Ten Years after SARS: Five Myths to Unravel

Ten years ago, China was dealing with an outbreak of the deadly SARS virus, which originated in Hong Kong and ending up killing 775 people worldwide. During the crisis, the government was widely criticized for its initial news blackout on the disease, which exacerbated the spread and severity of the epidemic. Ten years later, the Council on Foreign Relations’ Yanzhong Huang reflects on lessons learned from the crisis and five myths that he wants to dispel in order to “better prepare for the next disease outbreak”:

Myth #1: Strong political commitment and a centrally coordinated response was the most important factor in the control of SARS in China.

Not really. Once the initial dilly-dallying gave way to decisive and swift state action, resources were effectively mobilized against the epidemic and policy coordination was significantly improved. Yet many of the measures widely credited for stopping the spread of the virus, such as isolation and quarantine, were only implemented after the virus reproduction number or Rt—a critical value below which sustained transmission of the virus is impossible—dropped below one, or when the epidemic was already dying down. According to a study published in Tropical Medicine & International Health, those decisive government measures might have played a role in speeding up the disappearance of SARS or preventing the outbreak in yet unaffected regions, but they “contributed little to the factual containment of the SARS epidemic.”

[…] Myth #3: Government cover-up is no longer a major concern in the post-SARS era.

Not true. The SARS crisis has forced the Chinese leaders to take steps to be more open and transparent in disease reporting and information sharing. Yet as shown in the 2008 hand, foot, and mouth disease (HFMD) outbreak, local government officials found it difficult to adjust their existing behavioral patterns for crisis management, which still value secrecy and inaction. Similar communication problems also bedeviled the government’s response to the 2009 H1N1 outbreak. China’s SARS crusader Zhong Nanshan publicly expressed his distrust in government data on H1N1 fatalities. Political expediency continues to be put before epidemiological reality in sharing disease-related information with the public. The health authorities stopped updating the spread of H1N1 cases between September 30 and October 9, apparently fearing that reporting H1N1 deaths would ruin the celebrations planned for October 1, the National Day that marked the 60th anniversary of the People’s Republic of China. That said, government cover-up and inaction are not unique to China; India’s response to the 2012 dengue fever epidemic was riddled with similar problems.

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