Officials plan for possible SARS outbreak

By Warren King
Seattle Times medical reporter

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Even as people statewide battle an early flu season, King County health officials are preparing for the possible resurgence of SARS, focusing on the possible need for quarantine and isolation of patients.

About 350 health, hospital and municipal officials met in a closed seminar at a SeaTac hotel yesterday to discuss the logistics and legal ramifications of quarantine and isolation of patients, should those measures become necessary. Quarantine applies to those who have been exposed to a contagious disease but are not ill; isolation applies to people sick with the disease.

SARS — severe acute respiratory syndrome — infected 8,098 people worldwide last winter and spring, including 774 who died. No confirmed cases were reported in Washington state, but 172 people elsewhere in the United States contracted the disease and recovered.

SARS and flu The symptoms of SARS and influenza are very similar. Doctors usually differentiate between the two based on whether the patient has traveled to an area where SARS is present or whether he or she has been exposed to a known case. But right now, there are no known SARS cases anywhere in the world. "The likelihood of anyone having SARS now is approaching zero," said Dr. Jeff Duchin, director of communicable-disease control for Public Health — Seattle & King County.

The current flu epidemic dramatizes how quickly a disease can spread and emphasizes the need to be ready for deadly infections of any type, officials said.

"Preparedness means partnerships. Not one agency can do it alone," Dr. Alonzo Plough, director of Public Health — Seattle & King County said yesterday in a news briefing before the seminar.

Plough said Public Health has been forging partnerships with 19 hospitals, 20 law-enforcement agencies, six emergency-medical-service providers, 30 cities and more than 30 fire departments in preparing for public-health emergencies such as SARS.

Yesterday's discussions about the preparations were closed to the media and public. Jo Ellen Warner, a communications specialist for Public Health, initially said there wasn't enough room for reporters, then later said media presence might quell open discussion of the issues.

Dr. Jeff Duchin, director of communicable-disease control for Public Health, said the health agency has been working with hospitals, clinics and physicians to ensure SARS is recognized and reported promptly to health authorities.

Controlling the spread of any cases, Duchin and Plough said, will depend mostly on voluntary confinement by patients.

"We will do the minimally invasive things (to prevent an outbreak). We're not going to lead with the big stick of quarantine and isolation," Plough said.

Washington state regulations give health officials the power to order people into quarantine or isolation.

Duchin and Plough said there is no single hospital designated as the place to confine patients during an outbreak.

Rather, Duchin said, all hospitals are asked to be prepared to take patients and guard against disease transmission. He said a "good number" already are prepared, but he didn't know the exact number.

Jane Speakman, an attorney for the city of Toronto, said about 13,000 residents of the city were exposed to SARS or had the disease last winter or spring, but authorities found only 27 whom they had to order into confinement.

A person exposed to SARS needs to be confined for 10 days, the time in which symptoms develop. But Speakman said confinement was difficult for everyone, especially as they needed to buy groceries, collect paychecks, see loved ones in the hospital or attend funerals.

"Ten days became a monstrous period," she said.

Warren King: 206-464-2247 or wking@seattletimes.com

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