Tom Blackwell <a href=www.nationalpost.com>National Post Wednesday, May 07, 2003

A revised case definition of SARS may be excluding many people who have the virus, raising questions about whether quarantines are catching all those who could potentially spread the disease, according to a paper published yesterday by Canadian scientists.

The research paper, published yesterday in the online version of the Journal of the American Medical Association (JAMA), marks the second recent suggestion by experts that the ailment lurks in a significant number of individuals who do not meet the classic profile of a SARS patient.

A Health Canada scientist said last week that lab tests had found the strain of coronavirus thought to trigger the illness in 14% of patients deemed not to have SARS.

The JAMA paper, written by researchers at several Toronto hospitals and the University of Toronto, looked at 144 cases of the city's outbreak.

It notes the current case definition used worldwide excludes "a significant number" of people who have fever and had possible contact with SARS but no respiratory symptoms, such as a dry cough or shortness of breath. Such people would not be considered probable or suspect cases.

"This has important public health implications," the authors wrote. "Such individuals may actually have acquired the virus that causes SARS without developing the full syndrome. Accordingly, they and their contacts may require quarantine."

The cases examined by the group were all classed as probable or suspect SARS cases based on an early definition from the U.S. Centers for Disease Control. But under the criteria now used by Health Canada, the CDC and the World Health Organization, 16 would not be considered SARS cases, the paper said.

Dr. Frank Plummer, head of Health Canada's national microbiology lab in Winnipeg, said last week there is concern the non-SARS patients who tested positive for the coronavirus may be able to infect others, but there is no evidence yet of that happening.

Meanwhile, the outbreak showed further signs of weakening in Ontario yesterday, as the number of probable cases under treatment dropped by two to 29.

But more than a dozen countries seem to have doubts about Canada's safety. A week after the WHO lifted its controversial advisory against non-essential travel to Toronto, several countries still have similar alerts in effect about the city, according to Foreign Affairs Department records. They include South Korea, Venezuela and small nations that do not produce many visitors to Canada: Cayman Islands, Kuwait, Lebanon, Luxembourg, Macedonia, Malta, Nepal and Singapore.

Another group of countries has advisories that suggest their citizens avoid visiting Canada altogether, the Foreign Affairs records indicate. They are: Bhutan, Cooke Islands, Jordan, Libya, Malaysia, Mongolia, Panama, Uruguay, Vietnam and Yemen.

Foreign Affairs continues to tell nations there is no reason to restrict travel to Toronto, Reynald Doiron, a department spokesman, said.

Tourism Toronto is also spreading the word, writing to all Canadian missions abroad and to foreign embassies in Canada to point out the current status of the outbreak, Bruce MacMillan, president of the tourism agency, said.

"We've been successful in many cases and not in others," he said.

A major drug company yesterday addressed another fall-out of the epidemic: skin irritations suffered by health care workers who have to repeatedly wash their hands and use harsh antiseptics.

Pfizer Canada donated 40,000 tubes of its Lubriderm skin lotion, with a retail value of $120,000, to several Toronto hospitals.

tblackwell@nationalpost.com

<a href=www.vheadline.com>Venezuela's Electronic News Posted: Sunday, May 04, 2003 By: Patrick J. O'Donoghue

Mexican immigration officials have arrested a Venezuelan pilot and crew as well as 14 Chinese nationals and  for illegal entry in Cancun. Mexican authorities say they believe they uncovered illegal trafficking of people and confirm that the Chinese were all carrying false tourist papers. 

• The plane landed in Quintana Roo on a chartered flight from Venezuela. 

Mexican officials, who allowed the Chinese through have also been arrested on charges of corruption. Clarifying health risks, Mexican officials have confirmed that none of the Chinese aboard the flight have symptoms of SARS.

Venezuelan authorities say they are concerned about illegal trafficking of Chinese into Venezuela because the majority come from Hong Kong where the SARS outbreak started.

Reports have not indicated whether Mexico was the final destination or the USA. 

