The outbreak of severe acute respiratory syndrome (SARS) in Taiwan, which we had thought was under control, took a sudden twist when a cluster of SARS cases emerged at Taipei Municipal Hoping Hospital on April 23. The health authorities issued an emergency order at 11am the next day to seal off the hospital. People visiting their sick relatives and patients collecting routine medication were all confined to the hospital.
Through the long lenses of television cameras, we saw people fleeing in panic. We saw the helpless faces of people exasperated by the sudden deprivation of their freedom and by the fear of death. All this was reminiscent of terrorist hijacking incidents frequently seen on TV.
The health authorities certainly acted in accordance with professional considerations when adopting such drastic measures. But the containment of a disease requires, primarily, the cooperation of all the people, rather than surprise confinement and quarantine. People need to understand the situation if they are to be made to cooperate.
But when the Hoping Hospital incident occurred, the public saw only the fear of those isolated in the face of an imminent disaster and did not know the real situation. Here is a simple analysis of SARS and its social and psychological implications.
In November last year, it was rumored that a strange disease was spreading around Foshan in China's Guangdong Province and had caused some deaths. It gradually spread to Hong Kong, Hanoi, Singapore, Bangkok, Toronto and Taipei after February. In early March, the epidemic started to attract attention from the World Health Organization (WHO) and disease-prevention authorities across the globe. Initially termed an atypical pneumonia, this strange disease ultimately came to be called severe acute respiratory syndrome, or SARS.
Many strains of germs, moulds and even parasites and chemicals can cause pneumonia. Before antibiotics were invented, pneumonia had a high death toll. Indeed, it was the No. 1 killer of humans.
Because pneumonia can be caused by many things and often leads to combination infections, the pathogens in around 40 percent of pneumonia cases cannot be identified. But thanks to antibiotics, most germ-induced pneumonia can be cured, even though its etiologic agents are not recognized. Pneumonia is no longer a major worry to most people.
But the situation remains unchanged for virus-induced pneumonia. There is no effective cure, and patients can only count on sustained therapy to activate their own immune system's response. The SARS outbreak is the result of a virus. But experts still differ over which virus or viruses are responsible.
In addition to the commonly seen viral infection and pneumonia, SARS-affected patients might also suffer breathing difficulties when the situation becomes serious. Ten percent of them need to use auxiliary devices for breathing. If there is no appropriate equipment and care, 4 percent of the patients are at risk of death.
Just when we believed that communicable diseases had been contained or had disappeared, a new epidemic -- which is caused by unknown etiological agents, spread by unknown modes of transmission, can kill, and for which no specific therapy is available -- suddenly strikes human beings. It is no surprise that health experts are worried.