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The Heroes of SARS

Article #323 • Written by Matt Castle

On 21 February 2003, a physician in Hong Kong was feeling particularly unwell. He must have had an inkling that something serious was amiss, for his symptoms closely matched those of a number of patients he had treated in recent weeks: fever, aching muscles, headache, a dry cough, and shortness of breath. An alarmingly high proportion of these people had become critically ill, with inflamed, fluid-saturated lungs. Breathing was rendered somewhat difficult, and death frequently followed.

Although the sixty-four year old nephrologist resided in the Guangdong region of southern China, he was enjoying time away for a family wedding when the worst of the symptoms struck. Sketchy reports of a mysterious respiratory illness had been filtering out of his home province for several months, but the official channels gave no indication of anything untoward. The day he arrived in Hong Kong he felt well enough to check into his room on the ninth floor of the Metropole Hotel, and he even did some sightseeing and shopping later in the afternoon. But the following morning his condition had worsened, and he was forced to seek care at the territory’s Kwong Wah Hospital. There he told staff he feared he had contracted “a very virulent disease,” and suggested immediate isolation. Yet the damage had already been done.

Back at the Metropole Hotel, globetrotting guests from the ninth floor were preparing to leave for Canada, Singapore, and Vietnam. Soon, they too would fall ill. In less than a week, the world would be left poised on the brink of a pandemic. Severe Acute Respiratory Syndrome (SARS) had arrived. While the occupants of the western hemisphere often remember the events in the context of an overblown media frenzy, many epidemiologists today regard the outbreak as a near-miss for humanity-- one which might have become one of history's most unpleasant epidemics had it not been for the quick thinking and selflessness of a few individuals.

Dr Carlo Urbani
Dr Carlo Urbani

In early 2003, the first unfortunates infected outside of Guangdong began to seek medical attention. At this stage there seemed to be little cause for alarm. Respiratory disease is common in Southeast Asia, and although the rumours coming out of southern China had instilled a heightened sense of readiness, nobody knew exactly what to expect. Owing to the speed of modern air travel and the disease's incubation period of up to ten days, the individuals who had come into contact with the index case at the Metropole Hotel became unwittingly efficient vehicles for the newfangled virus. The next few days would be crucial.

On 26 February, a businessman named Johnny Chen was admitted to The French Hospital in Hanoi, Vietnam suffering from a respiratory illness. As his condition rapidly deteriorated, the staff sought the assistance of Dr Carlo Urbani, an Italian epidemiologist who was working with the local World Health Organization (WHO) office. Vietnamese doctors feared a human case of avian H5N1 influenza, or 'bird flu', and were keen to involve the WHO at an early stage. Donning a mask– unfortunately the hospital lacked goggles and other protective clothing– Dr Urbani examined the patient. There was no history of fowl interaction, so bird flu seemed unlikely. Two days later, hospital workers began to suffer from fever and dry cough. While the disease was clearly infectious, extensive tests failed to reveal any known pathogen.

The esteemed Dr Urbani gave his considered opinion: this was serious. The worried Vietnamese authorities concurred, and locked down the entire hospital. The hospital staff isolated all patients and employees who showed symptoms, placed the premises under guard, and garbed all yet-to-be-infected hospital workers with proper protective clothing. Over the next week Dr Urbani visited the hospital on a daily basis, helping the staff to maintain morale while introducing basic infection control procedures. Urbani quickly recognised that they were dealing with something unusual, and persuaded the Vietnamese government to allow outside help. He alerted WHO’s Geneva headquarters on the 05 March, and shortly Hanoi became host to numerous international experts, including a team from the US Centers for Disease Control (CDC).

After two weeks attempting to master the mysterious disease, Dr Urbani was exhausted. Eventually his wife and superiors persuaded him to take a break, and he decided to travel to Thailand, where he was scheduled to present a lecture at a medical conference. On 11 March, as his plane flew high above the dense jungle of Indochina, Dr Urbani developed a headache. Soon he spiked a fever and began coughing. Upon landing, he was met by a CDC colleague. Dr Urbani was quite aware of his symptoms' likely cause, so warned his friend not to approach, and called for an ambulance. For some time the two men sat in silence, facing each other across a hopefully-safe distance while the paramedics assembled their protective gear. One thing was certain: the Bangkok medical conference would be missing a speaker that year.

Elsewhere the virulent disease continued its global migration. Forewarned by Dr Urbani and events in Vietnam, workers from the WHO were quick to connect the mushrooming reports of respiratory illness in Southeast Asia and beyond. On 12 March, for the first time in its fifty year history, the organization issued a Global Alert. Two days later, the gravity of the outbreak was underscored by the death of Johnny Chen, one of the microorganism's first high-profile victims. SARS was formally named and defined, and a strategy of screening, isolation, and quarantine was recommended. Meanwhile, a worldwide network of laboratories was set up to identify the cause of the illness. Beakers and vials of various bodily fluids were shuffled around the globe for analysis. As part of this effort, the world saw the first widespread and coordinated deployment of 21st century information technologies in the battle against epidemic disease: international experts used a dedicated secure website to share information, and made extensive use of teleconferencing facilities to communicate. Virtually every weapon in mankind’s medical armoury was deployed against the emerging threat.

By the end of March, a hitherto unknown type of coronavirus was identified as the probable SARS pathogen. In an unprecedented two weeks, a Canadian team managed to sequence the virus’ entire DNA code. With this vital information, work could begin on developing diagnostic tests, treatments, and vaccines for the deadly disease. Nonetheless the rate of new infections continued to increase. The mortality rate of the disease approached 10%, much higher than that of common respiratory conditions such as seasonal influenza, and higher even than the mortality rate of the deadly 1918 "Spanish Flu" pandemic. Anybody– young or old– in close contact with an infected person was at risk of contracting SARS, including hospital staff members. An outbreak in Hong Kong's Amoy Gardens signalled that the disease was becoming endemic in the general population, indicating to epidemiologists that SARS was probably here to stay.

Soon the international media itself developed a headache-inducing fever. Anxious news reports braced the world for an orgy of wholesale death and disability. Some near-panicked citizens started wearing medical face masks, erroneously believing that the virus was readily transmitted in the outside air. The cost of masks doubled across the Far East, while in Taiwan, supply shortages prompted villagers to strap bras across their faces to guard against the fearful SARS germ. In the absence of any official information and guidance, confused Chinese citizens bought up vinegar and other ineffective folk remedies on a massive scale.

As epidemiologists redoubled their efforts to contain the disease, it became apparent that an important link was missing. As early as December 2002, the WHO had requested information from the Chinese authorities regarding the mysterious Guangdong disease. China's response was spectacularly sparse. As the crisis unfolded, China was quick to assume a leadership role in crisis-denial. They consistently under-reported the number of cases, they withheld information from international health organizations and from the Chinese people, and their official pronouncements ranged from highly misleading to laughably over-optimistic. Although a WHO team eventually gained access to the country, the Chinese government severely restricted their movements. When the disease reached Beijing and began to spread through military hospitals, the international experts were helpless to assist. Chinese doctors treating SARS cases in the city were sworn to silence, aware that their career, freedom, and personal safety were at stake.

