Public health lesson of SARS: First step in treating is reporting

A sound public health system is dependent on the vigilance of individual physicians.

Editorial. May 19, 2003.

Information is tightly controlled in China. So it is unlikely that world health officials will ever know the full story of exactly how severe acute respiratory syndrome spiraled into a public health crisis in that country before spreading to other parts of the region and then across the globe.

It is clear that Chinese government officials used incredibly poor judgment in deciding not to report the new infectious disease to world health officials until after the World Health Organization had begun to hear rumors that it had taken hold in the country.

The adverse attention and economic repercussions that the Chinese presumably wanted to avoid are now visited manyfold upon their nation.

China reportedly has a reporting system for infectious diseases, but observers don't hold out great hope for its effectiveness. For instance, it is generally accepted that the number of AIDS cases in China is grossly underreported. In any event, it is uncertain what alarm individual physicians could have sounded in such a closed and government-controlled society.

There is little doubt that had the first cases of SARS been detected in this country, United States public health officials would have been quick to alert the world health community. But the depth of that information, and how quickly it could be reported, would have depended heavily here on the good judgment and efforts of individual physicians.

The SARS outbreak, much like anthrax before it, underscores the importance of the individual physician in discovering and containing illness and disease outbreaks in this country.