The SARS Epidemic: Challenges To Chinas Crisis Management

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Control measures introduced in April reduced this down to 0. For a case to be considered probable, a chest X-ray must be positive for atypical pneumonia or respiratory distress syndrome. The appearance of SARS in chest X-rays is not always uniform but generally appears as an abnormality with patchy infiltrates.

There is no vaccine for SARS. Isolation and quarantine remain the most effective means to prevent the spread of SARS. Other preventative measures include:.

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Many public health interventions were made to try to control the spread of the disease, which is mainly spread through respiratory droplets in the air. These interventions included earlier detection of the disease; isolation of people who are infected; droplet and contact precautions; and the use of personal protective equipment PPE , including masks and isolation gowns.

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  • SARS is most infectious in severely ill patients, which usually occurs during the second week of illness. This delayed infectious period meant that quarantine was highly effective; people who were isolated before day five of their illness rarely transmitted the disease to others. Antibiotics are ineffective, as SARS is a viral disease.

    Treatment of SARS is mainly supportive with antipyretics , supplemental oxygen and mechanical ventilation as needed. Antiviral medications are used as well as high doses of steroids to reduce swelling in the lungs. People with SARS must be isolated, preferably in negative pressure rooms , with complete barrier nursing precautions taken for any necessary contact with these patients, to limit the chances of medical personnel getting infected with SARS. Some of the more serious damage caused by SARS may be due to the body's own immune system reacting in what is known as cytokine storm.

    As of , there is no cure or protective vaccine for SARS that has been shown to be both safe and effective in humans.

    MassBiologics, a non-profit organization engaged in the discovery, development and manufacturing of biologic therapies, is cooperating with researchers at NIH and the CDC in developing a monoclonal antibody therapy that demonstrated efficacy in animal models. Several consequent reports from China on some recovered SARS patients showed severe long-time sequelae.

    National Development and Reform Commission (NDRC) People's Republic of China

    The most typical diseases include, among other things, pulmonary fibrosis , osteoporosis , and femoral necrosis , which have led to the complete loss of working ability or even self-care ability of these cases. As a result of quarantine procedures, some of the post-SARS patients have been documented suffering from posttraumatic stress disorder PTSD and major depressive disorder. The viral outbreak can be genetically traced to a colony of cave-dwelling horseshoe bats in China's Yunnan province.

    The patient died soon after, and no definite diagnosis was made on his cause of death. Despite taking some action to control it, Chinese government officials did not inform the World Health Organization of the outbreak until February This lack of openness caused delays in efforts to control the epidemic, resulting in criticism of the People's Republic of China from the international community. China has since officially apologized for early slowness in dealing with the SARS epidemic.

    Thus, while the first reports of an unusual outbreak were in Chinese, an English report was not generated until 21 January Despite the successes of the network in previous outbreak of diseases, it did not receive intelligence until the media reports from China several months after the outbreak of SARS.

    Along with the second alert, WHO released the name, definition, as well as an activation of a coordinated global outbreak response network that brought sensitive attention and containment procedures. In early April, after Jiang Yanyong pushed to report the danger to China, [27] [28] there appeared to be a change in official policy when SARS began to receive a much greater prominence in the official media. Some have directly attributed this to the death of American James Earl Salisbury. This revealed problems plaguing the aging mainland Chinese healthcare system, including increasing decentralization, red tape , and inadequate communication.

    Many healthcare workers in the affected nations risked and lost their lives by treating patients and trying to contain the infection before ways to prevent infection were known. The epidemic reached the public spotlight in February , when an American businessman traveling from China, Johnny Chen, became afflicted with pneumonia-like symptoms while on a flight to Singapore. Several of the medical staff who treated him soon developed the same disease despite basic hospital procedures.

    Italian doctor Carlo Urbani identified the threat and communicated it to WHO and the Vietnamese government; he later succumbed to the disease. The severity of the symptoms and the infection among hospital staff alarmed global health authorities, who were fearful of another emergent pneumonia epidemic. Another larger cluster of cases in Hong Kong centred on the Amoy Gardens housing estate.

