- The Washington Times - Friday, May 9, 2003

The World Health Organization raised the death rate of SARS this week to 14 to 15 percent — nearly four times original calculations, but said it probably won’t rise any higher now that there are enough data to make an accurate estimate.”This is where the truer number is; the earlier numbers were just preliminary,” said Dr. William Schaffner, chairman of the department of preventive medicine and a professor of infectious diseases at the Vanderbilt Medical School in Nashville, Tenn.The WHO said the main reason for the jump is because it is very difficult to estimate the true death rate while an outbreak is still evolving. Death from severe acute respiratory syndrome typically takes several weeks, so people who have been in the hospital are now dying and the rate rises.”The death rate almost always goes up over time,” said WHO spokesman Ian Simpson, adding that the rate is not likely to rise any further.The death rate for SARS started out as an estimated 4 percent and had been raised to 6 to 10 percent.Older people and people with previous problems such as diabetes are more likely to succumb to SARS than young, healthy people, WHO and other health experts stressed.Different groups have different rates for dying,” the WHO’s director for communicable diseases, Dr. David Heymann, said this week.Mr. Simpson said this could be another factor in the rise of the death rate. In the beginning of the outbreak, SARS hit hard among health care workers, who were relatively young, so the death rate was lower, he said. As the virus spread, more older people got afflicted with it and the death rate rose.Based on the latest data compiled from Canada, China, Hong Kong, Singapore and Vietnam, the WHO said the fatality rate is less than 1 percent in people 24 or younger, 6 percent in people 25 to 44, 15 percent in people 45 to 64, and greater than 50 percent in people 65 and older. It averaged 14 to 15 percent.This has experts concerned.”It’s an even more serious disease than we had anticipated a few weeks ago,” said Dr. Schaffner.He said it “reinforces that notion that the WHO and the CDC were correct in the early attention they paid to this disease.” Some had criticized the intense worldwide focus on SARS, saying it was overshadowing more deadly diseases, he said.The death rate for cholera if left untreated is 50 percent, measles has a 4 percent death rate and influenza has a 1 percent death rate, though it is much more infective than SARS, said Mr. Simpson.Elizabeth Halloran, a biostatistics professor at Emory, said SARS is one of very few illnesses in developed countries that can kill healthy young people.”We didn’t have anybody in their 20s and 30s dropping from infectious diseases until AIDS,” she said.There have been no SARS-related deaths reported in the United States.Dr. Linda Degutis, associate professor of surgery and public health at Yale, cautioned that it still is a little early to pinpoint the mortality rate for SARS. But she said people in the United States should not panic when they see the higher rate.She said there is a much greater chance of dying in a car accident than from SARS — 40,000 people die each year from the former.”People should relax a bit, but still pay attention,” she advised.And Dr. Halloran said there is still a chance that SARS will be wiped out.”They’ve shown they can slow things down and it may be they can slow things down to the point of eradicating it,” she said. “I’m still hopeful.”

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