I’ve finished China Syndrome, Karl Taro Greenfeld’s fascinating account of the SARS outbreak, and again I urge you to get this book.
But I also want to talk a bit about the lessons I draw from China Syndrome, lessons we should bear in mind in preparing for H5N1 or whatever causes the next pandemic.
1. Expect surprises. When researchers identified SARS as a coronavirus, they were astounded—they'd first thought they were dealing with H5N1. Coronaviruses cause some of our colds, but they’re not associated with really nasty diseases. Yet somehow it found a way to infect thousands and to kill 15 percent of its victims.
And these authorities had been just as amazed when the cause of the 1997 flu deaths turned out to be H5N1, a virus that until then had infected only birds.
2. Rudolf Virchow was right. He was the brilliant and abrasive 19th-century Prussian doctor who saw the social factor in health and disease. Virchow famously observed that “Medicine is a social science and politics is nothing else but medicine on a large scale.”
Political decisions in Beijing and Guangzhou ensured the rapid spread of SARS, and then the clampdown. Political decisions in Washington or Jakarta or Bangkok will hasten or slow the spread of H5N1.
3. We won’t behave any differently than Hong Kong did. Greenfeld vividly describes the shutdown of Hong Kong’s economy: planes flying empty into the city, malls deserted, people leaving the city or staying in their cramped apartments. It was an economic catastrophe—not only in Asia, but in Toronto as well.
4. Individual doctors, nurses, and scientists may do more than institutions. If Jian Yanyong, a Chinese physician and survivor of the Cultural Revolution, hadn’t blown the whistle on Beijing’s cover-up, SARS could well have killed many thousands instead of merely hundreds. If Guan Yi hadn’t illegally brought SARS samples out of mainland China to his lab in Hong Kong, the virus could have burned through China until it was unstoppable.
Vancouver could have suffered Toronto’s fate, except for a Chinese nurse at Vancouver General who’d read a Hong Kong paper about SARS. When a patient turned up with SARS symptoms, she alerted the doctors, who put the patient into isolation. We really ducked the bullet that time.
5. Amnesia can be hazardous to your health. Most of us now consider SARS as a nostalgia item, something that gave us a good scare and then went away. That’s a disastrously complacent idea.
Dr. Guan Yi showed that civets were carrying the SARS virus, and on January 6, 2004 he got civets removed from the wet markets of southern China. That single act broke the chain of infection, and we’ve had no case of SARS since then. (Coincidentally, H5N1 got going just as SARS vanished.)
But the love of “Wild Flavour” persists among newly prosperous Chinese, so at some point an infected civet in a restaurant’s chop room will be beheaded, skinned, gutted, cooked, and served up to some customer. That customer, or the cook, or the poor slob who killed the civet, could be infected by the SARS virus and start the whole cycle over again.
And if it's not SARS, or H5N1, it could be some entirely new virus we've startled out of the wilderness in our relentless quest for the Good Life.
I hope I’m making my point: This is not just a hypnotically readable book. It’s a history of how we got to this point, and a warning about where we may end up if we choose to forget the lessons of the very recent past.