Philip Bowring: When fear is a virus
 
Philip Bowring IHT
Tuesday, April 8, 2003
HONG KONG First there was denial, then sluggish response - and now irrational fear. The evolution of the severe acute respiratory syndrome in Hong Kong resembles the mad cow disease scare that swept Europe three years ago - reaction out of proportion to the danger.
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The denial was in China, where the disease appears to have originated, the sluggish response was by Hong Kong and the fear has spread worldwide. A spate of advisories from the World Health Organization, governments, airlines and trade fairs suggesting that travel to Hong Kong and Guangdong is hazardous have combined with intense media coverage to make the outbreak of "atypical pneumonia" more dramatic than it has so far been.
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For sure, there was reason for major concern when it was thought that this could be an unusually virulent form of pneumonia with a high death rate. There is still justifiable concern that the identity of the virus and the main methods of transmission remain uncertain.
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The statistics of the disease, however, scarcely suggest the need for the restrictions being imposed on travelers to and from the affected areas, with their implications of slowing trade and tourism slumps around east Asia. The disease is routinely described as "highly contagious." But if it were there would now be tens of thousand of sufferers in this crowded city of 6.8 million. Most cases have been within three clusters - one housing block and two of the hospitals that had treated early victims, or family members who had been in close contact with them.
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Since the first cases were discovered in Hong Kong 883 people have been identified here as showing symptoms. Even assuming that all of these become confirmed cases, they represent one in 80,000 of the Hong Kong population. The new virus has merely doubled the normal number of "atypical pneumonia" cases here. Warning against visiting Hong Kong and Guangdong seems curious when there are more widespread or virulent infectious diseases abroad in the tourist havens of Southeast Asia such as dengue fever and encephalitis.
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Fewer than 15 percent of Hong Kong's sufferers have needed intensive care and the mortality rate (globally as well as in Hong Kong) has so far been around 4 percent, the norm for pneumonia here, which kills from 2,000 to 3,000 people a year. The vast majority of the deaths have been elderly people and those with pre-existing chronic illnesses. The incidence of new cases is also similar to that of tuberculosis.
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Of course, there is no excuse for complacency in the face of threats to public health, and lack of full understanding of the transmission of the virus is worrying. Fear may also help limit the spread of the disease by increasing precautions and limiting human contact. But perspective is necessary too.
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Disease threats make big news stories even in wartime, so the media has focused on the day-to-day progress of the disease and necessarily tends to ignore perspective. That is all the more reason why governments and the World Health Organization need to keep a better balance between caution and spreading exaggerated concerns. An obsession with risk not only creates disruption but diverts attention from dealing with ever present health and safety issues that in human as well as statistical terms are far bigger threats to life.

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