Reaction to SARS just human nature, experts say

Reuters health Last Updated: 2003-04-07 16:08:56 -0400 (Reuters Health) By Maggie Fox

WASHINGTON (Reuters) - Airlines suspend flights. A medical conference is canceled in Canada. Thailand forces tourists to wear masks. Such responses to a new but so far limited epidemic may seem extreme but are part of human nature, experts say.

Severe acute respiratory syndrome, or SARS, which has killed 100 people worldwide and infected more than 2,600, came to the world's attention just last month and has led to some unprecedented measures.

The World Health Organization issued its first travel warning based on a disease, advising people to avoid worst-hit areas like Hong Kong and southern China.

Hong Kong-based airline Cathay Pacific cut flights to Hong Kong by 14 percent, while Continental Airlines suspended non-stop flights between Newark and Hong Kong on Monday.

Yet SARS is hardly the deadliest disease. It is less infectious than influenza and, with a 4 percent mortality rate, not nearly as deadly as HIV/AIDS, which kills all its victims. Malaria kills up to a million people every year, mostly children.

But SARS is new and that scares people, said David Ropeik of the Harvard Center for Risk Analysis.

"Whether it is an over-reaction depends on whether it is a real threat, and we don't know yet," Ropeik said in a telephone interview. "The characteristic at work here is if it is new, it is always scarier."

POTENTIAL FOR DEVASTATION

Virus expert C.J. Peters, who helped discover the Ebola virus in Africa, said he would take extreme care with SARS.

"I have been involved with a lot of emerging diseases, viral diseases, and this is unlike any other because it is transmitted from person to person more efficiently than any of the others," Peters, now at the University of Texas Medical Branch at Galveston, said in a telephone interview.

"People got lathered up over Ebola because it can be 90 percent fatal, but a huge Ebola epidemic is 200 to 300 cases. It is not transmitted very efficiently."

SARS, in contrast, has spread to 19 countries and is carried by travelers.

Ropeik said tourists who abandoned plans to visit China and residents who fled affected apartment blocks are acting on primordial instincts, not logic.

"It is steeped more in emotion than in fact," he said. "When a threat is new to you, the safest thing is to get out of the way and then you'll live. The more you don't know, the more you treat it as a threat and the better you survive."

Also, he said, the enormous media attention given to SARS has made people more aware of it. "The more you are aware of a risk, the more you worry about it, he said.

That is why no one panics when an especially bad influenza epidemic kills 500,000 people around the world in one year. "The reason we are not afraid of flu is we are not thinking about it," he said.

But people may over-react, Ropeik said. "The danger is, sometimes it can lead us into more risk."

ILLOGICAL REACTIONS

For instance, during the anthrax attacks in the United States in October 2001, thousands of people who were not near an anthrax-laced letter took antibiotics just in case.

Sound scientific evidence shows such actions can lead to the mutation of bacteria in a person's body, making antibiotics less likely to work the next time that person needs them.

People want to have a sense of control over their destinies, Ropeik said. That is why people rushed to buy duct tape and plastic sheeting when the U.S. Homeland Security Department warned of risks of a chemical attack.

People can also under-react. The U.S. Centers for Disease Control and Prevention complains that one-third of Americans who should get flu shots every year do not, even though influenza kills 36,000 Americans a year.

CDC infectious disease chief Dr. James Hughes said the CDC was trying to find out just what the risk of SARS is. He said it was too early to know because it is not yet clear how many people have been exposed to the virus.

Hughes said the CDC had tracked down several Americans who had been staying in the Metropole Hotel in Hong Kong's Kowloon district where a single patient infected seven others. The CDC is also working on surveys of people who flew on the same aircraft with known SARS patients.

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