SARS scare? For Williamstown, threat is nearly nil, many say

Students watching last week’s South Park learned that the cure for SARS is simple: Campbell’s soup, Sprite and Dayquil. The real situation is far more complicated, but the episode does point out what might be termed an “overreaction” on the part of many Americans.

SARS stands for Severe Acute Respiratory Syndrome, a condition caused by a previously-unrecognized coronavirus and causing symptoms that may include fever, discomfort, headaches, body aches, dry coughs and difficulty breathing. It can kill, but none of the roughly 300 suspected or probable cases reported in the United States have been fatal. The probability of catching SARS in the U.S. is close to zero, and in general, public health officials feel confident that we have successfully contained the outbreak in this country. So why are people so concerned about SARS?

New diseases are always frightening, especially after the worldwide crisis of the AIDS epidemic. Furthermore, SARS is mostly spread through contact with infected droplets from coughing or sneezing. But as the outbreak in the Amoy Gardens apartment towers suggest, there may be other means of spreading as well, potentially including infected feces or surfaces on which the virus remains alive. The idea that a disease can spread through unknown avenues is particularly worrisome.

The virus is so new that we know very little about it. Coronaviruses commonly infect animals, but SARS is a recently mutated form that, unlike previous coronaviruses, is extremely harmful to humans. Researchers have already isolated the virus and shown that it causes a similar illness in other primates, which is the first step in determining the cause of an unknown disease. They have also sequenced the virus’ genome, although this information will need to be revaluated if the virus mutates again.

Despite this encouraging progress, we are still without a successful diagnostic test, a vaccine or a specific treatment not simply based on symptoms, all of which are necessary to effectively help those people who currently treat SARS and prevent its further spread.

Ideally, the World Health Organization would like to eradicate the disease, but Nicholas Wright ’57, an epidemiologist who worked with the Center for Disease Control, believes that once we know more about SARS it will simply become endemic, meaning there will be regular, expected cases. Epidemic refers to a disease whose numbers are above the endemic, or predicted, levels based on previous data. Thus, influenza is an endemic disease because the CDC knows roughly how many cases to expect each season and can vaccinate accordingly, whereas the medieval bubonic plague was an epidemic because far more people contracted the disease than was typical.

Wright noted how much we still have to learn about SARS, including exactly how it spreads, where it can survive, what are its defining characteristics, what is the time between exposure and the first symptoms – the incubation period – and when patients are most infectious.

He also said that the virus is likely to mutate because it is new and unstable. “What’s the job description for a virus?” he said. “To infect, multiply and not kill your host – if you kill your host, then you’re dead.” The high fatality rates of the disease could indicate this sort of instability, which might lead the virus to mutate into a more self-serving form. The high mortality rates might, however, be the result of not recognizing milder cases of the disease. These questions are particularly hard to answer because of a lack of good data from Southeast Asia, where the outbreak began.

SARS has dealt a heavy blow to China and Hong Kong, partially because governmental denial of the problem led to a rapid and uncontrolled spread of the disease. Health care workers were told to suppress news of any cases and the government refused to report accurately to the World Health Organization. At one point, 30 SARS patients were loaded into a van and driven around until World Health Organization (WHO) investigators left the hospital they were staying at.

Sam Crane, chair of Asian studies and professor of political science, said that he was not surprised by the government’s attempts to cover up the outbreak, given the country’s history. Communist countries such as China “attempt to dominate society in a certain way,” he said.

There are no free institutions outside of the government, and these restrictions cover the media as well. “The news at home is always good,” Crane said, because the government works to control the flow of information and maintain the image of power and positivity. Unlike the U.S., in China “there is just not a history of transparency,” he said.

This pattern of opaqueness, coupled with immediate concerns about tourism and investment, led to the Chinese government’s attempts to keep the situation under wraps. The world’s increasing globalization and the focused attention on China due to the upcoming 2008 Olympics made it impossible to conceal the SARS outbreak, however, and now that the story is everywhere, the government is trying to quarantine all individuals and disseminate public health messages regarding containment of the disease.

All eyes are now on Hu Jintao, China’s new president, to see how he will respond to the crisis. He has dismissed both the Chinese Health Minister and the mayor of Beijing, and the attempts to inform citizens are also encouraging. The May 5, 2003 issue of Time Magazine questions whether Hu will use the SARS epidemic as an impetus towards broader governmental reform directed at greater transparency, but Alan de Brauw, assistant professor of economics, is skeptical, saying that Hu has far less power than most Americans believe.

“We like to personify nations,” he said, and since George W. Bush is a powerful leader, we tend to assume that the heads of other countries have similar powers. De Brauw leans towards other factors when predicting what has been creating and will continue to cause more transparency in China in the future: the World Trade Organization accession agreement in late 2001, new anti-corruption laws and globalization trends in general.

Ideally, the next time China has an outbreak of a new disease, the government will not deny the problem, as in this case and that of the AIDS epidemic. If diseases are reported accurately and efficiently, WHO is able to do its job and more efficiently try to safeguard the health of all people. Wright stressed that all countries need a public heath care system and an organization like the CDC that tracks and provides information about disease, because private medical care concentrates on curing illness and fixing problems while public care works to prevent illness and maintain health. Regarding China’s system, he said, “It’s a classic case of the privatization of health care – it makes it an illness care system.”