WSJ On Saudi Efforts To Contain MERS-CoV

Coronavirus – Credit CDC PHIL

 

 

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Murmurs of impatience in the scientific community over the slow progress in  the MERS-CoV investigations in Saudi Arabia have grown louder in recent weeks, as we’ve reached the 1-year anniversary of this virus’s discovery.   One year after SARS emerged in 2003, not only had the virus been contained, we knew a great deal more about it than we do today about MERS-CoV.

 

Last week, in Branswell On MERS-CoV At The One Year Mark we saw reactions from CIDRAP Director Michael Osterholm, Dr. Larry Anderson who led the CDC’s SARS research a decade ago,  Dr. Mark Pallansch of the CDS’s MERS task force, Dr. Tony Mounts of the World Health Organization, and others.

 

Overnight some of you may have noticed a well publicized Wall Street Journal piece by Ellen Knickmeyer and Betsy Mckay on concerns regarding Saudi Arabia’s attempts to contain MERS, only to find the story was behind a pay wall.  I’m happy to report that this morning, that article has been `unlocked’ as a `public health issue’, and is now available to all.

 

Follow the link to read:

 

Saudi Efforts to Stop MERS Virus Faulted

Experts Still Don't Know How People Are Exposed to Mysterious Disease

By ELLEN KNICKMEYER in Hafr al Batin, Saudi Arabia, and BETSY MCKAY in Atlanta

More than a year after the emergence of a new virus that has killed dozens of people, mainly in Saudi Arabia, international health officials say they are concerned that Saudi officials may not be conducting—or aren't providing findings from—some critical investigative work that could help answer basic questions about the mysterious disease.

At the same time, relatives of some Saudi victims are demanding that their government do more to warn the public about the potential danger.

(Continue . . . )

 

With the Hajj now just three weeks away, and millions of religious pilgrims making their journey to the holy sites in Saudi Arabia, concerns over the spread of this emerging virus out of the middle east this fall are rising.

 

Despite reassurances from Saudi officials  (see Middle East Online Hajj pilgrimage without MERS outbreaks: Saudi Arabia remains optimistic), many public health officials remain wary.  Mass gathering events are an ideal environment for the spread of infectious illnesses, and international air flights are an extremely efficient way to disseminate them rapidly around the globe.

 

Today, the World Health Organization will hold their third meeting of the IHR Emergency Committee on MERS-CoV, and later today we should get some details on their findings, via a press conference by  Assistant Director-General Dr Keiji Fukuda.

I hope to have an update on the IHR committee meeting later today.

WSJ: Saudi MERS-CoV Concerns As Hajj Approaches

Credit Wikipedia

 

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Middle East correspondent Ellen Knickmeyer, writing for the Wall Street Journal today, has a report on Saudi Arabia’s MERS-CoV response as the Hajj approaches.  Included are reactions from tourists visiting the Saudi Kingdom, along with comments on the flow of information from Dr. Ian Mackay.

 

Follow the link to read:

 

September 2, 2013, 12:52 PM

Saudi’s MERS Concerns Grow as Hajj Season Approaches

Saudi Arabia continues to report sporadic new cases and deaths from a lethal new coronavirus, as hajj season in October — when the kingdom expects more than 3 million pilgrims from 187 countries –- approaches.

(Continue . . . )

A Confusing Coronavirus Picture In Saudi Arabia

 

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While the welcomed weekend communications by Dr. Ziad Memish – KSA’s Deputy Minister of Public Health - have added valuable line listing details on their coronavirus cases, our understanding of the scope of that outbreak remains very limited.

 

The sparse epidemiological comments he’s provided so far suggest some degree of human-to-human transmission has occurred and ties that to a single single health care facility.

 

But an article overnight by respected journalists Ellen Knickmeyer and Betsy McKay in the Wall Street Journal, and some hard-to-decipher translated Arabic news items on FluTrackers, raise questions over exactly what is going on with this outbreak.

 

Our first stop, the WSJ piece, which quotes a hospital's executive director as confirming that some coronavirus cases were being treated at his facility, but denying that his facility was the only one treating coronavirus patients.

 

If his statements are accurate, this would suggest a bigger problem than the Saudis are currently owning up to. 

 

This article also contains reaction from CIDRAP Director Michael Osterholm. Follow the link to read:

 

• Updated May 6, 2013, 6:34 p.m. ET

Virus's Toll in Saudi Arabia Raises Fears of Faster Spread

Saudi Arabia Reports 7 Deaths in Outbreak of SARS-Like Disease

By ELLEN KNICKMEYER in Hofuf, Saudi Arabia, and BETSY MCKAY in Atlanta

Saudi Arabia's announcements in the past five days of seven new deaths from a SARS-like virus have heightened fears that the Mideast outbreak is entering a more-aggressive phase.

