Hospital Sets Strategy in Case of SARS

Calmette Hospital officials said Thursday they have reserved two buildings as isolation wards in case of an outbreak of severe acute respiratory syndrome, strengthening the government’s existing preventive measures.

Respirators will be at the ready and teams of doctors are prepared to investigate hotels in case symptoms of the pneumonia-like disease appear in the capital, said Jean Baptiste Dufourcq, the coordinator of Calmette’s emergency room and intensive care unit.

Currently, emergency room patients exhibiting SARS symptoms are transferred across the hall to a small isolation room, which can hold two people, he said Wednesday.

Since March 18, 12 patients have been isolated and released; none of them had SARS. Until now, no other facilities have been needed to monitor patients. A SARS outbreak could change that.

Calmette Hospital has designated four colors to describe Cambo­dia’s SARS status, Dufourcq said.

Cambodia’s current status is green, SARS-free.

Orange describes five or more cases entering the country from abroad. Red signifies imported cases and a local outbreak of 50 to 100 cases. Black will be used to describe a SARS epidemic of proportions rivaling those in Hong Kong and Singapore, he said.

If Cambodia’s status chang­es to orange, patients will occupy the isolation ward, possibly the ICU and an empty building with 20 beds reserved for the medical treatment of monks, Dufourcq said.

Options for a red scenario are under consideration. One plan involves the use of a third building with 40 beds currently filled with surgical patients, he said. Patients would be moved to Preah Kossamak Hospital in Tuol Kok district.

“I am confident we have the capacity to do a red scenario,” Dufourcq said. “If we have a black scenario, we will need quick international aid. We’d need at least 300 beds. It would be a real problem.”

Dufourcq said his confidence has soared since the beginning of the regional outbreak, when a shortage of surgical masks would have compromised clinicians’ safety in the event of an outbreak. With international donor support, Calmette now has masks enough for a two-week epidemic, he said.

Calmette’s seven ICU respirators currently are in use, Dufourcq said. Since 10 percent of SARS patients require respirators, eight respirators from the city’s heart surgery center will be commandeered if necessary, he said.

Dufourcq said his biggest concern is the surveillance of hotels and garment factories, where SARS patients could quickly spread the disease to others .

Van Sou Ieng, president of the Garment Manufacturers Associa­tion in Cambodia, said Wednes­day that he would propose to the executive committee that all Chi­nese factory supervisors be adv­ised not to return to Cambo­dia after traveling through affected areas. If supervisors must come, he said, they should quarantine themselves in their hotel rooms for seven to 10 days.

Approximately 1,000 Chinese supervisors work in the industry, flying between Cambodia and China at different times throughout the year, Van Sou Ieng said.

Improving airports’ health surveillance systems was discussed in a meeting of Health Ministry and World Health Organization officials Wednesday, a ministry official said.

“We need to strengthen efforts at the airport. [Airport officials] aren’t fully cooperating,” he said.

The official said irritated passengers have blown past health inspectors, refusing to fill out travel and health history questionnaires. Greater efforts will also be made to take the temperatures of all travelers who have passed from affected areas, he said.

Health Minister Hong Sun Huot also proposed to head an inter-ministerial task force, whose responsibilities are yet to be determined, the official said.

SARS has devastated the airline industry worldwide, and Cambo­dia is no exception. Mekong Air­lines reduced its staff of 100 by 20 percent Monday, an airline representative said Wednesday. For­eign employees were fired, and Cambodians were laid off indefinitely because there is not enough work to occupy their time, the airline said.

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