How SARS Was Contained

By Heymann, David L | International Herald Tribune, March 15, 2013 | Go to article overview

How SARS Was Contained


Heymann, David L, International Herald Tribune


The response to the disease marked a turning point in the history of public health.

In the early hours of March 15, 2003, I was awakened by a telephone call at my home in Geneva from the infectious disease duty officer of the World Health Organization, who had just received a call from the health authorities in Singapore.

He said that a doctor in the city-state who had been treating patients with the unusual respiratory disease that we were monitoring had become ill with the same symptoms while flying back from a medical conference in New York. His plane was due to stop in Frankfurt.

Our first step was to alert the German health authorities and advise them to consider taking the doctor off the plane to reduce exposure to other passengers, and to put him under immediate medical supervision.

What followed marked a turning point in the history of public health as the W.H.O. issued an international appeal that galvanized global cooperation in an unprecedented effort to contain the dangerous disease.

As the chief of the United Nations health agency's infectious disease section, I called together the W.H.O.'s outbreak alert and response team. Within two hours we were urgently reassessing the evidence surrounding this unknown illness.

More than 85 suspected cases -- the majority of them among health care workers -- had already been reported in Canada, Hong Kong, Vietnam and Singapore, with many of those infected needing assisted breathing. Now there was a possibility that the disease may have spread to the United States.

Later that morning, we presented a summary of our findings to the director general of the W.H.O., Gro Harlem Brundtland: An apparently new and untreatable respiratory disease was rapidly spreading around the globe.

The facts behind the threat -- the cause, how far it had already spread, and its final ramifications -- remained uncertain. Could it become a disease like H.I.V.-AIDS, which had entered the human population via exposure to infected animals and had become firmly entrenched around the world?

Brundtland and our team carefully weighed what was known and what was not, and named the disease SARS, for severe acute respiratory syndrome. Quickly comprehending the urgency, Brundtland that morning issued an unambiguous call for health authorities worldwide to work together to stop the disease in its tracks.

Her announcement declared SARS to be a rapidly spreading threat, described how to recognize signs of the disease and offered guidance to travellers and airlines on what to do if someone exhibited symptoms.

In 2003, March 15 fell on a Saturday. Because that is not a working day for much of the world, and because of the urgency of the threat, the announcement was made simultaneously to the media and to health authorities without any opportunity to ease the way politically.

Brundtland understood that some countries might not agree with her decision to sound the alarm so precipitously. She also knew that officials of some governments might refuse to join in a global effort because of fear of spreading panic, concern about dire economic consequences, or injured national pride for not being the first to issue warnings to their people.

This was the first of several bold decisions Brundtland would make over the coming months -- bold because they were made purely on the basis of rapidly accumulating scientific evidence, because they put concerns for public health first and foremost, and because they were made despite concerns about potential political pressures. …

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