Severe Acute Respiratory Syn-drome (SARS) has not, so far, threatened to be a repeat of the world’s last great pandemic—the “Spanish Flu” of 1918-19. Nor is it as lethal as malaria, which, according to the World Health Organization (WHO), kills more than 3,000 people a day, and it hasn’t infected as many people as AIDS. Nevertheless, it is a mutated virus with a confirmed deadly potential that’s required health authorities to impose drastic measures in order to try and contain it.
SARS’ sudden appearance has served as a memento mori, a reminder to the world that for all of the wonders of 21st Century science, we remain vulnerable to depredations from the mutations of chemical compounds that are barely “alive.” It goes a long way to explain the near panic over the spread of the virus, which the WHO reported has, as of May 7, caused a cumulative total of 6,903 cases “from 29 countries on five continents.”
On April 16, it first announced “that a new pathogen, a member of the coronavirus family never before seen in humans,” caused SARS. Another report stated, “Most patients identified as of March 21, 2003 have been previously healthy adults aged 25-70 years. A few suspected cases of SARS have been reported among children.”
The WHO now estimates that the incubation period of SARS is usually 2 to 7 days, but may be as long as 10. According to a bulletin from the American Red Cross, “early symptoms in patients with SARS have included fever, muscle aches, dry cough, shortness of breath, or difficulty breathing. In some cases these symptoms may progress to insufficient blood supply to the brain, requiring the use of a respirator.” The WHO said that the “case fatality” among persons meeting its “case definition for probable and suspected cases of SARS is around 3 percent.”
However, those are preliminary figures. A study released May 6, which concentrated on patients in Hong Kong, indicated that the death rate could be much higher. According to a BBC report “the new study—the first to be based on a statistically sound sample of 1,425 cases—puts the death rate at one in five (20 percent) of those admitted to hospital.”
As of May 7, WHO figures, which are updated on an almost daily basis, said SARS had caused 495 deaths, while 2,885 people have recovered from the disease. In certain areas it is still out of control. Between May 5 and May 7, 320 new cases were reported, almost all of them in China, where the disease is thought to have originated.
While Chinese authorities initially tried to cover up the number of SARS cases, the government, under its new health minister Wu Yi has now begun enforcing rigorous measures to deal with the outbreak. It recently put 10,000 people in Nanjing under quarantine, even though the city has reported only four cases of the disease. As of May 7, China had reported 4,560 cases resulting in 219 deaths. Hong Kong has reported 1,654 cases and 204 fatalities. The U.S. has reported 65 cases, but no deaths.
Led by the WHO, health authorities have introduced strict quarantine measures to contain the disease. The actions have brought protests from a number of people, notably Toronto’s mayor Mel Lastman, who lashed out at the WHO for putting the city on a list of destinations to be avoided unless absolutely essential, following 15 SARS related deaths there. Although Canada’s death toll has now risen to 22, the country has reported no new cases since May 4, and the WHO has removed Toronto from its list.
Despite the complaints, the quick work of the WHO and the health authorities in countries hit by SARS appears to have limited the spread of the disease. Laboratory work that usually takes years was compressed into weeks to identify the virus, and how it might be spread. According to the Red Cross, it’s “primarily spread from person-to-person through droplet transmission when in direct close contact with a person with SARS.” Other than the available anti-viral drugs, there hasn’t been time to develop any specific medicines to combat it; therefore, the only alternative to prevent it from spreading are the strict quarantine measures, which inevitably have an economic impact.
The economic fallout from SARS is three-fold. First, there’s the direct cost to the health systems of the countries affected. Secondly, there are the immediate economic effects of reduced business activity, which hits everyone from the local taxi driver to multinationals. Travel and tourism have been particularly affected as potential visitors cancel their hotel and flight reservations. Conventions, sporting events and business meetings have been postponed, moved or cancelled outright. Thirdly, there’s the long-term economic fallout. SARS will probably reduce the level of foreign investment in affected countries, thereby slowing economic growth. Reuters reported that Singapore’s Prime Minister Goh Chok Tong estimated that economic growth in East Asia would slow by one-half to one percent this year due to the outbreak.
American International Group (AIG) mentioned the possible fallout from SARS in its first quarter report. AIG generates around 30 percent of its gross revenues from its Asian operations, and said that although SARS had not had an impact on the Q1 results, the outbreak “may impede agents from freely visiting prospects and will likely have some dampening effect on new sales in certain Asian markets in the second quarter.” Accordingly, AIG has increased its direct marketing efforts, including telephone marketing. It also noted that “there is growing demand for some of AIG’s traditional policyholder protection and critical illness products,” and concluded that the outbreak of SARS would “have only a slight impact on profitability.”
The quarantines seem to be working. As of May 7, Singapore hadn’t had a new case in 10 days, and the infection rate appears to be slowing everywhere, except in China and Taiwan.
The world’s last great pandemic shares a number of similarities with SARS. Viruses, probably mutated from birds or pigs, caused both diseases; the symptoms for both include fever, muscle pain and similar effects, which can quickly became life threatening. A person, who appeared perfectly healthy in the morning, often died by nightfall when hit with the Spanish Flu. Contrary to most epidemics, the disease strikes larger numbers of healthy young adults. Both are spread by simple contact, whereas malaria or AIDS are transmitted by blood contact.
The speed at which the epidemic spread is perhaps its most frightening aspect. According to some recent studies that have tracked the disease and its cause, the first known case of the Spanish Flu, named because it hit that country particularly hard, killing an estimated 8 million people, occurred at Camp Funston in Kansas on March 11, 1918. Troops returning from World War I, and displaced civilian populations spread the disease rapidly throughout the world. It’s estimated that one-fifth of the world’s population, roughly 400 million people, eventually contracted it by April of 1919, when it disappeared. Estimates of the number of deaths it caused vary widely, but the lowest is 20 million; many go as high as 50 million—in less than 18 months.
The world’s present population is over 6 billion, three times larger than it was in 1918. If SARS has even half the killer potential of the Spanish Flu, it could well cause 30 million deaths. That should be reason enough to justify whatever measures may be necessary to stop its spread. Any adverse economic consequences are minimal compared to the disruption 30 million, or even a million, deaths would cause.