Leader
Monday August 18, 2003

It might come back again: that was the sound advice offered by the Beijing Health Bureau at the weekend as the last two Sars patients in China were finally released from hospital. The World Health Organisation says that research must focus on many critical questions. Will the virus behave like many other respiratory diseases, returning when the season grows cooler? Will transmission continue at a level so low as to defy detection, or is the virus lurking in some human or animal reservoir?

In Asia, Sars has delivered a salutary lesson in more than one way. In China, the cover-up (at the cost of many unnecessary deaths) has prompted serious discussion about the need for greater government openness, and has exposed the inadequacy of public health services that had been left behind in the economic reforms. Throughout the Asian region, health authorities now acknowledge the need for better cooperation over emergencies. And, as with the 1998 financial crisis, Sars highlighted the vulnerability of Asian economies to unexpected shock. Estimates that the crisis might cost $10-30bn now seem excessive, but a return of the virus this autumn just as confidence is being revived would be devastating.

The Sars outbreak has sometimes been presented as an exotic oriental tale. The British attitude seemed to be that it could not happen here. Air passengers from east Asia joined the Heathrow throngs without any scrutiny. No special preparations were made for the rigorous barrier nursing which an outbreak would require.

Sars may be a relatively minor threat to international health compared with chronic diseases which kill millions of the young and vulnerable every year. Yet it has highlighted several growing risks in our more crowded globe. One is the danger of "species crossover" which intensifies as the environment comes under greater pressure. Another is the strain put upon even sophisticated medical resources when an exceptional demand is made. Deadly viruses no longer disseminate slowly by land or sea, but overnight by air: health officers everywhere should reflect deeply.

http://www.guardian.co.uk/leaders/story/0,3604,1020654,00.html