Beijing's Forbidden City
Beijing's Forbidden City

In early April, however, a 71 year-old doctor named Jiang Yanyong began to speak out against the official policy. Unlike most Chinese dissenters, Dr Jiang openly identified himself, and made no secret of his role as a senior military doctor in the People’s Liberation Army, and a lifelong member of the Communist Party. Perhaps he owed his doggedness to his advancing years; while he understood the authorities’ efforts to maintain prestige and public order, he was convinced that the free flow of information would be needed to halt the spread of the disease. If SARS were to rampage unchecked among the 1.3 billion Chinese population, the best disease-control efforts of other countries would be in vain.

Regardless of the great personal risk, Dr Jiang dispatched a concerned email to two TV stations in Hong Kong. Soon his writings were in the hands of the international press, including a translation in Time magazine which exposed China's information-tweaking hijinks to the English-speaking world. Not long afterwards, he openly criticized his superiors at an international press conference. Dr Jiang's gambit successfully stirred up widespread international outcry. The world's attention insulated him from repercussions, and his government was forced to acknowledge the true extent of the SARS problem and develop effective public health programs. The WHO team was permitted full access to study the disease in Guangdong, the mayor of Beijing and the Health Minister were sacked, and the authorities issued a rare public apology.

With the establishment of effective infection controls, the tide started to turn. By the end of May 2003, the rate of new cases began to fall worldwide, and by June they slowed to a trickle. By July, two hundred patients remained in various hospitals across the world but no new infections were being reported. Over the next few weeks the remaining patients either recovered or died. Suddenly– almost as quickly as it had appeared– SARS was gone.

Coronavirus
Coronavirus

Ultimately the disease infected over eight thousand people, and caused nearly eight hundred deaths. While these few hundred fatalities pale in comparison to the millions of deaths caused every year by familiar killers such as malaria and HIV, the importance of the SARS story goes far beyond a simple body count. Many troubling scientific questions remain unanswered, such as why and how the SARS virus triggered Acute Respiratory Distress Syndrome in many patients. It is believed that the Spanish flu virus caused a similar inflammatory response, thereby killing about 40 million people worldwide between 1918 and 1920. Another mystery concerns the origin of the SARS coronavirus. One possible animal source has been identified as the civet cat– a small forest-dwelling mammal confined to Southeast Asia and eaten as a delicacy by some people in southern China– but later an almost-identical virus was found in the horseshoe bat, a species found throughout Europe and Asia. How the disease jumped between these species, and onwards into humans, remains unclear. The solving of such conundrums would signal a new level in our understanding of epidemic disease as a whole, not just of SARS.

In public health circles, the SARS outbreak remains a vitally important case study for how to respond to emerging infections. International epidemiologists pore over the lessons from the near-pandemic, and consider how best to use them in anticipated outbreaks of bird flu, or other inevitable plagues of the future. But apart from one blip in 2004–related to an accidental laboratory spillage– SARS seems to have totally disappeared as a human disease.

For the general public, it’s difficult to know what to make of the SARS story. The public perception is polluted by images of isolation-suited medics, mask-wearing city-dwellers, and unearthly infrared figures in airport thermal scanners. Then, as now, it was easy to dismiss it all as "media hype." But victory in the battle against SARS was never a given. Prompt action by doctors and public health officials kept fatalities down, and the timely interventions of a few key people were crucial in preventing a probable pandemic that could have killed many thousands-- if not millions-- of people worldwide. Though some individuals such as Dr Jiang managed to weather the skirmish unscathed, Dr Urbani was not so fortunate. On 29 March 2003, the eminent epidemiologist succumbed to the SARS virus in a makeshift isolation room in a Thai hospital a long way from home. Let us not forget the efforts of Drs Jiang, Urbani, and the other heroes of SARS. Some paid a high price indeed.

Article written by Matt Castle, published on 23 May 2008. Matt is a writer and contributing editor for Damn Interesting, and not quite an anagram of 'Clam Taste'.

Article design and artwork by Alan Bellows. Edited by Alan Bellows.
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86 Comments
teken894
Posted 23 May 2008 at 01:30 am

Governments should hold no secrets when it comes to public health.


mustamike
Posted 23 May 2008 at 01:41 am

DI! I was too young to pay attention to all the news and stories about SARS. Good thing we have DI to write about it.


Jonny
Posted 23 May 2008 at 02:02 am

Third! Personal Best!


eyeyamrach
Posted 23 May 2008 at 02:07 am

DI - I wonder how many other things are lurking around out there...


Phoenix rider
Posted 23 May 2008 at 02:09 am

When bacterium out number the cell count in a typical human (or most other organisms), the mind of the typical germaphobe has to be at unease. The use of antibiotics in our food and in medical treatments render the most powerful at one time, now almost useless. I've seen so many people with virus infections, take powerful antibiotics as though they were vitaman pills, it makes me think that the pesulance horseman guy of the 4 is the one who will get most of us some day.


thegun
Posted 23 May 2008 at 02:10 am

I thought that this was yet another really great story. Well written and managed to steer clear from focusing in the Media hype.


Cloudshadow
Posted 23 May 2008 at 02:26 am

Somehow I feel safer after reading this.


Phoenix rider
Posted 23 May 2008 at 02:32 am

Actually my point is that to minimize risk I avoid chicken (Avian Flu virus) and beef (mad cows disease). MMMMMM bacon.


theleaningelm
Posted 23 May 2008 at 03:06 am

DI indeed! It's a refreshing change from all the media hype during that period. I can't count the number of things my frazzled mother forced on us because of it.

One small nitpick, though. The eminent doctor from Beijing should be referred to as Dr. Jiang. Yanyong is his given name.


Redrocket
Posted 23 May 2008 at 03:20 am

Phoenix rider said: "When bacterium out number the cell count in a typical human (or most other organisms), the mind of the typical germaphobe has to be at unease. The use of antibiotics in our food and in medical treatments render the most powerful at one time, now almost useless. I've seen so many people with virus infections, take powerful antibiotics as though they were vitaman pills, it makes me think that the pesulance horseman guy of the 4 is the one who will get most of us some day."

Antibiotics don't work on viruses


Phoenix rider
Posted 23 May 2008 at 03:21 am

Glad to see that Myanmar has agreed to let expertize look at their stuff (perhaps after China's pressure and it's example with the massively damaging earth movement. I believe that the CDC has my back (I represent 5% of the world as a citizen of the USA), but seeing that so many fowl (~80% in places like Vietnam) gave their life because of the fear of the avian flu virus in South East Asia, without being utilized, it makes me wonder when for the sake of humanity our government will require us to sacrifice our fowl.


Phoenix rider
Posted 23 May 2008 at 03:26 am

@ Redrocket
Your right, but we still administer the stuff like crazy.


magkneetoe
Posted 23 May 2008 at 04:59 am

Phoenix rider said: "@ Redrocket
Your right, but we still administer the stuff like crazy."

Please don't take offense but I think you are confused and should quit before you stick anything else in your mouth. Very little in which you have said, in all of your comments, makes sense.

Cloudshadow said: "Somehow I feel safer after reading this."

I agree. Although it's impossible to tell what could have been, it most definently would have been worse if it weren't for basic yet modern medical understanding of viruses and infectious diseases. We are all fortunate to live in times of greater understanding than of previous generations.


GigsTaggart
Posted 23 May 2008 at 05:04 am

Hmm, I guess this is kinda like the Y2K computer bug. It was a real problem. The media blew it out of proportion. Massive professional response kept it from becoming a much larger problem.


