" At the second hospital he was intubated to save him from suffocation. That is, a flexible tube was inserted deep into his mouth, past his glottis, and down his windpipe into his lungs, to help with breathing. This event represents another important clue toward explaining how SARS spread so effectively through hospitals around the world. Intubation is a simple procedure, at least in theory, but it can be difficult to execute amid the gag reflexes, sputters, and expectorations of the patient. The task was especially hard with Zhou, a portly man, sedated and feverish, and though his disease hadn’t yet been identified, the attending doctors and nurses seem to have had some sense of the danger to which they were being exposed. They knew by then that this atypical pneumonia, this whatever, was more transmissible and more lethal than pneumonias of the common sort. “Each time they began to insert the tube,” according to an account by Thomas Abraham, a veteran foreign correspondent based in Hong Kong, there was “an eruption” of bloody mucus. Abraham continues: It splashed on to the floor, the equipment and the faces and gowns of the medical staff. They knew the mucous [sic] was highly infectious, and in the normal course of things, they would have cleaned themselves up as quickly as possible. But with a critically ill patient kicking and heaving around, a tube half-inserted into his windpipe and mucous and blood spurting out, there was no way any of them could leave. At that hospital, twenty-three doctors and nurses became infected from Zhou, plus eighteen other patients and their relatives. Nineteen members of his own family also got sick. Zhou himself would eventually become known among medical staff in Guangzhou as the Poison King. He survived the illness, though many people who caught it from him—directly, or indirectly down a long chain of contacts—did not. "
― David Quammen , Spillover: Animal Infections and the Next Human Pandemic
![David Quammen quote : At the second hospital he was intubated to save him from suffocation. That is, a flexible tube was inserted deep into his mouth, past his glottis, and down his windpipe into his lungs, to help with breathing. This event represents another important clue toward explaining how SARS spread so effectively through hospitals around the world. Intubation is a simple procedure, at least in theory, but it can be difficult to execute amid the gag reflexes, sputters, and expectorations of the patient. The task was especially hard with Zhou, a portly man, sedated and feverish, and though his disease hadn’t yet been identified, the attending doctors and nurses seem to have had some sense of the danger to which they were being exposed. They knew by then that this atypical pneumonia, this whatever, was more transmissible and more lethal than pneumonias of the common sort. “Each time they began to insert the tube,” according to an account by Thomas Abraham, a veteran foreign correspondent based in Hong Kong, there was “an eruption” of bloody mucus. Abraham continues: It splashed on to the floor, the equipment and the faces and gowns of the medical staff. They knew the mucous [sic] was highly infectious, and in the normal course of things, they would have cleaned themselves up as quickly as possible. But with a critically ill patient kicking and heaving around, a tube half-inserted into his windpipe and mucous and blood spurting out, there was no way any of them could leave. At that hospital, twenty-three doctors and nurses became infected from Zhou, plus eighteen other patients and their relatives. Nineteen members of his own family also got sick. Zhou himself would eventually become known among medical staff in Guangzhou as the Poison King. He survived the illness, though many people who caught it from him—directly, or indirectly down a long chain of contacts—did not.](/image/2542739.jpg)