Posted on 04/28/2003 3:12:22 PM PDT by CathyRyan
WASHINGTON, April 28 (Reuters) - People around the world are overreacting to SARS, creating a sense of panic that could overwhelm common-sense measures for containing the virus, top AIDS experts said on Monday.
Sensational media coverage of Severe Acute Respiratory Syndrome, which has killed 326 people worldwide, has fanned the flames, said David Baltimore, who won the 1975 Nobel Prize in medicine for his work on how viruses cause disease.
"I think there has been overreaction," Baltimore, a leading AIDS researcher who is now president of the California Institute of Technology, said in a telephone interview.
"I have to agree with that," added Dr. David Ho, another top AIDS expert who heads the Aaron Diamond AIDS Research Center in New York.
"Obviously, the fear comes from the fact that this is a novel disease. Many aspects of this epidemic are still mysterious. Fear of SARS is outrunning SARS per se," Ho added.
Ho and Baltimore ought to know. AIDS kills virtually everyone it infects without treatment and 20 years into the AIDS epidemic there is no cure and no vaccine.
In contrast, 94 percent of SARS patients recover.
Baltimore said World Health Organization moves have been appropriate, such as the controversial recommendation against travel to Toronto, where 21 people have died from SARS.
But boycotts of Chinese-owned businesses and scenes of people walking the streets of Hong Kong wearing surgical masks show that the general public does not understand the real dangers, Baltimore said.
"As much as overreaction, there has been a lack of balance, of putting it into perspective, because it is a real problem, no question," Baltimore said.
"But people clearly have reacted to it with a level of fear that is incommensurate with the size of the problem and I think it is getting in the way of a reasonable response."
"IRRESPONSIBLE" COVER-UP
The government in China, where SARS appears to have originated late last year, has been criticized for covering up the initial outbreak -- but officials there have said they feared creating the sort of panic that has been seen.
"The Chinese government was totally irresponsible in covering it up," Baltimore said. "We can't get away from that. It is a demonstration of the value of openness."
WHO has praised Vietnam for its response -- which was to immediately call for international help in handling its own outbreak of SARS. WHO has declared Vietnam to be free of SARS.
"This thing literally never would have happened on anything like the scale it happened if the Chinese had been open about it from the beginning," Baltimore said.
SARS, caused by a relative of one of the common cold viruses, has infected an estimated 5,300 people in nearly 30 countries. It has a mortality rate of about 6 percent, which is higher than comparable respiratory diseases such as influenza.
But while SARS is new and frightening, its impact, so far, has been minor. In a mild year, influenza and its complications kill an estimated 250,000 people around the world. Malaria kills at least a million, mostly children.
Yet earlier this month two Chinese runners were asked to pull out of a marathon in the Netherlands because of SARS fears. Many cities have reported people are avoiding Chinatown districts -- including New York, where no SARS cases have been confirmed.
"What happened to Hong Kong, for example, with the hotel occupancy rate at 2 percent, is an overreaction," Ho said.
Much can be blamed on media coverage, Baltimore said. "What we are seeing is a playing up of the things that make people worry," he said.
But, he added, perhaps scary reports are just giving readers and viewers what they want.
"In some sense people like to be frightened," he said. "And so, to some extent what I am saying is a denial of what seems to be a basic human instinct -- to get a sort of frisson (shiver) of excitement out of danger. And the press is playing into that."
SARS apparently might also be transmitted through touching surfaces on which the virus has settled via sneeze droplets or touch by an infected person. These surfaces could include door knobs, benches, train straps, gas pumps, credit cards, shopping bags, elevator buttons, banisters, counter tops, etc. If the virus can live for 24 hours on such surfaces, the risk of such transmission is not minimal if SARS is rampant in the population around you.
If SARS becomes bad in my area, I'll wear a mask when I go out to prevent unconscious contact of my hands with my mouth and nose.
We will beat this. Bio tech companies are probably chomping at the bit to get samples of the virus to work with. Innovation, creativity, brilliance, vision and, yes, greed will save the day.