May 2, 2003, 11:48PM By JOSEPH A. GIANNONE Houston Chronicle-Reuters News Service

NEW YORK -- The global travel slump and a potential slowdown in Asia's economies prompted by the deadly SARS virus could cut into energy companies' earnings in the second quarter and beyond, analysts and industry executives said.

Severe Acute Respiratory Syndrome has claimed nearly 400 lives since spreading from China in March.

Efforts to avoid and contain the disease have crimped travel and tourism and shut down factories and office buildings in China and Hong Kong.

Industry analysts say demand for oil and refined fuels will suffer, sapping profit growth at Exxon Mobil Corp., ChevronTexaco Corp. and ConocoPhillips -- all global oil companies with big refining and marketing businesses in Asia.

"SARS has reduced airplane travel, reduced jet fuel demand and affected the economy," said analyst Lowell Feld of the U.S. Energy Information Administration, referring to China.

Energy companies, which posted record first-quarter profits amid soaring oil and gas prices, already face a period of falling prices.

The war in Iraq ended with little damage to oil facilities, and fears of disruptions in Venezuela and Nigeria have eased.

Yet companies face the prospect of reduced sales of jet fuel, gasoline, natural gas, chemicals and power in Asia, according to Lysle Brinker, an oil analyst for John S. Herold.

OPEC President Abdullah Al-Attiyah, Qatar's oil minister, estimated last week that SARS will reduce oil demand by about 300,000 barrels per day.

If the 2-month-old downturn persisted, SARS could erase much of Asia's projected economic growth. J.P. Morgan Chase has warned the virus may not be brought under control until June.

China's economy, once expected to expand by 8 percent, now may shrink by 2 percent in the second quarter.

It had been slated to consume an additional 100,000 barrels per day this year, according to Energy Information Administration estimates.

"The demand side of the picture is in big trouble because of the high energy prices we've experienced the past few months and SARS' impact on demand in Asia," said Fimat USA analyst John Kilduff.

The airline industry, a major consumer of jet fuel and other oil products, has been hard hit.

Industry group IATA in March said trans-Pacific flights were down 12 percent and Europe-to-Asia flights fell by 15 percent.

Prices drop to fresh 5-month lows amid fears of slumping global demand and impact of SARS epidemic.

April 29, 2003: 3:50 PM EDT

NEW YORK (Reuters) - Oil prices fell to fresh five-month lows Tuesday on expectations of rising spare supply in a weak global economy, where the deadly SARS epidemic is biting into energy demand.

Light crude oil for June delivery fell 25 cents to $25.27 a barrel on the New York Mercantile Exchange, coming within 20 cents of the lowest level in 11 months, after losing 20 percent in the past week.

In London, Brent crude fell 26 cents to $23.24 a barrel.

Prices have fallen for the last six sessions after the OPEC cartel last week cut back less than expected of the extra crude it pumped to cover supply during the U.S.-led war on Iraq.

While OPEC presented its deal as a cut of 2 million barrels per day (bpd), analysts said its threshold for the reduction was inflated, reducing the actual impact of the move.

"The market is still living through the aftermath of the OPEC meeting. It is surprised and disappointed with OPEC's decision," Societe Generale analyst Frederic Laserre said. "Now everyone is looking to see if U.S. crude stocks have risen again -- that will confirm the trend of a stock build and show that there is indeed a lot of oil out there."

Oil stocks in the United States, the world's largest consumer, have risen for two consecutive weeks. Analysts predict that new data Wednesday will show they rose again last week, pumped up by strong imports from OPEC.

OPEC raised production well beyond formal quota limits in March to keep oil prices under control ahead of war in Iraq and make up for supply disruptions from a strike in Venezuela and ethnic strife in Nigeria.

Helping weak economies

The increased OPEC supply, particularly from Saudi Arabia, has helped bring oil prices below the $30 a barrel level that analysts warn can hurt global economic growth.

"A period of moderate prices would be very helpful for the world economy," said Jean-Phillippe Cotis with the Organization for Economic Co-operation and Development (OECD).

