Viral scares

The Center for Disease Control (CDC) probably did not intend to make my life difficult, but it certainly succeeded.

On the eve of my making a long-planned trip to South Korea, CDC announced a general warning – advising people not to travel to Hong Kong, China, Vietnam and Singapore because of the risk of severe acute respiratory syndrome (SARS)(1). Most news bulletins simplified this to a general warning against travel to Asia.

Put this on top of the war in Iraq, continuing conflict with North Korea over invisible nukes and the orange (high) terrorist alert across the USA and there was a jittery feeling in the Derbyshire household. And we are generally a rational bunch.

As killer viruses go, SARS is destined to be another also-ran. Fifty-eight deaths, at the time of writing, from a virus first breaking sometime last November across a continent of some 3.5billion people is a long way from apocalypse. Most experts are taking the view that SARS is not infectious or virulent enough to cause global catastrophe and should not be getting in the way of most people’s lives.

Even the CDC warnings seem banal on close inspection, advising people with the disease to limit their interactions outside, for example, and for close family to wash their hands should they be in contact with, amongst other things, the saliva, blood or feces of the patient. Er, no shit.

John Oxford, professor of microbiology at Queen Mary’s Medical School in London, has argued for perspective, stating on 31 March: ‘I would not be put off travelling to Hong Kong. Six hundred cases in a population of several million is not a large number.’ (2)

SARS is a nasty form of pneumonia and certainly worth avoiding, especially if you are elderly or very young. It is also worth avoiding lightning, high velocity impact and poisonous animals. Viral infection, even the serious kind, is an everyday risk but, like many other everyday risks, it is being met with increasingly common precautionary warnings. It is easy to dismiss the CDC’s warnings as acting, in part, to cover its own back: it can always say ‘we told you so’ should tragedy strike a severely unlucky traveller.

But there is also a population thirsty for panic, and eager to hear the message of doom, demanding these warnings. The warnings blend with our self-conscious expectation of disaster and fear of the planet. Even the seemingly balanced Professor Oxford appears only to be waving away distractions from the anticipated real thing, ‘Neither of the two [potential SARS] viral families would really make my hair stand on end like a virulent new flu virus would.’ (3)

Professor Oxford aside, there are evidently many who believe SARS could be a new deadly plague. As I write this I am sitting in the departure lounge of Narita International Airport (Tokyo) waiting for my connection to South Korea. A quick survey of the (small) crowd produces a count of 21 people wearing surgical masks; almost all of them are Asians, demonstrating irrational fear to be a cross-cultural phenomenon.

It is odd to see people outside of a hospital wearing surgical masks: but in a poorly populated airport lounge in a country where not a single case of SARS has been reported it is positively bizarre. My favourite panic-stricken travellers, all seemingly American, currently have their masks round their necks – perhaps they have gills? More likely they are demonstrating their allegiance to the precautionary principle without the actual aggravation of having to breathe through a piece of cloth.

In the days before I left for Korea not a single person said how exciting it was to be heading to the far East. Most looked slightly worried and stated that they would not like to be travelling to ‘that part of the world’ right now. Others simply looked aghast and a few treated me as if I was going off to war never to be seen again. A friend of my wife helpfully informed us that they had just cancelled a trip to Australia because of the ‘situation’, and less than gently implied my irresponsibility for even considering such a journey.

International travel is now threatened by the same moral opprobrium currently reserved for those who fail to recycle their garbage. Inevitably, as people make fewer journeys and experience the normality of foreign shores less often, such narrow outlook will increase and exacerbate misunderstanding and unfamiliarity, further curtailing movement.

In short, the economic and human costs of this are becoming profound. I took a flight with barely 20 percent of the seats occupied. The airline, United, is highly likely to file bankruptcy within the next few weeks and several Asian carriers are also likely to suffer. More generally, there will be a loss of trade as buyers and sellers eschew journeys; trade shows and conferences will struggle; and the general exchange of ideas and information will be retarded.

The Canton Fair, for example, which begins on 15 April, normally attracts buyers from all corners and was predicted to generate deals worth $15bn. It is unlikely that this figure will now be reached and much of the blame will fall at the feet of the Chinese government for their tardy response to the outbreak. The CDC and their equivalents, however, will also be responsible for woefully failing to put the unease into perspective.

Stuart Derbyshire is an assistant professor in the University of Pittsburgh Department of Anaethesiology. He is a contributor to Animal Experimentation: Good or Bad?, Hodder Murray, 2002 (buy this book from Amazon (UK) or Amazon (USA)).

Note: Dr Derbyshire was due to speak at the Second Asian Pacific Postgraduate Course on Gastrointestinal Motility. He arrived in his hotel room to find the conference had been cancelled because of the SARS outbreak. The conference organizers noted that no case of SARS has actually been reported in South Korea. There has been one case of a massively pissed-off English guy.

Read on:

The SARS farce, by Mischa Moselle

(1) Severe Acute Respiratory Syndrome on the Centers for Disease Control and Prevention website

(2) Quoted in Financial Times, 1 April 2003

(3) Quoted in Financial Times, 1 April 2003