Can We Learn Anything from the SARS Outbreak to Fight COVID-19?
After being criticized for a slow response to SARS, China is once again facing global scrutiny for its handling of the new coronavirus. •By the time the global SARS outbreak was contained, the virus spread to over 8,000 people worldwide and killed almost 800. •The new coronavirus, SARS-CoV-2, which causes the disease COVID-19, has already surpassed the 2003 SARS outbreak.
It’s been 17 years since a respiratory virus called severe acute respiratory syndrome (SARS) appeared in China.
Within months, SARS spread to more than two dozen countries in Europe, North America, South America, and Asia.
By the time the global outbreak was contained, the virus had spread to over 8,000 people worldwide and killed almost 800. At the time, the Chinese government was criticized for responding slowly to the outbreak and concealing the seriousness of the illness.
Now, a new respiratory illness has emerged in China. Like SARS, it’s caused by a coronavirus, this one known as SARS-CoV-2. This new virus causes an illness known as COVID-19, with symptoms such as fever, cough, and shortness of breath. There’s currently no specific antiviral treatment or vaccine for it.
More than 170 countries Trusted Source now reporting cases, some experts are questioning whether China — and the rest of the world — has fully learned the lessons from the 2003 SARS outbreak.
SARS — Looking Back over the First 100 Days
•Each winter, a number of surveillance networks are put in place to detect unusual outbreaks of severe respiratory disease. •In late June of 2003, just about 100 days after it issued its first alert about SARS, the WHO sponsored an international conference about the disease hosted by the Malaysian Ministry of Health. The conference brought to life the maxim of the 19th-century Danish philosopher Søren Kierkegaard: life must be lived forwards, but it can only be understood backwards..
•Koch’s postulates, as modified for viral diseases, have been fulfilled for the SARS-associated coronavirus (SARS-CoV) and the clinical illness now known as SARS. •Because health care workers are often in close contact with patients, they are at high risk, especially if there has been no reason to raise the clinical suspicion of SARS. Most of the outbreaks of SARS have occurred in this fashion, because there is not much that distinguishes the clinical picture of SARS from that of any common community-acquired pneumonia. Fever, myalgias, diarrhea, and lymphopenia are frequent but not universal findings. Known exposure to a person from a SARS-infected area remains a critical epidemiologic clue, but patients have contracted SARS during air travel — circumstances in which such a clue is easily lost.
•SARS has left its mark. There have been more than 800 deaths and many secondary consequences. Busy airports became temporary ghost towns, stock markets lost substantial value, and schools have been closed. In some areas, health care workers have been subject to discrimination. Life is now returning to normal.
•The SARS epidemic, in which the disease spread to more than 30 countries within a few weeks, proves how small our planet has become. It has also illustrated how united we can be. A worldwide network of laboratories, assembled by the WHO, was responsible for the identification of the SARS-CoV, for elucidating its molecular genetics, and for demonstrating that the SARS virus could induce respiratory illness in monkeys. There is now a coordinated effort to identify and test effective vaccines for the prevention of SARS.
•Moreover, the coordination has gone beyond the scientific realm. Heads of state around the world realized that without cooperation among nations, SARS could not be contained or controlled. The SARSCoV refused to be hidden behind national boundaries. At the meeting in June, the minister of health of Vietnam, the first country outside of China to have SARS cases and the first to become SARS-free, attributed that nation’s success to its close working relationship with the WHO. The vice-minister of health of China admitted that the initial Chinese response had been slow and inadequate. China has now received help from the WHO, and as of the beginning of July, the disease appears to be under control. The SARS virus shows that when confronted by a common enemy, we can forget our differences and work together fruitfully. This was the most important lesson from the conference and from SARS. Let us hope that we can all benefit from it.
www.nejm.org