about Epidemiology & the department

Epidemiology academic information

Epidemiology faculty

Epidemilogy resources

sites of interest to Epidemiology professionals

Last Updated

31 Mar 2003

Source: Wall Street Journal, March 31, 2003


Quarantine China

The latest news on the killer pneumonia that has so far shown up in 15 countries includes the death of the doctor who first identified it in Hanoi, the closure of two Toronto-area hospitals, and a U.S. Centers for Disease Control warning that travelers stay away from China, Hong Kong, Singapore and Vietnam. As of Saturday, 54 people had died.

There's still a lot of mystery about this disease, which originated in southern China and has no known cure. But there's no mystery about why it is spreading world-wide. This is the price of China's initial cover-up.

It's clear that China was grossly negligent in refusing to sound the alarm about the disease, actively suppressing information from its own citizens and not bothering to ask for outside help in identifying it. Even today it refuses to give the World Health Organization full access to the information it needs.

Now health officials outside China are researching the virus on their own and trying to stop the spread. But individual travelers continue to carry the disease from China. For example, a 29-year-old Singaporean woman returned to the island state last week after being infected on a business trip to Hong Kong and Beijing. These new carriers threaten to negate the best efforts of the world's doctors.

Given Beijing's refusal to take even elementary public health measures, some hard choices are called for. The most effective way to halt the spread of the disease would be for other countries to suspend all travel links with China until it has implemented a transparent public health campaign.

Such travel bans would need to include Hong Kong in order to work. In the past two weeks, Hong Kong has proved to be a major transit route for the disease, and unfortunately the territory's government was slow to realize the need to quarantine those exposed to the virus and tell people how to avoid the disease. It now has started to educate the public and will start a quarantine program today. (Singapore did so last week.) But until these measures have had a chance to work, it would be prudent to suspend flights into and out of the city.

Such a policy is justifiable on several levels. First and most important is the protection of human life. We now know that the disease is much more contagious than initially thought. It spreads through water droplets that linger in the air long after an infected person coughs. Victims can also leave the virus on objects they touch, so that others who touch the same objects can be infected if they then touch their eyes or mouth.

The disease leaves its victims in serious condition, dependent on intensive medical care for their survival. The symptoms can be brought under control, but only if the disease is caught early and even then victims who suffer from other conditions are at grave risk of dying.

Isolating a large country would certainly cause economic losses for individuals and corporations. But these have to be weighed against the likely cost of doing nothing. For that we have to look at Hong Kong, which shows what could happen in New York, London or Tokyo. Schools are closed. Shops and restaurants are deserted. Companies are asking staff to work from home or even moving them abroad. The costs in this one city alone will likely be measured in the billions of dollars even if the epidemic is quickly contained.

As to panic, information and resolute action are the best antidotes. In transparent Hong Kong, people are angry that their government waited so long to decide on strong measures but there are no signs of panic. Families and businesses are making informed decisions based on the latest facts. The start of a quarantine is actually having a calming effect. If restricting movement out of China causes alarm there, Beijing always has the option of following Hong Kong and belatedly adopting measures that would show the population that their leaders have a plan to resolve the problem.

This isn't the first time that Beijing has swept health problems under the rug. When AIDS spread in the late 1990s as a result of blood sellers extracting plasma and then reinjecting pooled blood back into donors, Beijing suppressed information and did nothing even as the foreign media reported the horrific death toll. This time China's problem is also the world's, and a global quarantine may be the only way to get it to act responsibly.