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    Its spread is suspected to have been facilitated by defects in its drainage system. Concerned citizens in Hong Kong worried that information was not reaching people quickly enough and created a website called sosick. The trajectory of this outbreak is typically divided into two phases, the first centring around her son Tse Chi Kwai, who infected other patients at the Scarborough Grace Hospital and died on March The second major wave of cases was clustered around accidental exposure among patients, visitors, and staff within the North York General Hospital. The official response by the Ontario provincial government and Canadian federal government has been widely criticized in the years following the outbreak.

    The atmosphere of fear and uncertainty surrounding the outbreak resulted in staffing issues in area hospitals when healthcare workers elected to resign rather than risk exposure to SARS. In the experiments, macaques infected with the virus developed the same symptoms as human SARS victims. In late May , studies were conducted using samples of wild animals sold as food in the local market in Guangdong, China. The preliminary conclusion was the SARS virus crossed the xenographic barrier from asian palm civet to humans, and more than 10, masked palm civets were killed in Guangdong Province.

    The virus was also later found in raccoon dogs Nyctereuteus sp. Phylogenetic analysis of these viruses indicated a high probability that SARS coronavirus originated in bats and spread to humans either directly or through animals held in Chinese markets. The bats did not show any visible signs of disease, but are the likely natural reservoirs of SARS-like coronaviruses.

    In late , scientists from the Chinese Centre for Disease Control and Prevention of Hong Kong University and the Guangzhou Centre for Disease Control and Prevention established a genetic link between the SARS coronavirus appearing in civets and humans, bearing out claims that the disease had jumped across species. In December , "after years of searching across China, where the disease first emerged, researchers reported This strain has all the genetic building blocks of the type that triggered the global outbreak of SARS in As they point out, the cave where they discovered their strain is only a kilometre from the nearest village.

    The United States and Western countries import a great variety of products from China. Have the imports stopped? No, although I think there are some delays, as countries have taken steps to disinfect or quarantine incoming goods. Jiang Zemin is still there. He still holds the position of chairman of the Central Military Commission and on foreign policy he undoubtedly will continue to exert a significant influence.

    Also, his supporters are still within the Politburo. Whether Hu has successfully captured not just the throne but the power of the throne depends on how the epidemic progresses. If the epidemic can be contained within the next six weeks or so, Hu can claim victory in the way he responded to the crisis. With this outbreak, however, Beijing is in quite an awkward position.

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    • Taiwan participates in other international regimes, such as the World Trade Organization, without the status of a state. Something similar should be worked out in the case of WHO participation. There is also an opportunity for the United States to step forward. This is one way that we could use our increased influence with China to very positive effect.

      The SARS epidemic : challenges to China's crisis management - Semantic Scholar

      China has been as cooperative as its interests have dictated. Above all else, China seeks stability in North Korea. However, I think that once China understood that the Bush administration took seriously the option to use force, based on the war in Iraq, China worked much more diligently to bring both sides to the negotiating table.

      North Korea had stated quite explicitly that it wanted negotiations to proceed bilaterally with the United States.

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      China is a logical broker between the United States and North Korea. And I think the North Koreans realized that China was becoming impatient with their belligerent approach. China claimed that it was for technical reasons— but everybody, and in particular North Korea, knows that it was a signal to get back to the table. The Chinese want to see this matter resolved. They have a lot of leverage in North Korea, and I think that was the first indication that they were prepared to use it.

      According to this line of argument, while the newer thinkers advocated more openness, Jiang still retained control at the outset of the outbreak and was calling the shots. If these reports of factionalism are accurate, then all of this pressure provided the necessary opening for Hu and his allies to be more proactive and more upfront about what was transpiring in the epidemic.

      The reports today suggest that the epidemic is winding down, if the numbers are true, and that students are going back to school. Tens of thousands of people have left Beijing, have left Guangzhou, have left these major epicenters and fled back to their hometowns, and you see cases of entire towns in more remote parts of China having their own SARS outbreaks.

      Now expectations are closer to six percent. Although six percent is below the seven-percent mark that the Chinese leadership has staked as the minimum necessary for maintaining domestic stability. I think the real issue is that different sectors of the economy have been hit very differently.

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      The service sector has received the largest hit, but problems may also emerge in manufacturing over the next several months. The United States and Western countries import a great variety of products from China. Have the imports stopped? No, although I think there are some delays, as countries have taken steps to disinfect or quarantine incoming goods.

      Jiang Zemin is still there. He still holds the position of chairman of the Central Military Commission and on foreign policy he undoubtedly will continue to exert a significant influence.