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July 2003 Issue
Is SARS real, or is it just Memorex?
by Michael Fick
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Asia panicked, and now they wear their smog masks even on clear days. Toronto panicked, even if primarily because their image as a squeaky clean tourist town suffered when the World Health Organization (WHO) declared it Hazardous to Your Health. Generally panicky people everywhere panicked. And, of course, the press panicked … at least on paper, which is what sells their paper. If it’s not SARS the panicky panic about, it’s Red Alerts, duct tape, anthrax, or whatever the press hypes. Should you and I panic? I’m not, because I have better things to do and because I have no plans to visit China. That leaves you, and the real questions:

    a) how concerned should you be about SARS, and
    b) what precautions should you take?

Answers:


    a. Not much.
    b. Not much.

Caveats:


    a. Unless you plan to spend some extended time with people in or recently from China.
    b. See (a).

Now, for those who choose to let the media run their emotions and lives, or those who visit China or hang out with people just back from China, let’s dig more deeply, because there are some risks and some precautions, maybe even some travel restrictions, worth knowing about.

Realize the WHO Toronto travel “ban” was a very protective, aggressive measure influenced by the AIDS experience. The WHO didn’t want to be accused of ignoring an expanding and unknown threat, so they blackballed Toronto. Toronto objected, in part due to the impact on its tourism-based economy, and the WHO caved … then reversed itself again later to reinstate the Toronto advisory. Meanwhile, people wearing everything from Armani and Guccis to pajamas and flip-flops wore bras on their faces and fear on their sleeves. Of course, the press is eating this stuff UP because they’re geared to run 24/7, the Iraqi war is no longer big news, and the public is catching on to the fact that the Laci Peterson case never was big news. The press won hands down without having to fabricate anything, but the basic questions remain: How big a deal is Severe Acute Respiratory Syndrome, and what should you do about it?

SARS is a genuine, serious threat. It cost the tourist industry >$25 billion in China alone, clobbered financial markets and travel worldwide, sent political heads rolling in China, created a paper mask shortage, closed wingdings -- even high society parties -- and scared some 120 million Americans about coughs, especially someone else’s coughs, sufficiently for 50 of us to panic when a guy got sick on a plane over San Francisco. Oh, yeah … and some 300 people worldwide have died from it … way below the toll of lightning strikes or railroad crossing accidents and not even one percent of the snake bite death toll. Lightning kills 100 U.S. citizens each year; SARS has killed one.

The primary human victims so far are the statistically insignificant number of people who got very ill from SARS, the far fewer who died from it, their friends, and those who panicked due to the headlines. So, is this a man-made, primarily psychological, epidemic of press-induced paranoia with a few cases of really bad flu to give it credence? Did everyone from the WHO to the networks to the masked commuters in Beijing overreact? Or is it a dread new disease poised to make AIDS seem like the sniffles by comparison?

We think now that it’s just a new twist on an old enemy, the coronavirus. I.e., it’s a cold. A bad cold, sometimes a fatal cold, but a cold nonetheless … more or less … maybe. But the strong reaction by the WHO was considered justifiable because if this thing had taken off like AIDS, as some “experts” – people with a pen or a microphone – had initially feared, getting ahead of the power curve could have averted a real global catastrophe.

To a large degree, the global medical community did get ahead of it. Canada mapped the SARS virus genome within a week, and knowledge of its DNA helped researchers study its sources, vectors, targets, and threat quickly. Even though there is no vaccine, reliable diagnostic test, or specific treatment for it yet, the WHO is optimistic about its eradication because outbreaks at all the initial flash points are contained or coming under control and SARS is clearly in decline. Scientists everywhere are working very hard to understand and eliminate it, but where does that leave you, now?

Postponing all unessential travel to most of China, plus taking precautions in Toronto, that’s where. The stuff is airborne and spreadable by coughs and sneezes, so minimize your contact with people with colds symptoms, especially in those regions. Avoid third-world plumbing; SARS is probably also transmitted by sewage. Think twice about air travel to and from China, even though passengers departing from China are screened. For a current WHO travel restriction chart, go to http://www.who.int/csr/sars/en/ and click on the SARS Travel Recommendations Summary Table link in the right-side menu. The CDC has deeper discussions about travel alerts and advisories at http://www.cdc.gov/ncidod/sars/. Both websites offer extensive, clear, easily-navigable coverage of the entire issue, including world SARS statistics, data of interest to frequent foreign travelers, and the history of SARS. For information specific to travel in Canada, visit http://www.hc-sc.gc.ca/english/protection/warnings/sars/index.html. In general, it currently lists no Canadian travel restrictions beyond normal foreign country precautions.

On a more personal and immediate note, if your temperature hits 100.4 with unusual headaches, fatigue, and chills, dry cough, breathing difficulty, muscle aches, loss of appetite, and diarrhea, see a doctor. But minimize your exposure to hospitals in active SARS areas, as almost all victims are health care workers or families of SARS patients … i.e., people in hospitals. The best simple way to prevent SARS is the same way we minimize colds across the board: frequent, thorough hand washing with ordinary soap and warm water for 20 seconds, or with alcohol hand wash gels. Exaggerate those precautions if you are sick or have a weak immune system.

SARS cases are declining in number everywhere, the death rate among known SARS patients is “only” six percent, and SARS is still extremely rare in the U.S. Does that mean our turn is still to come, or that we have dodged it almost completely thanks to Canada’s -- especially Toronto’s -- quick and aggressive actions? No one knows yet, but with very few new cases even in the hot zones in several incubation periods now, it seems to be on global, not just region-by-region, decline.

If nothing else, the brevity of SARS concerns and precautions should be a message in itself. There’s no reason to give SARS a great deal of thought if you don’t fly to China or Toronto often, SARS masks don’t help even in China, and SARS is declining even in China and Toronto. Most people compelled to worry in general will just have to watch the news for their next thing to worry about. SARS is a natural and still-evolving mutation of long existing organisms, not a terrorist invention.

Speaking of which … a certain politician threatens our freedoms and scares me far, far more than SARS or terrorism, but we won’t go into that here. Enjoy your SARS fright while it’s on top of your threat list.



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