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Fear, Truth and SARS | The Nation

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Fear, Truth and SARS

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By focusing only on the worst-case scenarios regarding the spread of SARS, the World Health Organization and the Centers for Disease Control are trying to control the populace through fear. This is helping to spread worldwide economic havoc--many estimates say that SARS has cost $30 billion already to local economies worldwide. Toronto had been cut off by the new WHO travel advisory until today. Chinatowns are deserted. And people around the world are stigmatizing anyone who comes from an Asian country.

About the Author

Dr. Marc Siegel
Dr. Marc Siegel is a practicing internist and an associate professor of medicine and a fellow in the Master Scholars...

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The city lacks the resources to address its residents' urgent mental health needs.

The United States has fueled a worldwide overreaction to the threat of a bird
flu pandemic, putting AIDS, malaria, malnutrition and other crucial
global health programs at risk.

There is no evidence that quarantining entire countries does as much to prevent the spread of a disease as targeting those who actually have it or may have it. That seems to be the lesson behind Vietnam's recent success in limiting the spread of the virus. Quarantining hospitals where SARS has spread to healthcare workers, or designating certain centers as "SARS hospitals," is at the upper limit of what seems reasonable. Careful monitoring of traffic from countries where SARS has been sighted, or emphasizing careful precautions in such countries, is also reasonable but is not the same thing as frightening everyone who may have traveled there or who wants to do so.

The problem with AIDS information back in the 1980s was a different form of distortion: Affected groups were marginalized and the prevailing rhetoric minimized the disease. Now the propaganda suggests that everyone can get SARS overnight, which is far from the case.

This notion is having a negative impact on many people. Physician/essayist Dr. Abraham Verghese, writing in the New York Times, attacks the transparent political agendas that apply to bioterror preparation but makes an invalid assumption that none of this applies to SARS. Certainly, restricting movement and imposing quarantines is necessary with a known killer such as TB, but with SARS, people have been restricted just for having a cough. Many life insurance companies won't grant a person a policy if they've been anywhere near Asia in the past month. This is overkill.

The distinction must be made between the need for global control of a virus before it gets out of hand and the political agendas people may have to save their jobs and project themselves as soothsayers. The CDC has been very public on SARS. This is in part because the agency was fleabitten on anthrax and now doesn't want to be caught napping. There is no doubt that CDC vigilance and the large-scale involvement of its scientists has been laudatory, but unfortunately, the machinery for public broadcasting that has been set up for bioterror prevention is being used indiscriminately for SARS. It's a blind assumption that speaking about SARS incessantly on TV will prevent its spread.

When people panic, they only spread an infection more. It is human nature to run away from perceived risk, human nature to make common mistakes when engaged in overinflated, hypervigilant activity. And people under suspicion and facing heavy stigmatizing are more likely to lose their common sense altogether.

SARS must be seen in perspective. The Asian longhorned beetle may ultimately be more of a threat to us here than SARS. But the real problem is that by talking only in terms of worst-case scenarios, you strive to commit massive resources to your agendas. If you approach people where they feel the most vulnerable and may know the least, as with healthcare and disease, it's easier to sign them up for a program purported to be in their interest. This is exactly what government officials have done with bioterror to whip up public support for their antiterror programs. Make people afraid, make people feel they need you to protect them, and they'll allow you free rein with your agenda.

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