I just am not sure how many will die in the meantime.
It's not being spread anymore in Viet Nam, so all the victims must have been isolated. Singapore's numbers have dropped dramatically, and might well match Toronto's very soon. Toronto is out of danger, unless you're a health care worker.
Hong Kong has made a lot of progress, and they may be getting control of it, too.
A big city, with modern medicine and strict health controls can contain this thing, with relatively few people inconvenienced or endangered.
A few new suspect and confirmed cases are popping up around the world, notably in India, but everyone is on watch for it. Those are very encouraging things.
China is a completely different matter, and if it weren't for them, this story would be rapidly beginning to fade from the front pages. They've allowed SARS to escape from the cities where they could handle it, and now it's almost certainly everywhere. Given the incubation period, we probably won't know for another week, and that's assuming we get accurate and timely information.
Without the level of healthcare in rural China that residents on the coast can get, it's likely to be a very serious problem.
The rural Chinese aren't too likely to get onto any planes flying into your hometown anytime soon, so even if it gets pretty bad there, it's probably not much immediate threat to us.
But they can bring it back into Hong Kong and Beijing and Shanghai at a later time, so even if a city can contain it today, it might come back from an outside source later.
Recovered SARS Patient Continues to Shed Virus in Stool --------------------------------------------------- An issue that has not been discussed anywhere in ProMED-mail in detail (perhaps because little is known about it) is that of continual viral shedding by clinically recovered SARS patients. A colleague of mine in Singapore, who has had the SARS illness and was diagnosed with the SARS coronavirus by RT-PCR culture and electron microscopy, has informed me that SARS coronavirus RNA has continued to be detected in stool samples by RT-PCR, although it has not yet been successfully grown in culture. This continued for sometime after the quarantine period of 10-14 [days?] after recovery from illness (up to 3 weeks post-recovery). If such is the case for most -- or even some -- of the recovered SARS patients, perhaps this may account for the ongoing transmission we are seeing in places like Singapore in household and workplace contacts of clinically recovered SARS patients. Perhaps the laboratories of the WHO collaborating network should ask for convalescent stool samples as well as sera to monitor and characterise this phenomenon.
[The current RT-PCR tests utilize primers that amplify short sequences of the polymerase gene of the putative SARS coronavirus. These tests may do no more than detect the presence of defective virus in gut contents. The replication of many RNA viruses is accompanied by the progressive accumulation of defective interfering particles (the equivalent of deletion mutants), which are thought to be a determining factor in the self-limiting characteristics of some acute virus infections. The failure to isolate infectious virus from the patient after recovery suggests that transmission of SARS via gut contents post-recovery does not represent substantial risk. Nonetheless, it is not possible to discount this route of transmission of SARS virus without knowledge of the relative sensitivity of the cell culture employed, and Dr. Julian Tang has drawn attention to an important question. - Mod.CP]
http://www.promedmail.org/pls/askus/f?p=2400:1001:102727813954567900::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,21428
"Billions will die from this mighty retribution. Kneel down and repent, sinners, for the hour of judgement is at hand. He shall come from a sweaty, unhygenic place, and know that his name be SARS!"
"This MUST be a bioweapon created by the NWO, and spread by black helicopters, to help cause a panic that will let the government start the gun grabs. I'll be in my Y2K shelter if you need me."
"Dude, it'll be just like, you know, The Stand. Won't that be freaky?!?All that death and stuff? I should buy a white mask and gloves, like, you know Micheal Jackson. Who knew he was right all this time, about the germs, and stuff?" </The Stand>
Maybe it's the number of viruses a person comes into contact with that makes the difference, and infection from recovered patients' stools is relatively low.
The interesting thing is that recovery isn't dependent on elimination of the virus. It has to be based upon sufficient antibodies being developed, or some other protective measure.
Or maybe the fact that these shed viruses haven't been successfully grown in culture yet is an indication that they've been somehow neutralized genetically. Just guessing here.
Seriously, I broke my addiction to FR for a whole month there but this stuff brings me back.
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