Bleupea
Posted 23 May 2008 at 05:33 am

Does this remind anyone else of "The Stand" by Stephen King?
Not to sound like a conspiracy theorist, but how do we know that it wasn't something made in a lab in China and tested on a small portion of the population, but it just got out of control?
Now, that may have been answered above, and I just missed it, but it doesn't seem like they really know where it came from or how is spread from species to species, so is it possible it was man-made?
That would really explain China's threats and their urgency to not seek outside help. Who knows?
Anyway, damn interesting article Matt. Good job.


Two Cents from Girth
Posted 23 May 2008 at 05:49 am

I like the article, some juicy facts the media omitted, surprised??? :)

Virus, what an interesting creature... as a few before have stated, antibiotics have no effect.
This is because it contains a non permiable membrane and sparce numbers of receptors, if any. It does not use active or passive transport; simply, it is encapsulated and attacks the genitic protiens/Amino Acids (DNA/RNA/TRNA) of cells, to produce more Viruses, very naughty creature.
According to the rules of Biology in order to be classified as "living" there are five categories, Virus does not meet these criteria... Bizarre to say the least. The structure of these things is very interesting to observe as well. Their "life cycle" is a bit pecular too, with the possibility of long stages of dormancy or pheonominal "population" growth. These pose a very real threat to man and can surface at any time or place. I think it is creatures like this that keep our egos in check and remind us we are stewards of the Earth, not masters...
As far as China goes, this government really needs a 21st century wake up call when it comes to humanitarian issuses; just because they have 1.2 oh wait a minute, there is 1.3 oops, 1.4 billion people :) doesnt mean the value of the individual is any less... They are a great people and like the virus, have the potential to one day reshape the planet. Looking forward to the Olympics!!


Pasketti
Posted 23 May 2008 at 05:59 am

magkneetoe said: "Please don't take offense but I think you are confused and should quit before you stick anything else in your mouth. Very little in which you have said, in all of your comments, makes sense.

He makes perfect sense.

Antibiotics don't work on viral diseases. BUT PEOPLE TAKE THEM ANYWAY. They pressure their doctors to give them "something", and the doctors will prescribe an antibiotic just to get them out of their hair.

What this does is select for antibiotic resistance in the bacteria already present in the body. Bacteria are promiscuous little beasties. They swap genetic material around all the time, even outside their own species. So by increasing the prevalence of genes for antibiotic-resistance, the chance of those genes crossing over to something malevolent increases.


Zenesque
Posted 23 May 2008 at 06:24 am

I find it strangely comforting, when I think about the impending doom of mankind. I like to think that nature will one day balance out the imbalances we have caused. We might not be quite untouchable and omnipotent.

The density of population increases continuously. We face inevitable natural disasters and wars. The survivors are often forced to live in conditions that are cramped and unsanitary. It is the perfect breeding ground for disease. When we add to the equation the fact that people can travel from anywhere in the world to any other place on the planet in less than a day, we have the ingredients for pandemic of apocalyptic proportions. I can hardly wait.

I have to admit that the people mentioned in this article were probably the right people in the right place at the right moment. I would not have thought that people could be so efficient. Usually things get a lot worse, before they get better. Perhaps we are finally beginning to learn. Better late, than never, I guess.


magkneetoe
Posted 23 May 2008 at 06:39 am

Pasketti, okay, although I don't think that the average doctor is smarter than you or me, they have just spent more time studying and hopefully, understanding exactly what we are talking about. So the fact that this happens, as you say it happens and as I said, it doesn't make sense. That seems like borderline malpractice because in the end, no good can come from it. We are probably just creating a new strain of MRSA that could kill us all. I would hope that it is not as wide spread as you are both refering.
And for the record, I think not eating chicken and beef in fear of avian flu and mad cow disease is a little paranoid. Of all the great reasons to not eat meat, that should not be realistically high on anyone's list.


errna
Posted 23 May 2008 at 06:42 am

Cool story, and man, it takes me back.. I was in Shanghai (I still am, actually) in 2003, and I remember all this. Face masks, body-temperature-taking at airports (remote scanner of some sort) or ferry landing areas (a reader stuck in ear), disinfectant-filled-mats at the entrance to my housing complex, I also remember a woman on Nanjing Lu, Shanghai, spitting on the ground, and a tiny drop of saliva landing on my hand...


GilaMonster
Posted 23 May 2008 at 06:48 am

I think one of the most interesting themes here is the role of modern, popular technology in the spread and control of disease. In the first chapter of "Hot Zone" Richard Preston writes about a man in Africa who, deathly ill, boards a plane to seek medical attention in a city. On the plane, he begins vomiting blood, and hemorrhages to death in the emergency room of the hospital, splashing hot virus in the process. By the end, Preston returns to this episode, and points out that the ease of international travel has set the stage for a modern pandemic. Matt's article gives a case in point.

At the same time, information technology allows medical professionals to offset the negative effect of air travel by quickly spreading news of new epidemics and collaborating on research in remote locations around the globe. In addition, the disease can't be spread among doctors who collaborate remotely, as it can by medical staff working in close proximity.

I think this is very much like modern "cops and robbers." Cars allow crooks to commit and escape from crimes much more easily, but the speed of radio waves partially offsets this technology. However, the tool is only effective if those who need it have the technology, know how to use it, and have a system for using it effectively. I'm glad that the disease researchers have had the foresight to do this in advance of a major pandemic, rather than in reaction to it.


Catkilller7
Posted 23 May 2008 at 06:58 am

All things considered, though, China's response to health hazards IS improving.

Look at the Earthquake that happened recently... They're diverting billions of money from government agencies for rebuilding... And as far as I know, I think I heard something about them actually rebuilding an entire city in a different location.

Anyways, DI, nice to hear the World can actually concentrate in harsh times.


lostindustrial
Posted 23 May 2008 at 07:01 am

I enjoyed the relative recent-ness of this article. DI seems to bring up things from "history" so often - which is fine. But memories of this episode are still fresh in my mind. Brings a much needed perspective to the whole situation. More articles about recent history please! :)


nihil
Posted 23 May 2008 at 07:10 am

"The esteemed Dr Urbani gave his considered opinion: this was serious. The worried Vietnamese authorities concurred, and locked down the entire hospital. The hospital staff isolated all patients and employees who showed symptoms, placed the premises under guard, and garbed all yet-to-be-infected hospital workers with proper protective clothing."
"After two weeks attempting to master the mysterious disease, Dr Urbani was exhausted. Eventually his wife and superiors persuaded him to take a break, and he decided to travel to Thailand, where he was scheduled to present a lecture at a medical conference."

If it was that serious and he knew it was highly contagious then why would he get on a plane and go to another country? If doctors can't be trusted to follow their own advice then we're all doomed.


Two Cents from Girth
Posted 23 May 2008 at 07:13 am

The virus that scares me when regards to Gila Monster's (and Zenesque's cheery outlook) "cops and robbers" is a Viral outbreak where you getted robbed, dont know it, is contageous and months later fatal, fast symptoms emerge before cops even know a crime has been committed and reaction time is irrevealant because the virus has already actively infected a substancial number within the population over the, literally, "last few months" (catchy movie title??). That is a scary one considering everything would be passive until one day... we could be infected right now!!! :) just a little something to ponder! Relax, of course, some of them would be spared... :) some of them... hehehe have a good weekend!!