 

On Monday, security guards, their faces covered by green medical masks, stood watch outside the intensive-care unit at a small hospital in Hofuf, in the country's Eastern province, that is treating some of the victims in the most lethal surge yet of the year-old outbreak of a novel coronavirus.

(Continue . . .)

 

Other reporting in Arabic papers – which suffer greatly from the limitations of machine translation – paint a confused picture as well.

 

Caveat: Given the cryptic nature of machine translations in general, I have deep reservations over drawing too much from these type of reports, so I present them without endorsement. 

 

One such report, captured and translated last night on FluTrackers, mentions a press conference held by the KSA’s MOH, where they supposedly announced the virus had picked up `three-gene mutations, suggesting that there is a shift in the virus’.

This article also mentions multiple hospitals in regards to this outbreak, but the translation is so syntax-challenged, I’d be reluctant to draw any firm conclusions from it.

 

There are also reports of wild rumors, and of panicked parents keeping kids home from school, and the worried well showing up at hospitals.

 

So we are left with a lot of questions, and very few answers. 

 

• Does this outbreak extend beyond one facility?  
• Has the virus really `mutated’?
• Has the virus become more easily transmissible?
• Do the Saudis have it contained?

 

I certainly don’t pretend to know the answer to any of these questions.  

 

We may simply be seeing a public relations backfire created as a direct, and 100% foreseeable, consequence of an overly secretive Saudi risk communications policy.

 

If there’s one thing you can count on in a crisis, it’s that rumors and speculation will rush in to fill any information void.

 

The other possibility is that this outbreak is somehow substantially worse than we are being told. But if that’s true, it seems unlikely that they could keep it hidden for very long.

 

Which puts us in a watchful waiting mode, looking for any indication – one way or the other – of how this outbreak is playing out.

WSJ Video: Saudis Reject Claims Of Withholding NCoV Information

 

Coronavirus – Credit CDC PHIL

 

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While it’s true infectious diseases respect no borders, sovereign nations wield a great deal of power when it comes to divulging disease information.

 

As we saw with China in 2002-2003 and SARS, and Indonesia for several years with bird flu, some nations can be very `selective’ when it comes to releasing information.

 

International agencies, like the World Health Organization, FAO, and OIE must rely upon the relevant Ministries in member nations for timely and complete infectious disease updates.

 

In recent months we’ve seen a small number of novel coronavirus (NCoV) cases emanating from Saudi Arabia, and the Middle East, including a family cluster in the UK (see Eurosurveillance: H2H Transmission of NCoV In UK Family Cluster).

 

Of concern, the doctor - Ali Mohamed Zaki - who revealed the first case in a letter to ProMed Mail last summer (see Sometimes They Come Back) was subsequently fired.

 

And based on onset dates, some of the case reports coming out of the Kingdom of Saudi Arabia (KSA) appear to have been slow in being released.

 

The last case report – released March 6th – relayed information about a who had died two weeks earlier from the virus - `hospitalized on 10 February 2013 and died on 19 February 2013.’

 

All of which has led to some speculation that we might not be getting the full picture of what is going on with this emerging virus. Yesterday, Betsy McKay of the Wall Street Journal was interviewed in a 3 minute video, where she discusses these concerns, and the Saudi’s rejection of those claims.

 

Follow the link to watch the complete video:

 

Saudis Reject Claims of SARS-Like Virus

Saudi Arabia has rejected accusations that it is covering up details of a deadly new SARS-like virus, which has recently been shown to be capable of spreading from person to person. Betsy McKay reports.

 

 

You’ll note that the WSJ continues to use the `SARS-Like’ appellation for NCoV in their headlines (as does most of main stream media), despite calls from the WHO to use NCoV instead (see WHO: Please Don’t Call It `SARS-Like’).

 

Although I use NCoV in this blog, my readers are already familiar with the nomenclature. It is admittedly more difficult for mainstream headline writers to switch to a relatively new, and little known substitute.

 

Which explains why the term `Swine Flu’ is still sometimes used by the press, instead of the WHO recommended A(H1N1)pdm09.

 

Full Disclosure:  I served on a Pandemic & the Media with Betsy McKay in 2009 at a CIDRAP conference in Minneapolis.