Wednesday, March 4, 2020

Lessons from the SARS epidemic

The bad boy virus COVID-19 is on Canada’s doorstep, trying to smash down the door.

The betting is that it will break through and spread into communities across the country. It has infected people in more than 60 countries and is about to become a global pandemic.

The SARS (Severe Acute Respiratory Syndrome) crisis of 2003-2004 gave us good lessons about how to handle infectious disease emergencies. I’m not certain how well we have learned from those lessons, but I guess we are about to find out.

One important lesson of SARS is: Keep the politicians out of this. Medical crises need to be handled by medical professionals basing decisions on science, not politicians acting on the whims and wishes of their parties and their supporters.

The SARS Commission, an independent panel established to investigate the introduction and spread of SARS, reported that crisis demonstrated the importance of “medical leadership that is free of bureaucratic and political pressure.”

“SARS showed us that while co-operation and teamwork are important, it is essential that one person be in overall charge of our public health defence against infectious outbreaks,” the commission said. “The Chief Medical Officer of Health should be in charge of public health emergency planning and public health emergency management.”

The United States has ignored this lesson, and that’s bad news for us because it is our closest neighbour.

President Donald Trump has appointed politically toxic Vice-President Mike Pence to lead that country’s efforts against the virus. Pence was governor of Indiana during the 2015 HIV epidemic there and was criticized for his handling of that health emergency. It took him two months to declare an emergency, then critics accused him of saying that prayer, not science, was the way to stop the epidemic.

Another key lesson from SARS was the importance of effective communication that is factual and undistorted: Effective information provided by medically-trained people whose jobs are to make decisions on rigorously tested evidence.

U.S.  medical authorities now are forbidden to make COVID-19 information public without having it vetted by Pence.

We individual citizens need to ignore misinformation campaigns, conspiracy theories and other factless information that floats through the airways as easily as the virus itself.

We all need to listen to our medical professionals, and not overreact. Fear tends to give people louder voices, and emptier heads.

For instance, don’t run out and stock up on medical masks. Masks bought off a drugstore shelf will not prevent you from getting the virus. They don’t stop tiny particles from being inhaled into the lungs.

Masks that do block tiny particles, such as the N95 respirators, often are in short supply during epidemics and should be reserved for medical workers.

The other thing about masks, even those effective in filtering tiny particles, is that you just can’t slap them on your face and be guaranteed safe. They need to be properly fitted by someone who knows what they are doing.

Health professionals say that the best way to prevent infection is to be vigorous in practising basic hygiene.

Wash your hands regularly, and properly. Most of us do that after using a washroom, but don’t after touching handrails or something else used by hundreds of other people.

Wearing rubber gloves is not recommended because they pick up germs just as your skin does. If you are washing your hands regularly, you don’t need gloves.

Health professionals also advise avoiding crowded places, and touching things that a lot of other people touch. Keep a few feet of distance from people who are coughing or sneezing.

The SARS Commission emphasized the precautionary principle: That where there is reasonable evidence of a public health threat we should not wait for absolute proof of the threat before taking action against it.

COVID-19 is a threat requiring individuals to take precautions – based on accurate medical information - in a calm and reasonable manner.

“Public co-operation is essential in the fight against any outbreak of infection,” the SARS Commission said in its final report . . . . “It was voluntary public co-operation, not legal orders or emergency powers, that won the fight against SARS.”

Public cooperation means voluntarily isolating yourself if you feel ill during this COVID-19 epidemic and checking with your healthcare professional sooner than later.


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