Redrocket
Posted 23 May 2008 at 07:14 am

magkneetoe said: "Pasketti, okay, although I don't think that the average doctor is smarter than you or me, they have just spent more time studying and hopefully, understanding exactly what we are talking about. So the fact that this happens, as you say it happens and as I said, it doesn't make sense. That seems like borderline malpractice because in the end, no good can come from it. We are probably just creating a new strain of MRSA that could kill us all. I would hope that it is not as wide spread as you are both refering.
And for the record, I think not eating chicken and beef in fear of avian flu and mad cow disease is a little paranoid. Of all the great reasons to not eat meat, that should not be realistically high on anyone's list."

Its exactly how these superbugs came to be, over perscription of antibiotics that is. The problem is compounded by people getting antibiotics, then getting over their virus and stopping half way through their course. Natural selection in fast forward.

To get some background on this, Wickedpeida had some good info

http://en.wikipedia.org/wiki/Antibiotic_resistance

Resistance will be selected for anyway but it happens faster the more times antibiotics are handed out. Thats why antibiotics for virus infections is so bad. I know it is harder now to get antibiotics in Australia because of this.

So in essence, antibiotics DO NOT affect viruses (anti virals do). Bacteria, which are the target for antibiotics, do develop resistance throught natural selection and this is accelerated through incorrect prescription.


kevinmk2
Posted 23 May 2008 at 07:42 am

DI Mr Castle!
As a local in Hong Kong who experienced more-than-wanted share of this terrible period, I can't help but point out another huge batch of heros are the nameless medical staff in Hong Kong.
At first nobody knew what this SARS virus was, how it spread (rumors initially suspect it wasn't airborne, others say the virus could spread even after patient death, much like black death), and most importantly, how it could be controlled.
Nonetheless the noble medical staff knowingly risked their lives and treated all flu patients nondiscriminately, while our government officials, being pressured by Chinese government, kept saying everything is under control and there is no outbreak. Many medical staff unfortunately passed away, while other experts applied all imaginable cocktails of medicine to treat the desease.
Apparent sheer luck assisted microbiologist Dr. Yuen and his team to administer the right drug to control the spread, but many side effects are yet to be seen, while Chinese government still remains curiously quiet on this epidemic....


Bleupea
Posted 23 May 2008 at 08:07 am

kevinmk2 said: "while Chinese government still remains curiously quiet on this epidemic…."

Do you suspect the possibilty of foul play too?


Ard Ri
Posted 23 May 2008 at 08:39 am

SARS sounds like the movie 28 Days Later...coincidence?


tykxboy
Posted 23 May 2008 at 09:51 am

Wow, another DI article. We've come along way since the days of the Black Death and Spanish Flu. Although, with all the general media frenzies and anxieties about overpopulation, perhaps a nice pandemic would quiet things down for a while...


morpcat
Posted 23 May 2008 at 10:06 am

I was at school in Singapore when SARS broke out; although the media there is far from being a free voice, international papers and news are readily available, and I'm impressed by how little a media frenzy it was. I'm now resident in the UK, and the fuss made by the media here over avian flu is comparatively incredible. SARS was/is highly infectious, easily transmitted, and spread across borders before anyone even noticed it was there. Combine that with a mortality rate that goes as high as 70% depending on age and viral form and it's a recipe for a global disaster.

The reporting I read, watched, and heard during that time was informative and realistic. There was a degree of scaremongering during the initial stages, but that was because nobody really understood what was going on. Once the implications of SARS were understood, and governments started to take action, I at least found the media to start reporting in a very informative manner, and keeping people aware of the current situation.

The psychological effect that SARS had on most people was incredible. In a country with some of the world's best healthcare, the streets were literally emptied. For the first time, I could get a seat on a busy MRT train. People did not want to be outside. Children still went to school, but everyone had their temperature taken before going to school and upon arrival. A cloud of worry was held over everyone's head. It must have been hard for the media not to make a frenzy over it, they were in the middle of it as well.

Even if there was a media frenzy, would that have been such a bad thing? Spreading awareness should always be a primary goal with such a pathogen. I for one am relieved that there was a lot of reporting, and condone anyone who says it was a lot of fuss over nothing. It may have been nothing, but it could have been everything.


GeorgeAR
Posted 23 May 2008 at 10:29 am

lostindustrial said: "I enjoyed the relative recent-ness of this article. DI seems to bring up things from "history" so often - which is fine. But memories of this episode are still fresh in my mind. Brings a much needed perspective to the whole situation. More articles about recent history please! :)"

I just thought I was getting old, and the Damned Intersting articles were catching up to me. It does make it more interesting (damnder?) when it is humanized or physical. I.E. I can go to the corner on Wall St where the 'first' terrorist bomb went off (See DI history).

Some people I've talked to, inteligent and not, think we, as humans, are 'due' for a pandemic. If only Robert Klark Graham took viral defense into consideration....

Thanks for another DI article!


Ronald
Posted 23 May 2008 at 10:42 am

Zenesque said: "I find it strangely comforting, when I think about the impending doom of mankind. I like to think that nature will one day balance out the imbalances we have caused. We might not be quite untouchable and omnipotent.
"

Last time I checked we were winning the fight vs nature. Go man! But seriously why is it every third article I read some one is posting how man is doomed to die within the next few years. Relax people there is a lot of horrible stuff going on in the world but that doesn't mean doomsday is around the corner, nor is every damninteresting article yet another sign of the end times.


tunapez
Posted 23 May 2008 at 11:58 am

Damn Interesting to see the original(?) host found, hope nobody hates on him. Great read, thanx DI.

GilaMonster said: "I think one of the most interesting themes here is the role of modern, popular technology in the spread and control of disease. In the first chapter of "Hot Zone" Richard Preston writes about a man in Africa who, deathly ill, boards a plane to seek medical attention in a city. On the plane, he begins vomiting blood, and hemorrhages to death in the emergency room of the hospital, splashing hot virus in the process. By the end, Preston returns to this episode, and points out that the ease of international travel has set the stage for a modern pandemic. Matt's article gives a case in point."

Awesome book! A frightening and [b]true[/] account of a little understood threat to the entire global population.
We've been lucky so far, let's hope it lasts.


GigsTaggart
Posted 23 May 2008 at 12:21 pm

Zenesque said: "I find it strangely comforting, when I think about the impending doom of mankind. I like to think that nature will one day balance out the imbalances we have caused. We might not be quite untouchable and omnipotent.

Life *is* the imbalance. The natural state of things is either a uniform cloud of gas or dead balls of rock. Life is an imbalance and an anomaly. Even the generous estimates for life in our universe still point to it being pretty rare. So your precious "nature" is just as unnatural as we are.

The density of population increases continuously. We face inevitable natural disasters and wars. The survivors are often forced to live in conditions that are cramped and unsanitary.

Most of the world is empty. There's really not that many humans. We *choose* to live in cramped cities. Well, some of us.

It is the perfect breeding ground for disease. When we add to the equation the fact that people can travel from anywhere in the world to any other place on the planet in less than a day, we have the ingredients for pandemic of apocalyptic proportions. I can hardly wait.

Disease used to be a much worse problem than it is now. We know what makes people sick and how contagious things work. Sure, travel has advanced, but medicine has advanced much more.

I have to admit that the people mentioned in this article were probably the right people in the right place at the right moment. I would not have thought that people could be so efficient. Usually things get a lot worse, before they get better. Perhaps we are finally beginning to learn. Better late, than never, I guess."

Sure, if it had been a less ideal situation, maybe 2 or 3 times more people would have died. Even 10 times more people dying is no where near a crisis for humanity. Stop being so negative. The human race is a robust strain of pathogen.


sh0cktopus
Posted 23 May 2008 at 01:13 pm

Phoenix rider said: "Actually my point is that to minimize risk I avoid chicken (Avian Flu virus) and beef (mad cows disease). MMMMMM bacon."

