X-ray technician ends SARS quarantine today

The x-ray technician who developed a fever after taking the chest x-ray of Adela Catalon, the first fatality from Severe Acute Respiratory Syndrome (SARS) in the country, may be released from quarantine today.

Dr. Consortia Quizon, head of the Department of Health (DOH) National Epidemiology Center (NEC), said "RT" has been without fever for 10 days now, a strong indication that she does not have SARS.

RT, who works at the San Lazaro Hospital (SLH), was already suffering from fever when she performed the chest x-ray on Catalon last April 13, Health Secretary Manuel Dayrit earlier said.

Reports said the technician did not wear goggles when she attended to Catalon, exposing her eyes to mucus that could have been discharged by the patient and making her vulnerable to the killer virus.

Catalon died of SARS on April 14 at SLH after infecting her cancer-stricken father Mauricio, who died on April 22.

Mauricio died while under quarantine at the Research Institute for Tropical Medicine (RITM) in Alabang, Muntinlupa City, making him the country’s second SARS fatality and first local transmission case.

His remains, however, are still in the RITM morgue because private crematoriums have refused to cremate him.

The DOH is studying the possibility of forcing private crematoriums to cremate people who died of SARS.

"We want to know if we can force private crematoriums to cremate (SARS patients). This is one of the issues we want to address," Quizon said.

She added that the DOH will also study if it could revoke a private crematorium’s license to operate if it refuses to cremate SARS patients.

The paranoia brought about by the SARS epidemic has also prevented the ashes of "CY," the second Filipina to die of SARS in Hong Kong, from being repatriated.

Local officials, led by the mayor, are strongly opposed to the plan to bury her in her hometown of Mabalacat, Pampanga because they fear her ashes could trigger the spread of SARS in the town, Labor Secretary Patricia Sto. Tomas said.

Sto. Tomas said she has asked the help of the DOH to assure local officials in Mabalacat that CY’s ashes do not pose any health risks.

"I asked the DOH to help us in explaining to the community that the remains of CY passed through 2,000 degrees Centigrade of heat and no virus could survive such (conditions)," she said.

The parents of Adela Dalingay, the first Filipina to die of SARS in Hong Kong, also faced the same problem when they returned home bringing the ashes of their daughter to Abra until health authorities explained to the people that there is no danger, Sto. Tomas said.

"To refuse burial (to CY) is very unfair. The problem is we are proceeding from the absence of clear information," she said.

CY died of SARS Friday night, after more than a month of confinement at a Hong Kong hospital. Her body was cremated a day after her death, but negotiations for the repatriation of her ashes are still underway.

Sto. Tomas said the ashes of another Filipino who died of SARS in Singapore Wednesday night are also awaiting repatriation.

Sources said the employer of JP, a male nurse, is working on the repatriation of his ashes.

A total of 25 cases, including three deaths, have been recorded among Filipinos abroad.

To help screen local suspected SARS cases, the DOH has formed a five-man panel of experts who will review and identify SARS cases in the country, according to Quizon.

The panel — composed of experts from the NEC, World Health Organization (WHO), Philippine College of Chest Physicians, Philippine Society of Microbiology and Infectious Diseases and Makati Medical Center — will meet twice a week to discuss all suspected SARS cases in the country, Quizon said.

"Actually, what will happen now that we have an expert panel, the decision whether it is a SARS case or not is (no longer) the call of any single physician but a diagnosis of an expert panel. This group agreed to meet two times a week to review all admissions in our hospitals for SARS," she said.

The move was apparently intended to prevent a repeat of the DOH’s misdeclaration that Hong Kong-based domestic helper "JP" of Maydolong, Samar had contracted SARS. She later turned out to be suffering from another infection.

Under the new scheme, the panel will study all SARS suspects reported to the DOH to determine if they are indeed SARS cases.

The experts will also decide which among the SARS suspects should be released from quarantine to prevent the deadly disease from spreading.

Quizon said the doctors who admit a suspected SARS case into the hospital would still do the initial analysis of the case, but the results would be discussed by the panel.

She added that under the new system, the panel of doctors — with their varied fields of expertise — would lessen the chances that an important detail about a patient will be missed.

"All admissions will be discussed by the panel. They will provide technical inputs to confirm a certain case. This is part of our system of double-checking SARS cases," she said.

WHO, for its part, is requiring the DOH to submit the x-ray results of all suspected SARS cases for verification by experts abroad.

"The results could be sent abroad electronically. We are lucky because we can get inputs from people abroad who have experience on SARS," she added.

Dayrit will also consult the SARS Crisis Management Committee if the days a SARS suspect spends under quarantine can be charged against his leaves of absence.

"We’ll be coordinating with concerned agencies like the (labor department). We know that the economic issue is one of the concerns of those up for quarantine," Quizon said.

Two birds, one stone

To prevent the spread of SARS, Dayrit urged local government units to ensure that their surroundings are clean.

"Cleaning the environment will also prevent the spread of other diseases like dengue. It will be like hitting two birds with one stone," he said.

Dayrit added that local officials can also use their calamity funds for relief operations and other services related to SARS prevention.

"We can only prevent the upsurge of cases and deaths if we maintain clean surroundings, particularly in a situation where the virus can survive in the environment for several hours," he said.

Dayrit also asked the public to observe personal hygiene such as the constant washing of hands with soap, and covering the nose and mouth when sneezing, to prevent the spread of SARS.

In a related development, airport authorities are expecting the arrival and installation of a walk-through thermal imaging device this May 15 at the east concourse of the Ninoy Aquino International Airport (NAIA) Terminal 1 arrival area.

The device, made by Singapore Technologies Electronics, costs P4,296,000. Two more units will be installed this June at the west concourse of NAIA-1 arrival area, and at NAIA-2 arrival area, said Manila International Airport Authority (MIAA) officer in charge Marcelino Yumol.

The devices are reportedly the same ones used at the Changi airport in Singapore to detect fever in passengers.

MIAA statistics show that about 6,000 to 8,000 passengers arrive daily from abroad at NAIA’s two terminals.

Airport authorities are also mulling over plans to install these thermal imaging devices at the departure areas of both terminals, as well as arrival and departure areas of the Manila Domestic Airport — a total of 10 machines — Yumol said.

According to Yumol, another company that sells temperature scanners, Spectrum Scientific Corporation, has also presented their equipment to MIAA officials recently. Each of their scanners range in price form P1.8 million to P3.9 million.

At present, quarantine staff at the airport are using forehead thermal strips to check a passenger’s temperature. Each strip costs P57 and this costs the government about P399,000 a day to check the passengers for fever, Yumol said.

Sources, however, said the quarantine staff are reusing these thermal strips because they are not supplied with enough strips to check an average of 7,000 daily.

Yumol said that these thermal strips should ideally be used only once. — With Mayen Jaymalin, Sandy Araneta