Within the same vein, the MOH has announced that two cases passed away. The first case is for a 41-year-old female resident working in the health sector in Riyadh.Until now I hadn't paid much attention to the terms "citizen" and "resident" (what the Saudi media call "expatriate"). Now I'm beginning to wonder if the nationalities of the cases is relevant information.
The only other explicitly foreign case is that of the Sudanese doctor, who was mentioned as such in some media reports. But has anyone done a breakdown of cases by citizenship status?
So while healthcare workers seem to be contracting a lot of MERS, are they Saudi HCWs or foreigners? And if foreigners, of what nationality?
Reading the Saudi media has taught me that "expatriates" form a large, necessary, but awkward part of the labour force. They tend to do jobs the Saudis can't or won't do, like being housemaids (A few Ethiopian maids have lately killed their employers' children, causing a domestic-service crisis). Many of those jobs are by definition low-status, but I'm not sure if healthcare work is among them. Are expatriate HCWs given potentially dangerous work like caring for MERS cases? And do expatriates get such tasks more often than Saudi citizens do?
I have no idea. But if the Saudis were giving us much more detailed reports on cases and deaths, some interesting patterns might emerge. We might be able to trace human-to-human transmission more accurately if we knew the type and duration of physical contact between patient and HCW, for example.
This in turn makes me think about how little we still know about cases contracted outside hospitals. Surely the Saudis are interrogating patients and their family members about where they've been, what they've eaten, what animals they've been in contact with, and so on.
I would like to think they're sharing this information with WHO, ECDC, and the CDC. If so, those organizations are as tight-lipped as the Saudis themselves. If not, the agencies must be beside themselves with frustration at Saudi silence.
In effect, Saudi policy appears to be to let MERS spread where it will, while suppressing any information that might remotely embarrass the House of Saud.
Perhaps the Chinese Embassy in Riyadh might do everyone a favour by advising the Saudis on the intensity of embarrassment Beijing suffered during the SARS outbreak.