Mmmmm .... trichinosis.


pog-mo-thon
Posted 23 May 2008 at 03:42 pm

It's nice we dodged a bullet.....to bad nature has a machine gun.


AndrewB
Posted 23 May 2008 at 06:28 pm

First! (my first post, I mean).

A few comments. First, I would recommend the book "The Coming Plague" by Laurie Garrett (I think she's a Pulitzer winner) it's a great book.

Yes, antibiotics are overused in many instances, often by the public (demanding), the doctors (prescribing), but particularly in agriculture.

I disagree that avoiding eating chicken and beef is reasonable based on chances of contracting bird flu or Creutzfeld-Jacob (human form of mad cow).

Bacteria are like the infinite number of monkeys at typewriters writing a thriller, and when someone dies, that's the editor picking the story...

Makes me think upon those who are protesting the Olympics in China (through protesting at the torch relay).


another viewpoint
Posted 23 May 2008 at 08:06 pm

...Knock, knock...Who's there? Andromeda Strain!

Way to go Matt...DI again! Thanx.


Silverhill
Posted 23 May 2008 at 10:10 pm

Two Cents from Girth said: "as a few before have stated, antibiotics have no effect.
This is because it contains a non permiable membrane and sparce numbers of receptors, if any."
There's not even a membrane, permeable or otherwise. Most antibiotics interfere with a bacterium's ability to form new cell membrane, thereby restricting it from dividing. Such compounds are bacteriostatic, keeping down the numbers of the bacteria until the host's defenses can catch up. The penicillin group is different: molecules of this class interact destructively with existing cell membranes, allowing the bacterium's critical fluids to leak out.
In either case, though, there must be a cell membrane for the compound to affect. Since viruses have no such membranes, nor any internal metabolic processes to disrupt, antibiotics are useless against them. What are needed instead are antibodies---but these are much more difficult to obtain or synthesize, alas.

Here's a salute to the heroes of SARS (and other epidemics, past and future), and here's a warning to those over-prescribing doctors: evolution is not likely to be your friend!


Zenesque
Posted 23 May 2008 at 10:32 pm

We understand how viral and bacterial diseases work and it has kept us alive so far, but because we choose to live in tightly packed cities where we share doorknobs, keyboards, faucets and toilet seats with thousands of other people and we can travel fast and far, we are vulnerable to to contagions. Also our close proximity to domestic animals has made it possible for some diseases to jump species. In fact, because people in Europe lived in unsanitary conditions with pigs and whatnot, explorers and conquistadors took with them many nasty surprises for the native people of the American continent.

When I said that mankind has imbalanced the ecology, I mean the way we selectively breed animals and plants and preserve cute and pretty things, while at the same time we cause mass extinctions. We decrease the diversity of life on the planet. Survival of the fittest has become survival of the cutest and survival of the most lucrative. Our gung ho use of antibiotics has also caused interesting development in bacteria.

I have a morbid personality, so I'm always interested in all the horrible ways the universe might end our existence. Here is one site I find especially amusing and informational: http://www.exitmundi.nl/


SoxSweepAgain
Posted 23 May 2008 at 11:28 pm

Superb article.

Natural selection will never allow a massive viral or bacterial die-off of humanity, but unnatural selection certainly might some day.


Matt Castle
Posted 24 May 2008 at 12:45 am


One small nitpick, though. The eminent doctor from Beijing should be referred to as Dr. Jiang. Yanyong is his given name."

Good point! Caught out by Chinese naming conventions. This has been/will be fixed.

Castle Matt


chuckygobyebye
Posted 24 May 2008 at 01:29 am

I visited Hong Kong and Guangdong at the height of the crisis. In Hong Kong everyone was masked and ATMs, lift buttons and taxis were wrapped in plastic. In Guangdong there were a few masks, but nothing like over the border. Up north in Xiomen I was the only one wearing a mask.


Phoenix rider
Posted 24 May 2008 at 02:51 am

sh0cktopus said: "Mmmmm …. trichinosis."

NAA... I love pork, and I'll bet that I eat more meat then the average American. Still knowing that this animal will eat anything and that to maximize profit, this animal needs to be treated with such generous amounts of antibiotics, given what it's fed, were it's kept in tight quarters, that the flu virius is just so recombatant...I feel as though that someday my grill will be my (your) end.


Two Cents from Girth
Posted 24 May 2008 at 04:45 am

Silvehill,
Absolutely right! The "outer structure" is essentially a hardened shell of armor and is deviod of interaction with its surrounding environment. It is also going to exibit Gram Negative traits
as would a non permiable bacteria/cell. Also it can exist in aerobic or non-areobic environments as it is thought not to respire, a required trait to be considered "living" by the Biological mandates.
Lysis as you have pointed out is not the cause of death for these creatures but subtle shifts in surroundings that force dormancy and the physical removal from the body once/if the lympatic system "learns" to identify and adapt to the Virus. In either case, much energy is required to make these changes occur within the body.
Cell Lysis is the common "cause of death" to a cell "infected" with a Virus. The replicating system is attacked by the virus, the genetic info is injected into the cell genetic strand and "high speed photo copying" ensues. The cell reprodues the Virus from the building codes injected into its system and simply builds until it can no longer hold the new Virus generation and explodes/under goes Lysis, releasing the new batch to the body... (this spiel may be dated and new shades of the process added; the info is from memory from lectures attended in 1992...)
So thank you for being specific and I enjoy the intelligent conversations of this site.


Two Cents from Girth
Posted 24 May 2008 at 04:47 am

Sorry, that is "Silverhill". My poor spelling is known across the land...


quasimodo
Posted 24 May 2008 at 05:55 am

Lovely little article but - unless I missed something, they have no idea why the virus stopped. Sharing of information didn't stop it. As infectious as it appeared to be ( e.g. "Back at the Metropole Hotel, globetrotting guests from the ninth floor were preparing to leave for Canada, Singapore, and Vietnam. Soon, they too would fall ill." ) and with the large number of people exposed and traveling all over the world, it should have kept going. But it didn't. Why not?


supercalafragalistic
Posted 24 May 2008 at 09:39 am

Wow- I can imagine a suicide bomber intentionally infecting themselves with bird flu or SARS and shaking hands with a lot of important diplomats and strategically placing themselves to do the most damage....yikes!


supercalafragalistic
Posted 24 May 2008 at 09:53 am

http://www.slate.com/id/2093538/

I found this article on the civet cat. Apparently they excrete coffee beans prized for their flavor, and aren't really cats. I wonder if anyone keeps them as pets?


MyDNA
Posted 24 May 2008 at 10:43 am

Very interesting article Matt, which brought back a multitude of emotions.
However you might be interested to learn that your first two paragraphs are not correct.

I am not saying that you have not thoroughly researched the story, clearly you have. However your article pretty much follows the Hong Kong governments official sequence of events. This was subsequently accepted as the official line by the WHO (World Health Organisation). Unfortunately they are both wrong, and for good reason - there was a cover up.

So why should you believe me, well two reasons:
(1) the original story has a few significant flaws. Research a bit further, and you will soon find them. Here are a few "Damn Interesting" questions to point you in the right direction :
- Where exactly had the nephrologist come from ?
- Was there a link between his institution and Kwong Wah Hospital ?
- What had happened to his colleagues ?
- Was he therefore really in Hong Kong Kong by chance ?
- Why was he staying at the Metropole Hotel ?
- Why was there no significant outbreak of SARS at Kwong Wah Hospital, in sharp contrast to Princess Margaret Hospital ?

