
Is this safe for me to return to work to my coworkers before I am well?  Is it safe for me to go to the grocery store?  I don't have any new masks.  I don't know what procedures to use or how to get supplies.  By WHO definition, I am a SARS suspect.
Why am I not monitored or instructed what to do and why I am left out here for 5 weeks with no income, while I am sick?
Thank you, Sabin. I hope you will continue to explore these questions and issues for myself and others in your future articles.
Astraea Kelly
Health Care Worker
Bay Area California



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