Also weighing on prices, the International Energy Agency has said it may have to cut its world oil demand forecast for this year as the deadly SARS virus combines with other factors to hit economic growth.

OPEC has said it expected Severe Acute Respiratory Syndrome to hit Asian demand alone by some 300,000 bpd mainly due to declining air travel. The epidemic coincides with the second quarter, when oil demand falls about 2 million bpd from its winter peaks.

"SARS is one of the elements contributing to the fact demand is not very, very high in general. Economic growth and therefore consumption are not as strong as it might be," IEA Executive Director Claude Mandil said Monday.

Weekly air traffic data released Tuesday showed that European airlines had seen demand for seats to the Far East plunge by almost a third from week-ago levels. Asia's Singapore Airlines has cut capacity as much as 10 percent.

"We are now entering the secondary effect phase of SARS when we see a slowdown in the overall economy and less industrial production," said Societe Generale's Laserre.  

Boston.com By Colin Nickerson, Globe Staff, 4/27/2003

TORONTO - Canceled theater tickets and poker nights have given way to canceled weddings, as crestfallen brides discover they can bring the groom to the altar but can't coax out-of-town friends and relatives to risk the trip to Toronto for fear of SARS.

''We'd planned for June, but keep getting frantic e-mails and calls - `Is it safe?' Everyone's frightened by the idea of Toronto, especially our loved ones in the States,''' said Kathleen McKay, 27, a commercial artist originally from Quebec.

''So now we're wondering whether to make it next year. In Montreal. I mean, who wants to get married in an empty church?''

At Union Station, Canada's biggest rail hub, some arriving passengers slip on surgical masks, or simply clamp a handkerchief over nose and mouth before braving the streets.

''When someone sneezes on the commuter car, people react like it's a gunshot,'' said James Stevens, 39, an executive with one of the city's financial firms. ''Everyone flinches, and eyes go wide.''

Chinese restaurants, which have been all but deserted for weeks, have taken to airing desperate radio ads boasting of disinfected tables and sterilized napkins rather than promoting flavorful salt-and-pepper shrimp or General Tao's Chicken. ''At Mandarin, we have a longstanding tradition of being masters of good health,'' goes one blurb, run by a well-known buffet chain.

Health officials insisted last week that severe acute respiratory syndrome has been all but conquered in Toronto, the country's largest city and its financial center - with 4.6 million people in the metropolitan area, and about half of Canada's corporate headquarters. Yet the city continues to be pilloried and shunned.

There have been 20 SARS deaths in and around Toronto, and at least 268 people have been infected with the disease, by far the worst outbreak of the virulent virus outside Asia.

Residents of the proud Queen City are reeling.

''It's like living in a leper colony,'' said Darsit Singh, a 32-year-old construction engineer. ''I have to keep calling home to India - India! - reassuring my family, `Hey, it's OK, no one's dying in the streets.'''

The World Health Organization stunned Canada last week by issuing a strong warning against ''unnecessary'' travel to Toronto because of the risk of contracting the virus that causes SARS.

Government leaders and public health officials voiced outrage at the advisory, which effectively placed Toronto at the same level of international alarm as such SARS hot zones as Beijing and southern China, where the disease has spread much farther and has exacted a far deadlier toll.

Last week, Mayor Mel Lastman, a blustery former TV pitchman, lashed out at the United Nations health body in an interview with CNN: ''They've never even been to Toronto; they're located somewhere in Geneva,'' he said. ''They're hurting Toronto badly.''

In headlines abroad and at home, Toronto has been dubbed the ''Pariah City'' in this frightening SARS spring. To wit:

British Airways crews have been instructed to stay out of Toronto hotels and to travel to Montreal instead.

Some cruise ship lines in the Caribbean have announced that they will not accept Torontonians as passengers.

Several conference organizers in the United States are starting to demand that anyone from southern Ontario wanting to attend must bring a medical certificate proving he or she isn't infected by SARS.

