Wednesday, 27 November 2013

The MERS-CoV case slience has fallen lifted thanks to the WHO

Well, apart from a blatant Dr Who references, this post is dedicated to providing a huge portion of back-patting for the great job the World Health Organisation (WHO) have done on their recent Disease Outbreak News reports (see yesterday's here). I now have a new colour code in my Excel sheet that indicates "confirmed by WHO" - because its become worthwhile doing that. 

The current approach to detailed MERS-CoV News posts continue to hold the sort of detail I'd hoped for. 

Also, congratulations must go to the Kingdom of Saudi Arabia's Ministry of Health (KSA MOH; and at other times, other MOHs from the region) for providing the WHO with these details. As well as a global tally, which may still lag a little behind Ministry or media case announcements because of the time it takes to officially collate and centralize the data from multiple sites (I presume), we now seem to be regularly getting:
  1. Sex
  2. Age
  3. Occurrence of animal exposure
  4. Presence of comorbidities
  5. Date of illness onset
  6. Date of hospitalization
  7. Date of death if a fatal case
  8. Region the case occurred in (still a bit patchy)
On September 11th I wrote a specific wishlist, revised from an earlier version and from that of Crawford Kilian's memo to the Ministry somewhat to account for patient confidentiality, that included 16 items. The WHO's efforts address most of the items on that list. Well done and keep up the good work!

My full wishlist, with some amendments, is below. I still feel these extra few bits (in blue) of information would be useful, especially the unique code to globally track cases and some detail on what may have worked to help support the infected patients course. 
  1. A unique, continuous identifying code of KSA cases
  2. Sex of case
  3. Age of case
  4. Possible exposures to animals and other human contacts
  5. Occurrence of comorbidities
  6. Date of illness onset
  7. Date of hospitalization
  8. Date and type of laboratory testing
  9. Date of death if a fatal case
  10. Region the case occurred in 
  11. Date of release from hospital
  12. Treatments or management
In the meantime, FluTrackers curates the world's best, and most rigorously checked, MERS-CoV case key. Such a stable Rosetta stone of MERS-CoV cases is essential. It provides the world with a solid, unchanging and reliable set point for each case around which our discussions and ideas can revolve. Not the kind of stone out of which a Weeping Angel is made - one that shifts menacingly every time you blink or look away - but one with the dependability of a Dalek's determination to "Exterminate", or of a Sontaran's desire for a good fight.

Research papers come and go and their conclusions change like a shape-shifting Zygon, but a permanent list of public information on MERS-CoV cases over time is the gold standard against which they can be given important context. 

The more information we can rely on during times of emerging viral outbreaks (or slow-moving epidemics), the better prepared we are to get in front of them, contain them and not be unnecessarily scared by them.