SARS: An Opportunity Within an Epidemic

On February 19, 2003 when an unsuspecting nephrologist was admitted into a Hong Kong hospital for what seemed to be an innocent respiratory infection or, at worst, a bad pneumonia, the world witnessed the public birthing of a new disease. Now in its 12th week, researchers have discovered that SARS (severe acute respiratory syndrome) is caused by a new coronavirus, which comes from a family of viruses that cause the common cold. The viral protein structure, the clothes it wears, have been photographed; its genetic code has been unraveled and most importantly its likely source and mechanism of spread has been established.

Yet in its early journey, this new virus has left more than 480 people dead, caused a loss of billions of dollars, and tilted the ever fragile airline industry towards bankruptcy. What good can come of this?

Though it may seem hard to believe, the SARS epidemic may lead to three critical changes. First, the research may spin off a possible cure for the common cold. Second, collaborative efforts will bring about greater respect for WHO (World Health Organization, a United Nation’s agency.) Lastly, an averted global SARS disaster will galvanize the world towards a war against emerging diseases just like the war against terrorism.

Coronaviruses never hailed much attention. There was no glory and no dollars in finding the cure for the common cold, something which could be managed by a box of tissues, warm soup, and few extra hours of rest. Hence, there are no vaccines or antiviral treatments.

But with SARS as an imminent threat to millions, researchers have a mission. I can hear the voice over the speakerphone and the theme song of the 70’s TV show “Mission Impossible” playing. “Team – you have to find the infectious agent causing these deaths and illnesses, control and contain this disease, and ultimately find a cure – may it be pills or a vaccine. The resources of the world are open to you.” The search will inevitably lead to potential drugs or even a vaccine for SARS and since the SARS virus and the common cold virus are cousins, this will fast-forward us in our search for the treatment for the common cold.

HIV (human immunodeficiency virus) is a case in point. In 1981, the HIV epidemic jump-started the public, political and research industry (in that order) towards a cure against viral diseases. Though there is still no successful vaccine today, doctors routinely dispense a drug cocktail that is more tolerable and provides greater longevity than cancer chemotherapy in most cases. With another jolt by SARS, within years we will move decades ahead in the treatment of viral diseases.

Secondly, the SARS epidemic has engendered in us, especially in Americans, new and necessary respect for WHO, the United Nations’ agency which looks after our health. Even though the Centers for Disease Control has unparalleled technical know-how, it has no authority to parachute into Hong Kong and contain an epidemic before it reaches the United States shores. The WHO has the respect, the relationships, as well as epidemiologists, physicians, and researchers planted in every country to do this. It was a WHO doctor, Carlos Urbani, 46, who discovered the SARS epidemic and ultimately died from it. The rapid and unprecedented response by WHO (declaring China, Hong Kong, other nations and for a brief time even Toronto as no-travel zones) deserves a standing ovation. I dread to think what political pressure David Heyman, WHO’s director of communicable diseases, and the UN director general must have faced - knowing that Canada alone would face additional loses to the estimated $30 million per day from the SARS epidemic.

Lastly just as in the case of 9/11, we will never be the same in the post-SARS world. In Southeast Asia, new and emerging diseases are lurking. The SARS virus emerged from animal reservoirs from the food market of Guangdong province in Southern China where animals are housed, slaughtered and sold in an open market. The SARS virus likely jumped from a chicken or a pig to a food handler and then to his co-workers, family, health care workers and then to the nephrologist who traveled to Hong Kong, and then to an elderly couple who were hotel guests from Toronto staying on the same floor as the nephrologist. Just as we insisted on sending UN inspectors in Iraq, we will insist on sending WHO inspectors in countries such as China at the next disease outbreak.

Though the SARS epidemic has elevated our fear level, it will ultimately reap rewards. I am convinced that if we had today’s technology and know-how at the birthing of old diseases such as malaria, tuberculosis and HIV, we could have prevented suffering of millions every day. With such attention, these old diseases may haven fallen to the same fate as smallpox, ebola, and hopefully SARS. Eradicated or contained.

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