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Living in fear of SARS
May 26, 2003

By ANITA MANNING
Gannett News Service

The only thing that seems more contagious than the mystery disease SARS, severe acute respiratory syndrome, is the fear of SARS.

“It’s not a panic yet, but it’s getting there,” says John DiScala, a travel expert in Los Angeles. “People flying, especially to Asia, are nervous,” he says. But “I’ve had e-mails from people on the East Coast asking, ‘Should I go to the Caribbean?’”

It’s no wonder. The messages coming from health authorities have been distinctly ominous. Surgeon General Richard Carmona said he thinks a quick health screening for passengers before boarding international flights from SARS-affected countries is a good idea, and President Bush gave U.S. health officials the power to involuntarily quarantine people suspected of having the disease.

The disease continues to spread.

“We’ve seen it spread rapidly and dramatically to a number of countries,” James Hughes of the Centers for Disease Control and Prevention said in a briefing. “We’re not totally on top of this, by any means.”

For reasons not understood, most of the American cases have been milder than those in other countries, but concern is high just the same. Airplanes have been grounded while passengers are evaluated for possible symptoms. Colleges and church choirs have postponed or are reconsidering trips to Asia. At a school in Connecticut, students and teachers recently back from a China trip were sent home for a few days, even though they all seemed healthy.

Three days before the start of its annual meeting in Toronto, the city most affected by SARS outside Asia, the American Association of Cancer Researchers canceled the event, citing the need to “minimize the risk of spreading SARS, especially for those whose immune system is already compromised from their fight with cancer.” Officials said they had expected 16,000 people to attend, but thousands had pulled out, and they had no choice but to cancel.

Among those most concerned about SARS are flight attendants, says Pat Friend, president of the Association of Flight Attendants, which last week urged the Federal Aviation Administration to issue an emergency order requiring airlines to offer gloves and surgical masks to airline attendants, or at least allow them to bring their own. Some already are making them available to passengers and crew on Asian flights.

SARS, says Friend, “is particularly frightening because of the nature of the disease, the fact that it has been reported to be communicable by inhalation or by coming in contact with used food or beverage items the infected passengers have had.”

CDC experts say that while much is still unknown about SARS, they believe it is passed most often through direct exposure to “droplets” expelled when an infected person speaks or coughs. But there is some evidence that the virus — thought to be a new bug in the family of germs that causes colds — can live for hours on objects and may even spread through the air.

About 85 percent of passengers on flights from Asia are wearing masks, Friend says. The CDC is advising people to reconsider nonessential travel to Hong Kong, China, Vietnam and Singapore, but “that’s not an option for us,” she says. “It’s our job.”

SARS, first diagnosed in Vietnam in February, has raced around the world, carried by international travelers to at least 19 countries. Many of the early cases involved hospital workers who cared for patients before it was known how contagious the disease was.

San Francisco internist Hans Yu, whose practice is about 80 percent Chinese and Chinese-American, says he has been getting calls daily from patients who have returned from China or have relatives visiting from there.

WHO’s advice to travelers to postpone nonessential travel to Hong Kong and China’s Guangdong Province has rattled the Chinese community.

Yu says that surgical masks have sold out in Chinatown stores, and that he has had requests from friends in Hong Kong to send some there because they’re in short supply.

He has posted a sign outside his office asking patients if they have symptoms of SARS — fever, dry cough — and have traveled recently to SARS-affected areas.

“If so, we say don’t come into the office. Go home and call me,” he says. “It’s to protect the staff and waiting room. By doing that, if a case does come up, we don’t want it to spread.”

With few exceptions, most people seem to be reacting with an appropriate mix of calm and caution, says Arthur Reingold, professor of epidemiology at the University of California-Berkeley and head of the California Emerging Infections Program. He says the advice and precautions being taken by public health officials make sense.

“This is, if not unprecedented, certainly a highly unusual and scientifically interesting new disease,” he says. In the United States, “we don’t have evidence of transmission in the general public, and at the moment things appear to be well-controlled in Canada,” where the disease does not appear to be spreading broadly in the community.

Still, uncertainty is the word of the day, says travel expert DiScala, who runs a travel Web site, www.johnnyjet.com. He says he gets “Should I go?” e-mail every day.

He won’t make decisions for others, he says, but he would not hesitate to go to the Caribbean, for example, or to other unaffected parts of the world. He wouldn’t wear a face mask while traveling, either, he says, unless he were heading to Asia.

At this point, DiScala doesn’t see travelers going to extremes. “I just came through an international terminal the other day, and not one person was wearing a mask. I think right now it’s not panic time. It’s time to find out what the facts are, so we can go forward.”

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