SARS: Scare worse than the disease

Images of Beijing residents shielded behind face masks have now become a familiar sight on the nightly news. This phenomenon, along with the beating suffered by Asian economies, took root as news of severe acute respiratory syndrome (SARS) began to spread. But some Penn experts say the reaction to SARS, which they link to the media’s alarmist coverage of the disease, have been overblown.

Neil Fishman, director of infection control and the anti-microbial management program for the Penn Health System, said that SARS’s mortality figures alone cannot justify the hysteria surrounding the outbreak. “There are other diseases that have a greater toll with respect to morbidity and mortality.”

As of press time, SARS—which generally begins with a fever greater than 100.4 F and includes symptoms such as headaches, body aches, and an overall feeling of discomfort—has been reported in 27 countries, with China being hardest hit. It has infected about 5,500 people globally and claimed fewer than 350 lives.

Fishman, who also sits on the University task force that has been assembled to address SARS-related issues, pointed out that influenza kills approximately 200,000 people each year and tuberculosis 2 million, yet neither have grabbed headlines like SARS has.

No need for panic

In an e-mail addressed to the University community on April 30, Provost Robert Barchi and Executive Vice President Clifford Stanley said that Penn is taking appropriate measures to protect the health of the campus. Included among these is a moratorium on all University-related travel to SARS-affected areas. The e-mail also stated that the University is not requiring or recommending quarantine of individuals coming from SARS-affected areas who are healthy and without symptoms.

Fishman said that American hospitals, which adopted new emergency response procedures after 9/11 and in response to the growing threat of bioterrorism, are prepared to handle an epidemic such as SARS. He also noted that certain countries, such as Canada and Singapore, have done a great job at controlling the threat of infection.

“SARS is in its infancy. We don’t know how the disease will progress [but] intervening early with aggressive control will alter its history,” said Fishman. His is a sentiment echoed by Nursing School Dean Afaf Meleis, who said she found it encouraging seeing “the world springing up into action.”

In the last few months, international healthcare organizations like the World Health Organization have launched an aggressive awareness campaign to educate the public and stem the illness’s spread. Guidelines regarding travel, quarantine and clinical care are readily available from both the WHO and the Centers for Disease Control and Prevention.

Yet even while experts applaud the WHO, they recognize that politics often undercuts efforts by the healthcare community to curb an epidemic. China, which has been aware of SARS since last fall but failed to come clean until only recently, has been sharply criticized for underreporting the disease.

“ We need to develop very clear mechanisms and processes for disclosure,” said Meleis. “We need new mechanisms and processes that we would put in place even before the media gets a hold of it and sentimentalizes and sensationalizes it.”

Meleis said early disclosure could help prevent the economic disaster that heavily-hit SARS nations are facing. “If there is an early disclosure and early containment then the economic fallout is minimized. It’s a risk but it’s a calculated risk.”

Past repeats itself

David Barnes, associate professor of history and sociology of science, said there are lessons to take away from this most recent episode of public panic. One is to abandon the notion that we can wall off the threats of disease or that diseases always originate from other nations. “Denial and quarantine,” said Barnes, “are very common features of epidemics.” He said officials need to reevaluate on a global level what kind of public health infrastructure is needed. “What’s the role of the WHO? Should the WHO have more powers to enforce certain rules and certain policies? These are important debates to have.”

Barnes is also critical of remedies that only rely on science. “Science can’t always find a magic bullet and even if they can it’s going to take a long time. To place all our eggs in that basket runs the risk of obscuring other kinds of factors… [We may be] shortchanging other kinds of policies and practices that may be beneficial.”

Use common sense

As public health and government officials search for more lasting responses to global diseases, Americans need to temper their fears of SARS with common sense, said Fishman.

“ There have been one or two new diseases every year for at least the past decade and we’ve dealt with them,” he said.

“ Americans just need to live their lives. I think it’s safe to eat in Chinatown, for instance. People should practice good hand hygiene [but] that should be true every day.”

Originally published on May 15, 2003