(2) I worked at Kwong Wah during the SARS period, so know first hand what really happened.

Anyway if you research the answers to the above questions, then you will be 80% of the way to putting the pieces of the puzzle together, and understanding why the SARS outbreak really happened. Should you hit a dead end, and still be interested in learning the truth, then email me.

So the title of your article is spot on, as there were real SARS heros. Some of my brave colleagues died trying to save the lives of others. Unfortunately what sticks in my throat when I think of them, is the knowledge that some senior officials were more concerned about saving their own necks.


MyDNA
Posted 24 May 2008 at 10:55 am

Sorry - typo:
Why was there no significant outbreak of SARS at Kwong Wah Hospital, in sharp contrast to subsequent events at the Prince of Wales Hospital.


smokefoot
Posted 24 May 2008 at 04:46 pm

Bleupea said: "Not to sound like a conspiracy theorist, but how do we know that it wasn't something made in a lab in China and tested on a small portion of the population, but it just got out of control?

Now, that may have been answered above, and I just missed it, but it doesn't seem like they really know where it came from or how is spread from species to species, so is it possible it was man-made?

That would really explain China's threats and their urgency to not seek outside help. Who knows?"

The reason that this is unlikely is that nobody uses highly infectious agents for biological warfare - the danger of it getting out and attacking your own population is too high. That is why people use anthrax instead - it is not transmitted from human to human, so only the people you drop it on die.


fantaz
Posted 24 May 2008 at 10:50 pm

good question quasimodo. I would think if all one had to do was inhale same air as an infected person everyone at the hotel would be infected not just the 9th floor. And people travelling from the hotel all over the world, i doubt they could quarrantine everyone that breathed same air. So yeah how did it stop?


afeeney
Posted 25 May 2008 at 09:54 am

I also lean towards the idea that SARS and other diseases are natural in origin and that it's human behavior in general that makes them so virulent.

Pathogens typically have an incredibly fast reproduction cycle which means that they evolve at tremendous rates. They also incubate in virtually every living creature, so as humans encroach on territory that used to be solely wildlife, the effect is the equivalent of asking all the pathogens in those creatures to give us a try. So from evolution's point of view, it is experimenting.

We also give the bugs chances to spread quickly among humans, evolving as they go, by exposing them to literally millions of other humans through our travel habits and our dense populations. It's quite likely that when humans lived in relatively small groups in prehistoric times, groups were wiped out by pathogens that then ran out of human hosts and died off themselves or evolved into versions that didn't use human hosts any longer. Since those groups never ran into other groups of humans, the pathogen didn't get to infect enough people to turn into an epidemic.

We overcrowd our prisons, which is probably where most of the drug resistant strains TB and MRSA first started to develop. Our culture in the US and Japan (and possibly other countries) encourages us to come into the workplace when we're sick. We put children in preschools, which means kids with shall we say imperfect hygiene methods are all doing their thing in large groups and then go to separate families who go to separate workplaces. Working parents often can't stay at home with a sick kid, so send them to preschool or school as long as they're ambulatory.

Aside from the ridiculous Russian roulette that we play with unnecessary antibiotics, even the antibiotics that we use appropriately play a role in potentially creating superbugs. We also--and rightfully--keep those with weakened immune systems alive through medicine and technology, so our human values also create breeding grounds for pathogens to get down and dirty and keep evolving in our hospitals and nursing homes as well as in the community.

All this makes it much more likely that nature and human habits are the factors that keep rolling the dice, rather than human experimentation. If SARS had gotten the additional roll of the dice that made it air-borne, plus perhaps a latency of 15 days instead of 10, it could have been the big one that got a significant proportion of the population.

Imagine something that combines HIV's long incubation, Lyme Disease's ability to fake out tests (even 30 years after it was first detected, it still often takes 3 tests to pick it up), SARS' deadliness, MRSA's drug resistance, and air-borne transmission.

Ah-choo! Oh, just allergies, I'm going to the movies tonight in a crowded theater. Wow, that door handle is dirty...


Bewildered
Posted 25 May 2008 at 05:58 pm

Great article, are there any readers/posters that have been infected with SARS and lived, and would like to tell us what it was like?


mkp
Posted 25 May 2008 at 08:25 pm

It's interesting to read about the SARS epidemic from this perspective. I was in my final years of a public health degree during this event and even within my course the threat was played down and rationalised by the relatively low mortality rate, despite the potential number of cases which could have resulted. In any case it certainly caused the world to recognise the threat of such diseases and in many ways gave health organisations around the world a reprieve in dealing with such incidences such that despite a number of shortcomings in the response, whether due to a lack of resources or pure negligence, the final toll was relatively low and allowed important lessons to be learnt for the future.


Anthropositor
Posted 26 May 2008 at 03:08 am

Yes, there were heroes of the SARS epidemic. There was enough villiany and stupidity to go around as well. The bottom line is, we as a species got very, very lucky -- that time. We were also very lucky in November, 1962, also a time of great villiany and stupidity.

Today, we have crises of major proportions coming at us at a pace that is accellerating seemingly beyond our collective abilities to cope. And we dither. We prattle on. The evils of regimes, small and large, continue to grow apace. Saving face, maintaining political power of the elite takes precedence. This is true of the largest, wealthiest and most ponderous powers. It is true of the smallest powers as well.

It is both the best of times, and the worst of times. Let us each, in accord with our abilities, try to do something about it. Let us not just passively find it interesting, and DO virtually nothing!


Ronald
Posted 26 May 2008 at 10:49 pm

MyDNA said: "Very interesting article Matt, which brought back a multitude of emotions.

However you might be interested to learn that your first two paragraphs are not correct.
etc.

Why not give the "true" facts as you know them? All of these brave men and women died yet you can only give hints and riddles? Why? Fear of retribution? From posting under an alias on a web page? If that was the case then why post anything at all? I am sure you believe in some grand conspiracy but I believe you are lying when you speak of your first hand knowledge.


Anthropositor
Posted 27 May 2008 at 06:44 pm

I cannot say I never backed away from a story out of an unduly high regard for my safety. I did it once, and have regretted it ever since. And I live in a country which has a great heritage regarding our freedoms, although they seem to have taken some heavy damage in recent years, and it's not the first time that has happened.

So, while I tend to agree with Ronald's perspective in the bold strokes, there is no real protection in the illusion of anonymity provided by our aliases on the internet. I too am curious about the details hinted at, but I won't be casting any judgments.

Back in 1918, in the influenza pandemic, there is a considerable body of evidence of various full-blown conspiracies to minimize the proportions of the epidemic in certain areas of the United states, so that tourism would not be adversely affected. I think that those most involved simply did not understand the full consequences of what they were doing: that concern for tourism did cost many additional lives. Certainly the excess deaths were at least in the hundreds or thousands.

But even the official estimates of a worldwide fatality total of about forty million seems debatably low for that two year period.

If we were to translate that into numbers proportionate to the world population today, we would have fatalities in excess of 130,000,000.

Scattered around the internet in various locations, is the prophylactic procedure I developed for the prevention of viral respiratory infection. Since 1984, it has been tested empirically by tens of thousands of people. It works. No, there haven't been any multi million dollar double blind studies. There won't be. It cuts into the profits provided by a great many over the counter nostrums which have virtually no real value, other than minor symptomatic relief for those already sick.

