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."
Hong Kong style panic got the virsus less than linear in less than a month. That will contain its immediate effect there to some economic disruption and a few score deaths.
The overall epidemic is capable of doubling in size every 20 days. Meaning it will either be contained, or will infect millions, and likely kill hundreds of thousands, within 6 months. A year from now nobody will give a tuppenny damn about Hong Kong hotels if millions are dying from a Chinese plague. A year from now nobody will care about SARs if it goes less than linear next month, and so tops out at a few hundred deaths worldwide.
Beating the damn critter is the only policy issue that matters. The enemy is not press, or spin, or reactions, or hype, or funding, or my pet theory vs. yours or anybody else's. The enemy is the damn bug.
Oh PLEASE - pure panic does not allow for rationality in the decisions to isolate, treat and track those who may have contracted as insidious (YES, insidious) disease such as SARS.
Tell me - do YOU do *your* best work in a panic-state?
A) The virus is intensely infectious. B)It kills 5% to 20% C)Many of those recovered are severely disabled. D) It mutates rapidly. E) There is no vaccine or real treatment
That is what I have suspected, for the past two weeks....I hope I am wrong....
And it has worked. New cases in the last 10 day generation period are running about 100, one fourth what they were at their peak. This is a disease with the potential to spread exponentially, and instead it went linear in 20 days and its absolute rate of transmission has been quartered less than a month later.
Meanwhile in mainland China, they didn't want people to panic, so the told nobody the truth, and they've got 3000 cases and it is still growing exponentially. Sometimes "remaining calm" is just plain stupid. There is nothing to be gained by underreacting to this, beyond a little tourism for a month or two. There is an enourmous upside to overreacting to it - the eventual scale of the epidemic can potentially be lowered by many orders of magnitude.
If you can lose your head while all about are keeping theirs... Works in market bubbles too, by the way.
Dr. Ho and the wife of Dr. Baltimore are both ethnic Chinese. They all do biological research, but probably not on anything as infectious as SARS.
For example see the BBC at http://news.bbc.co.uk/2/hi/asia-pacific/2955655.stm
Eyewitness: Vietnam's Sars survivor
Nguyen Thi Men, the only health worker at the centre of Vietnam's Sars outbreak to fall severely ill and survive, tells her story to the BBC Vietnamese Service's Nga Pham. The hospital where I work is pretty small, everything is laid out on a few floors. Normally I only take care of newly born babies, but sometimes when it's busy they ask me to assist the other nurses.
When the American-Chinese patient, Johnny Cheng, first came to the hospital another nurse was looking after him. He showed the usual flu symptoms and we suspected he might have the so-called Hong Kong chicken flu. But what was unusual was that he coughed so much - the whole 40 minutes he was coughing and expelling huge amounts of phlegm.
My whole body was aching, but I told myself it was just fatigue, maybe a cold His health deteriorated quickly overnight. Yet he was still thought to have flu. We didn't take any special preventive measures, as we normally don't wear masks when taking care of flu patients.
They asked me to look after him during a night shift. He was already in a critical condition and had to use a breathing machine. We still didn't know what he had. But then we ourselves began feeling unwell. My whole body was aching, but I told myself it was just fatigue, maybe a cold. I was struggling for about four days until 4 March, when I suddenly felt extremely weak at the end of my shift. They gave me some flu medicine. It didn't help. On the night of 5 March I developed a high fever. So they put me in the hospital together with 10 other staff who had the same symptoms.
The American patient had been transferred to Hong Kong, where he died. We were told we might have contracted something from our contact with him. Only then I began to worry. We were put in an isolated area of the hospital, which remained full at that time. The thing that disturbs me most is my right leg - I can't walk, can't even move the leg without feeling an excruciating pain in my joints When I realised that the illness was infectious I started to panic, as I was worried my family might have caught it from me.
But the whole time I was still hoping that I would recover soon - we didn't know how deadly the virus is. More and more people got infected and had to be hospitalised. The staffing was scarce as most of us were sick. Then my situation started getting worse at an amazing speed. Breathing was difficult and I had to be under a respirator for about 10 days. I was unconscious most of the time.
Now, looking back, everyone says I am lucky because I had been one of the worst cases. I guess I am, as some of my colleagues have already died.
Slow recovery
The luckiest thing is that none of my family got anything from me. My husband, my kids - they are all healthy now. I have been back with them for more than 10 days. My lungs haven't got back to normal and I still feel tight in the chest. But I suffer from a bad insomnia; most nights I can only sleep for a couple hours. My muscles are so weak I can hardly lift anything, and my eyes are swollen and red. I don't have many visitors as most people worry they might catch it from me even though I have been cleared by doctors But the thing that disturbs me most is my right leg. I can't walk, can't even move the leg without feeling an excruciating pain in my joints. I used to be very active, very physical and I did a lot of exercise. I'm training to walk with the help of a physiotherapist and I do it every morning until midday.
I don't have many visitors as most people worry they might catch it from me, even though I have been cleared by doctors. But it's not easy to catch Sars unless you have face to face contact with a very sick patient. To my friends I say: don't stay in an air-conditioned environment, have your windows open, and your house well-ventilated. I have the feeling that the virus dies quickly in open air.
Don't remember for sure, probably Science News Magazine.
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