Australia, Britain, France, Ireland, and Venezuela are among countries that have advised citizens against venturing into southern Ontario. (The United States has advised travelers crossing the northern border to avoid hospitals, to pack a first aid kit, and to wash their hands frequently.)

In Massachusetts, the Marian Fathers religious order has asked 450 pilgrims from Toronto to stay away from an annual outdoor Mass officials scheduled for today at the Shrine of Divine Mercy in the Berkshires.

''Even US baseball teams visiting the Blue Jays have been warned not to mingle with fans,'' the National Post said in a gloomy editorial. ''The WHO advisory can only compound the economic fallout the SARS scare has already wrought in Ontario.''

Toronto hotels are facing the worst slump in occupancy rates experienced anywhere in North America since the 9/11 terror attacks, with more than 70 percent of rooms empty in some cases.

''The SARS outbreak is creating not just a public health crisis; it has become a jobs crisis in Toronto's hospitality industry,'' said Paul Clifford of Toronto's hotel and restaurant union.

Economic analysts fear the damage done by SARS will reverbrate through the entire Canadian economy. David Dodge, governor of the Bank of Canada, warned that national economic growth will be slowed significantly this year because of SARS.

Ted Carmichael, chief Canadian economist with J. P. Morgan Securities Canada Inc., estimated that the outbreak would siphon billions of dollars from the economy and would cut economic growth across the country by half this year.

Public health officials said that Toronto has turned the corner in its fight against SARS, thanks to fast action by physicians and dramatic quarantine measures. At one point, more than 10,000 Canadians were under emergency orders to remain at home, often only because of suspicion that they might have been exposed.

''We're seeing an incredible decrease in the curve, I don't think there is a crisis anymore,'' said Dr. Donald Low, chief microbiologist at Toronto's Mount Sinai Hospital and one of the physicians at the forefront of the battle to contain SARS.

As eight new cases were reported in Toronto late last week, however, Ontario Public Health Commissioner James Young acknowledged, ''We're not out of the woods yet.''

Under intense pressure from the Canadian government, the World Health Organization indicated that on Tuesday it will review its warning against travel to Toronto, according to Canadian officials.

But a top official yesterday said yesterday that the outbreak in southern Ontario is still regarded as one of the most serious in the world. And the organization is especially concerned that the disease might continue to spill from Canada into the United States and other countries. A nursing assistant from Ontario died last week in the Philippines after contracting the disease in Toronto. Her father also died.

There is growing concern among epidemiologists that the Canada strain of SARS may be more virulent than those in Asia.

Canada remained adamant that the economically-devastating travel warning is unwarranted. ''We all believe that the World Health Organization came to the wrong conclusion,'' Prime Minister Jean Chretien told reporters. ''We believe that Toronto is a good place to visit and it is a safe place.''

SARS, which has a mortality rate of about 6 percent, has killed 293 people and has infected about 5,000 in more than 20 countries since first appearing in China's Guangdong Province in November, according to official figures.

SARS arrived in Toronto on Feb. 23, borne by a 78-year-old grandmother who was returning to suburban Scarborough after a trip to Hong Kong, where she contracted the virus from another guest at the Metropole Hotel. The grandmother, Kwan Sui-Chu, died at home on March 5, with the coroner listing ''heart failure'' as the cause, paying no attention to the flu-like symptoms she had suffered.

But Kwan's 43-year-old son, Tse Chi Kwai, contracted the mystery ailment and was taken to Scarborough Grace Hospital, where he came in contact with an estimated 200 doctors, nurses, health technicians, and fellow patients before his ailment was recognized for what it was - a new killer virus hitherto confined to China.

Since then, however, Canadian public health officials insist that the disease has been confined to an ''index'' of persons known to have been exposed directly or indirectly to the original Toronto victims. At least 66 of those infected with SARS in the Toronto area are health professionals.

''There is no evidence of casual transmission of SARS in Toronto and every case can be linked back to the index case,'' said Dr. Paul Gully of Health Canada, the federal Health Ministry.

This story ran on page A1 of the Boston Globe on 4/27/2003.