It is my gift to my fellow human beings. Just crank me into a search engine and look around. You will find it if you try. And one out of every three or four of you will get in the habit. In another major viral respiratory pandemic, that could equate to a few million lives not lost. That makes me feel good. It also makes me feel good that I haven't had a cold or flu since 1984.

Although I need some intraocular lenses which I can't afford, to correct cataracts, and will soon have to settle for a clearly inferior monocular lens in the first eye, or be blind for a certain indefinite period of time because I wont risk my house to come up with $4000 for two plactic lenses that weigh a tenth of a gram apiece, I am still not inclined to solicit gratuities.

Just protect yourselves against viral respiratory infections, and tell others how easy it is and how well it works. And please let me know too. It's the only pay I get, other than not getting colds and flu.

Hey! If someone finds it, they could come back right here and be FIRST to post one of the links. Wouldn't that be neat!


Hoekstes
Posted 28 May 2008 at 08:14 am

SARS (or the South African Revenue Service) are still infecting tax payers on a daily basis. Myself included.


Hoekstes
Posted 28 May 2008 at 08:15 am

are? ARE! I is actually Afrikaans speaking.


guzzi
Posted 28 May 2008 at 01:07 pm

Antibiotics don't work on viral diseases. BUT PEOPLE TAKE THEM ANYWAY. They pressure their doctors to give them "something", and the doctors will prescribe an antibiotic just to get them out of their hair.

Not only patients, but doctors themselves, and for decades. Andrew Weil wrote about this in the early 80's, see his book On Health and Healing. In it, he wrote that doctors took antibiotics themselves for viral infections because they did not know that they would be ineffective.

This means that many patients were given them by mistake on 'doctor's orders' as well. I have had to turn them down myself, explaining that they would not work in certain cases. I sometimes think the misuse of antibiotics has a possibly darker, more profit-oriented side as well.


guzzi
Posted 28 May 2008 at 01:13 pm

"Antibiotics don't work on viral diseases. BUT PEOPLE TAKE THEM ANYWAY. They pressure their doctors to give them "something", and the doctors will prescribe an antibiotic just to get them out of their hair."

Not only patients, but doctors themselves, and for decades. Andrew Weil wrote about this in the early 80's, see his book On Health and Healing. In it, he wrote that doctors took antibiotics themselves for viral infections because they did not know that they would be ineffective.

This means that many patients were given them by mistake on 'doctor's orders' as well. I have had to turn them down myself, explaining that they would not work in certain cases. I sometimes think the misuse of antibiotics has a possibly darker, more profit-oriented side as well.


ben.farmer
Posted 28 May 2008 at 07:00 pm

Since no-one seems to have mentioned this I thought I would point out that the reason anti-biotics are given to people with serious viral infections is that the immune system is weakened trying to fight off the virus and often more vulnerable to secondary infections. I'm sure your family would sue your doctor if you died of a bacterial infection instead of the original virus and he had decided not to give you anti-biotics just because it could harden future generations of bacteria.
This is not to say anti-biotics are not overused; they clearly are, but it's just another case of the needs of the present pushing aside considerations of the future, along with lay people being able to get hold of these kinds of drugs too easily.


Two Cents from Girth
Posted 28 May 2008 at 08:20 pm

ben.farmer
Great observation and an ability to see beyond the Virus itself. The immune system does get lost, sidetracked and weakened by the abnormal activity the Virus causes. At times the balance is thrown off, it is at these times treatment should be administered. If Anti-Bs are always given, the process is much like a gym that offers free training for a shot at the title in an up and coming bout. The immunities of bacteria stand the chance of accelerated advancement due to "unnecessary" medicating. You are right to describe a fine line between the medication and adverse conditions of a weakened immune system. Again, much energy is expended to rid the Virus from the body or force a dormancy.
Obviously, it is up to the Doctors discresion when to adminster the Anti-Bs, I am not a Doctor, nor do if feel justified challenging their practices... I know I would want the best or more than what is required when treating my family and yes even myself when it comes to illness and infection. Like another writer mentioned, I have no doubt that there exists people who strive to have us all bow to the institution of "Modern Medicine" by making the masses consumers of "Meds"... The art and practice of healing is a noble endeavor but the baggage that goes along with it is rediculous! There are institutions within institutions which all charge each other and us, then just point the finger. For the Socialist sector, we are a long way from Socialized Medical Care. First we would need to buy out/tear down our insurance companies, regulate drug manufacturers prices etc.... not gonna happen, they own too many people on the Hill and are wildly profitable.


regeya
Posted 30 May 2008 at 10:16 pm

A very timely DI! Thank you!

And scary how close we keep coming to pestilence killing us off. I'm thinking the recent spike in oil prices, with its subsequent decrease in travel, especially business travel (when a phone call will do nicely anyway) is a very good thing overall.


tech42er
Posted 30 May 2008 at 10:43 pm

Anthropositor,
I just googled and found your blog and technique. It's very interesting and seems like it should work. And obviously you have evidence it does. With all due respect, though, the sense of gravity that seems to permeate your posts is a bit off-putting. You act like it's the end of the world. I think you'd experience more success if you popularized the treatment as what it is, a way to coat your nose with water and oil to prevent viral infection. You don't have to couch it in apocalyptic terms. You're going to freak people out. But it's very DI!


Anthropositor
Posted 31 May 2008 at 09:34 am

Yes I do try to inspire a certain sense of urgency. Disasters seem to be bigger and more frequent and of a greater variety and scope. I am certainly not an apocalyptic prophet. I believe there is great potential for utilizing the resources of space, and eventually, have a substantial human population off-Earth.

But I don't believe that it will happen unless we regenerate the spirit of ingenuity and adventure. Little innovation comes out of apathy. I have had twenty five years of teaching the prevention of viruses. I know with certainty that more people are moved to do it regularly if they learned it when the risk was highest.

To develop a health habit that takes a couple of minutes a day is not just a matter of informing the passive public about it. You read it. You think it "should work," yet, if I do not miss my guess, you yourself will probably not be trying it in the foreseeable future. But I'll also bet that with another bigger outbreak of SARS or H5N1 or other emerging virulent virus, you might well refresh your memory on the details and actually do it. There is no greater motivator than necessity.

We currently apocalyptically slaughter and burn or bury millions of possibly infected chickens worldwide every year, in an abundance of caution. Does it afford us much additional security? Probably not much. H5N1 is in the wild bird populations, including migratory water fowl like ducks and geese. Swine too, are intermediate vectors. It is not apocalyptic to say that we could, at any point in time have just the sort of random mutation that brought about a pandemic like 1918. That is not just my perspective. Check with CDC or WHO.

If such a pandemic did spread, there no companies that could produce even a tiny fraction of vaccine doses needed, and only for delivery long after when it would have first been useful. In other words, for most of the population there will be no timely vaccine. Yet currently, we place a lot of our faith in this way of dealing with it. It is possible that we will learn methods which will cut the time frame sharply, but I don't see that happening right away. Are we better able to deal with such a disaster than we were in 1918? Yes we are. Will we make the same sorts of mistakes today that we made then? Almost certainly.


Terri D-C
Posted 01 June 2008 at 06:20 am

Heh heh heh, Hoekstes, you and me both!

I thought it quite fitting that they named the disease after our taxman.

