Because the etiology of severe acute respiratory syndrome (SARS) is still difficult to ascertain, the medical world does not have a clear understanding of SARS or of appropriate response measures. Unfortunately, on April 24 the public health authorities gave an administrative order to seal off Taipei Municipal Hoping Hospital. All medical workers, patients and visitors were immediately and forcibly quarantined inside the hospital, a measure which led to a major backlash on the part of those affected.
The crux of the dispute was that the hospital didn't institute different levels of quarantine for SARS patients and those individuals who had not been infected. This caused some healthy people who were quarantined to suffer severe discomfort, anxiety, fear and even loss of self-control.
SARS has already had a major impact on the mental health of our society. It has not only highlighted the lack of vigilance among the general public regarding the spread of contagious disease. On the other hand, excessive self-defense measures on the part of the public can lead to a lack of trust between people and even the projection of negative emotions.
People may be misled into believing that pathogens are lurking everywhere. At the same time, while surgical masks have isolated the virus, they have also isolated feelings of friendship, trust and goodwill between people and created enormous "alienation" in society.
There are quite a few members of the public as well as a small number of medical personnel who don't properly understand SARS and therefore contribute to an ineffable and unnecessary sense of panic. Thus I would like to take this opportunity to boost morale by sharing a new interpretation of "SARS," developed by the people of Hong Kong.
"S" is for "sacrifice." SARS is a highly contagious disease with causes that are not fully understood and everyone living in this environment has the potential to become infected. What is certain, however, is that the vast majority of individuals who are infected will produce neutralizing antibodies in response. Only a very small minority of cases result in death, usually because the patient is elderly and has long suffered from a chronic disease. All probable SARS cases must therefore be sent to a hospital for treatment or put into quarantine.
The medical personnel responsible for caring for SARS patients, as well as patients' families, must accept the risk of being infected in order to devote themselves to the care and rescue of those with the disease. Their actions demonstrate the power of familial love and the traditional spirit of noble sacrifice and selfless service on the part of health workers.
"A" is for "appreciation." Both SARS patients in isolation wards and suspected cases quarantined in their homes should be appreciative of the hard-working public health authorities and medical personnel. They should also treasure the sacrifices made by medical personnel and their own family members. Meanwhile, everyone should be thankful to patients and those in quarantine because they have accepted restrictions on their own freedom to safeguard the health of the entire population.
"R" is for "reflection." SARS patients, their friends and relatives, and health care providers should all reflect carefully on their respective roles. Could certain suspected-SARS patients sacrifice their own interests and accept quarantine to avoid spreading the virus to those around them and causing the epidemic to spin out of control? And could those who are close to SARS patients give them timely condolences and encouragement?
Could health care providers rapidly learn to recognize the characteristics of this new infectious disease and then use this knowledge to educate the public?
"S" is for "support." SARS patients are, after all, very unfortunate to have gotten this disease, and through the entire course of their treatment, these quarantined patients will inevitably be suffused with loneliness, anxiety, fear and a sense of helplessness. The public must do its utmost to give them encouragement and support. More importantly, people shouldn't discriminate against SARS patients, making them feel abandoned or like second-class citizens.
Although surgical masks have created a barrier to interpersonal relationships, heartfelt condolences, prayer and concern from the public are still the most important forces keeping SARS patients alive.
Tam Kin-man is the chief of the Department of Family Medicine at the Country Hospital in Taipei.
Translated by Ethan Harkness
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