IN 1918, a virulent new strain of influenza swept the world, killing at least 20 million people before it disappeared. It was the worst human epidemic on record.
Yet on a patient-by-patient basis the virus responsible for this slaughter was not so lethal. Untreated, HIV kills virtually everyone it infects. Ebola and hantavirus kill about half. The 1918 flu virus finished off between 3 and 5 per cent: nearly everyone who contracted it survived.
The problem was that, unlike Ebola and HIV, the virus was airborne, extremely contagious and capable of rapidly infecting hundreds of millions. As any successful currency trader knows, small percentages can add up to a mind-boggling number when the figures they are applied to grow large enough.
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That is a lesson we need to remember when looking at severe acute respiratory syndrome, already better known as SARS. With fewer than 100 fatalities so far, and a modest death rate of about 3.7 per cent, it may be tempting to write off the current epidemic of public health measures as alarmist overreactions, especially perhaps in view of the millions who are at more immediate risk of disease, hunger and bullets in Iraq. But this is to miss the point about what makes SARS genuinely scary 鈥� its contagiousness.
The virus may not be in the same league on this count as the 1918 flu, but health authorities are right to be working flat out to contain it. The sight of quarantines and facemasks on TV news bulletins might spell short-term jitters on the financial markets and trouble for the airline industry. But failing to curb SARS will spell far worse. Given the time and freedom to spread, this is the sort of pathogen that could eventually infect millions. And because of the shroud of official secrecy that lay over the early stages of the epidemic in China, we have already missed the best chance we will ever have to stamp out the infection without having to rely on a vaccine.
杏吧原创s have been warning for a decade that new diseases would emerge this way. At least governments may in future take the threat more seriously and think twice before indulging in cover-ups. The fear of being thought backward, and the certainty of losing tourists and foreign investors may loom large. But if SARS has proved anything, it is that ignoring a disease can be more expensive than owning up.
But owning up to whom? The international community has weapons inspectors poised to force entry into a country at the first hint that it may possess chemical weapons. But when it comes to disease, we have no international body empowered to take charge, even though the disease may be vastly more dangerous. And prospects for such a body are hardly bright, as national sensitivities are likely to resist the loss of sovereignty it demands.
But we can still create an effective global system for monitoring disease 鈥� a system that would allow the next SARS to be spotted early and recognised for what it is by someone other than a local health inspector scared to admit to head office that there is a problem. And we can still improve the way we respond to surveillance reports. The WHO has built up an organisation that has the potential to mount a highly effective response to outbreaks. Now we need to let it work. That means governments giving the WHO the power to go in and at least observe countries dealing with serious outbreaks.
Some governments also need to drop the pretence that they can do the job themselves. Admirable though the US Centers for Disease Control and Prevention may be, it is not the global authority for infectious disease. Its tendency to act as though it is risks strengthening the resolve of some countries to keep foreign disease experts out.
Finally, we need to find some way to limit the economic penalty for admitting disease. This will be difficult, but as long as new infections shave a percentage point off your growth forecast, as SARS already has in east Asia, governments have a powerful incentive to remain reluctant to own up. Maybe we could encourage whistle-blowers by giving them intellectual property rights over the genetics of the new bug, or a cut of the profits from any eventual treatment.
SARS is a warning shot across our bows. It spreads slowly and may yield to a vaccine. But eventually we will face a rematch with some relative of the 1918 flu 鈥� and it will spread like wildfire. We had better be ready. SARS has shown us that we are not.