Enjoyed this article by the way.

T


CrowdKiller
Posted 01 June 2008 at 09:01 am

Hoekstes said: "are? ARE! I is actually Afrikaans speaking."

As a fellow Afrikaner I can only quote Mark Twain in response:

"What is the difference between a taxidermist and tax collector? The taxidermist takes only your skin."


Socacrates
Posted 02 June 2008 at 06:31 pm

thegun said: "I thought that this was yet another really great story. Well written and managed to steer clear from focusing in the Media hype."

I know, I just joined I've just joined and so far all of the stories have been really good.

first posting :)


Ronald
Posted 04 June 2008 at 05:11 pm

Anthropositor I typed in your name to google and got nothing, could you post a link please? Thank you.


tech42er
Posted 05 June 2008 at 04:39 pm

BlackFoxOne
Posted 16 June 2008 at 05:15 am

When I first heard of SARS I thought "Oh great, the next AIDs". I still think they are both a result of biological warfare gone awry! I know, call me crazy!

JT


birdybrains
Posted 16 June 2008 at 06:42 am

GigsTaggart said: Most of the world is empty. There's really not that many humans. We *choose* to live in cramped cities. Well, some of us.

I don't think this is what is meant by overpopulation. Its not about how many people there are per square mile but rather how many billions of people the earth's natural resources can support. For example, biologists note that there is an overpopulation of rabbits in Australia. This doesn't mean you can't put a foot down on bare ground, it just means that the abundance is causing major problems like soil erosion and deforestation (from grazing). Also, I don't think people have *necessarily chosen to live in cities. Historically and anthropologically speaking, cities formed out of the necessary centralization of resources and services (not to mention people to breed with, ha).

Also, (GigTaggart, I'm not directing this at you by the way)
I've noticed that quite a few people have a tendency to belittle others on this forum for their opinions or lack of knowledge (which we all have to some degree). This site should be a place for people to share information without fear of rebuke by those who only wish to masturbate their intellectual ego. So leave the hostile undertones behind, please. just sayin.


ao
Posted 22 June 2008 at 02:25 pm

spam removed


Anthropositor
Posted 02 July 2008 at 10:21 am

I had a conversation with someone the other day who concluded that the SARS crisis was nonsense: "Look at what occurred. Nothing. It was just a scare." Such complacency is common and infectious. I am told I was unkind. Maybe.


dec
Posted 09 July 2008 at 01:17 am

just a small comment on the naming of the disease as "Severe Acute Respitory Syndrome": the "severe" part is redundant since "Acute" includes this meaning. The disease should rightly be called "ARS" (rhymes with arse).


argosinfotech
Posted 03 August 2008 at 09:44 am

Really very interesting :)


Anthropositor
Posted 19 August 2008 at 03:55 pm

FUTURE PANDEMIC PREVENTION
I want to talk a bit about the good news with H5N1, the strain we currently fear the most, the one that has now shown a clear ability to cross species barriers into humans in triple digit numbers now, and the present day analogue of the strain that caused the world pandemic killing unknown millions at the close of the First World War.

It turns out that there are a number of survivors still living, some of them living with ages in the triple digits, having been older children during the epidemic when they contracted the disease. Our astute and sophisticated medical establishment apparently was not particularly interested in this fact until very recently. A fact which fails to surprise me.

Now though, the interest is keen. These unusually healthy and robust elders in our midst are now the objects of considerable attention, and are being gleefully probed for their blood in the very real hope and prospect that antibodies can be mass produced that will afford real protection even before a new outbreak gets out of control.

But frankly, I wonder how good it is for these centenarians to be jabbed for these samples.

The current procedure throughout the world is, a chicken or two in an industrial chicken house is positive for the virus, wipe out the infected chicken and the whole damn chicken house, many thousands of apparently healthy chickens. Destroyed. Buried. Burned. Who takes these losses? The farmer. Sort of gives him some incentive to button his lip and hope for the best, doesn't it?

I wonder if it would not be a good idea, the next time their is an outbreak, to let it run its' course through a very, very, very quarantined chicken house. Actually take the very best care of those chickens! (No, I don't mean to treat the stricken ones in any way.) I just mean, feed them excellent rations and very good water, remove all corpses promptly, and see how many survivors there are.

Let us say that out of 10,000 chickens, 100 survived. Now you have a hundred chickens you could poke with needles to get some samples to make a vaccine with which a pharmaceutical company could them make billions of dollars. Ah, the wonders of private enterprise!

OR, you could even breed those survivor chickens, ultimately producing tens of thousands, even eventually millions or even billions of chickens, which were totally immune, not only to the deadly virulent strain, but also to a great variety of other common influenza's. Apparently these aged survivors have, more often than not , not subsequently been troubled by colds or flu that they noticed. In other words, the original infection seems to have made the survivors a LOT healthier. Would it not be nice if we could make the entire chicken population of the planet much, much hardier and less prone to disease in general.

Naw, couldn't work. Otherwise, one of those experts with all that formal training, all those diplomas and honors,in cooperation with all the high ranking health organization bureaucrats with their unique expertize om writing protocols and edicts and regulations... they would have already thought of it. Certainly, no self-taught bumpkin from the middle of nowhere could ever come up with anything valuable. What would people think?


cdagirl
Posted 07 November 2008 at 10:37 pm

Zenesque said: "I find it strangely comforting, when I think about the impending doom of mankind. I like to think that nature will one day balance out the imbalances we have caused. We might not be quite untouchable and omnipotent.

The density of population increases continuously. We face inevitable natural disasters and wars. The survivors are often forced to live in conditions that are cramped and unsanitary. It is the perfect breeding ground for disease. When we add to the equation the fact that people can travel from anywhere in the world to any other place on the planet in less than a day, we have the ingredients for pandemic of apocalyptic proportions. I can hardly wait.

I have to admit that the people mentioned in this article were probably the right people in the right place at the right moment. I would not have thought that people could be so efficient. Usually things get a lot worse, before they get better. Perhaps we are finally beginning to learn. Better late, than never, I guess."

This is a happy thing for me to look forward to too! I just can't wait for us to get what's coming to us. It will be fun dying of disease. And I don't mean this sarcastically. I know it's a strange thing to look forward to, but I am a strange person, so what can I say?


James Monroe
Posted 01 December 2008 at 02:00 pm

Thanks goodness for people like Jiang Yanyong. His selfless act of letting the world know what was going on behind closed doors in China was the right thing to do. He opened up the floodgates of truth behind the closed faucet of communism.

The world needs more leaders that do what is right instead of what is popular.


TwicKeR
Posted 06 January 2009 at 05:09 am

I think its quite a feat for the hospital staff to show up for work each day, knowing full well they may be infected with a potentially lethal virus.
I tip my hats to you all.


rizz3
Posted 02 August 2009 at 09:42 pm

" The public perception is polluted by images of isolation-suited medics, mask-wearing city-dwellers, and unearthly infrared figures in airport thermal scanners." I visited Taiwan during the SARS outbreak and I had to go through a thermal scanner as soon as I got off the plane. If anyone's temperature was even slightly above normal, they would be quarantined for two weeks.


ALLTHETHINGS
Posted 06 March 2014 at 05:33 am

I remember when the SARS outbreak was happening, the only thing I knew was that I didn't need to go to school (or do homework) for a while. The streets were completely deserted - the only person I saw leave their apartment was our neighbor who was a nurse. I thought she was really brave for going to work when everyone was so terrified.


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