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"It is the worst medical disaster I have ever seen," the Dean of Medicine at the Chinese University in Hong Kong told a prominent Asian newspaper. This irresistible quote was then shot ’round the world by other media, seeking desperately to hype the "mysterious killer pneumonia" or "super-pneumonia." But a bit of knowledge and perspective will kill this panic.
Start with those scary tags. "Mysterious" in modern medicine usually means we haven’t yet quite identified the cause, although it appears we have now done so here. What’s been officially named Severe Acute Respiratory Syndrome (SARS) appears to be one or more strains of coronavirus, commonly associated with colds.
"Killer pneumonia" is practically a redundancy, since so many types of pneumonia (there are over 50) do kill.
The real questions are: How lethal, how transmissible, and how treatable is this strain? And the answers leave no grounds for excitement, much less panic. Super?
At this writing, SARS appears to have killed 49 people out of 1323 afflicted according to the World Health Organization, a death rate of less than four percent. In Hong Kong, that alleged "worst medical disaster" has killed ten people out of 316 known victims. But since this only takes into account those ill enough to seek medical help, the actual ratio of deaths to infections is certainly far less.
In contrast, the 1918-1919 flu pandemic killed an incredible 20 to 40 million people among a world population far smaller than
Further, virtually all of the deaths have been in countries with horrendous health care, primarily mainland China. In the U.S., 40 people have been hospitalized with SARS. Deaths? Zero.
Conversely, other forms of pneumonia kill about 40,000 Americans yearly.
Each year millions of Americans alone contract the flu. Compare that with those 40 SARS cases and – well – you can’t compare them. Further evidence that SARS is hard to catch is that health care workers and family members of victims are by far the most likely to become afflicted.
"There are few drugs and no vaccines to fight this pathogen," one wire service panted breathlessly. But there are also few drugs to fight any type of viral pneumonia, because we have very few antiviral medicines. Nevertheless, more become available each year and one of the oldest, ribavirin, appears effective against SARS.
So why all the fuss over this one strain of pneumonia?
First, never ignore the obvious: It does sell papers.
But an added feature to this scare is the cottage industry that’s grown up around so-called "emerging infectious diseases." Some diseases truly fit the bill, with AIDS the classic example. Others, like West Nile Virus in North America, are new to a given area.
TB kills about 3 milion people yearly. There’s nothing exciting in that.
But there’s fame, fortune, and big budgets in sounding the "emerging infection" alarm and warning of our terrible folly in being unprepared. The classic example is Ebola virus, which is terribly hard to catch, remains in Africa where it’s always been, is now usually non-fatal, and – despite what reporters love to relate – does not turn the victims’ internal organs "into mush."
Yet you’d almost swear that every outbreak of Ebola in Africa is actually taking place in Chicago. Laurie Garrett rode Ebola onto the bestseller list and talk show circuit with her book The Coming Plague: Newly Emerging Diseases in a World out of Balance.
Since then, the U.S. government and various universities have also seen these faux plagues as budget boosters. The CDC publishes a journal called Emerging Infectious Diseases, though in any given issue it’s hard to find an illness that actually fits the definition.
The U.S. Institute of Medicine just issued a report warning that we’re grossly unprepared to deal with emerging pathogens. Soothingly, however, it adds that it’s nothing that an injection of lots of tax dollars can’t cure.
Meanwhile, a disease that emerged eons ago called malaria kills up to 2.7 million people yearly. Another, tuberculosis, kills perhaps three million more. Both afflict Americans, albeit at very low rates.
The big money and headlines may be in the so-called "emerging diseases," but the cataclysmic illnesses come from the same old (read: boring) killers. In fact, there may no fatal illness that will cause fewer deaths this year than SARS.