In 2003, a Singaporean woman went to Hong Kong to shop, but returned to Singapore instead with a deadly virus from mainland China. Soon, she was so sick that she was warded in a hospital, showing no signs of recovery. Family and members of her church all came down to visit her – oblivious to the fact that they were exposing themselves to SARS.
While the woman eventually survived, her father, mother and pastor passed away due to the exposure. In fact, almost a hundred cases of SARS in Singapore have been traced back to this one woman alone – with health authorities dubbing her a “super-spreader.”
There is a good news though: this wouldn’t technically be possible today. Governments’ experiences with SARS, and the nature of the new Wuhan Coronavirus makes it a bit different from the SARS epidemic.
Here are four reasons why.
1. Yes, it’s true the Wuhan Coronavirus seems to spread faster
The scariest thing about the coronavirus seems to be its rate of transmission.
In the two months since the first reported case of the Coronavirus, there have been 6,065 confirmed cases. This is alarming, considering that it took the SARS epidemic more than six months to reach the same levels of transmission. This faster rate of spread may be attributed to two things.
Firstly, we don’t know how the virus is spreading as of yet. Early studies suggest that it jumps between people who are in close contact, probably when the infected person coughs or sneezes. Chinese scientists also suggest that people are infectious even during the incubation period – the 14 days that it takes between the time of infection and symptoms. In contrast, people with SARS and Ebola are only contagious when the symptoms appear. Thus, since health officials aren’t entirely certain how the virus works, it might be harder to stop further spread.
Secondly, China’s meteoric economic rise over the last two decades has led to more citizens traveling abroad. As per Chinese government figures, outward bound tourism has increased by over 9 times since the SARS epidemic in 2003. In fact, China is the world’s top spender in tourism, accounting for over 21% of the market. In terms of the virus, this means more vessels and routes of transmissions. Even the first confirmed patient in Singapore was a 66-year-old tourist from Wuhan.
2. But, the virus is way less lethal than SARS (for now)
As of January 29, 132 out of the 6,065 coronavirus cases have led to deaths. That is approximately a death rate of 2.17%. Contrast that to the total 9.56% death rate of SARS, and it seems like the new coronavirus is less lethal. The people who have died as a result of the coronavirus have also had underlying medical conditions. They had weakened immune systems from issues like hypertension, diabetes or cardiovascular disease.
This doesn’t mean that everything is alright though. It is common for viruses to mutate and adapt to changes, and the coronavirus is no different. Last week, Chinese health officials announced that the Wuhan virus was already mutating, underscoring efforts to control the outbreak. An altered strand of the virus might also be more dangerous and lethal – but at this point these things are impossible to predict.
Some have also pointed out that the calculation of these death rates might be simplistic. To them these statistics are unreliable as there seems to underreporting and be a shortage of test kits in China.
3. China’s response to the situation has been (mostly) encouraging
China was widely criticised for its handling of the SARS outbreak – supposedly covering-up the virus’s existence to maintain stability. Newspapers avoided reporting on the disease, and the information released initially were statements from officials, telling citizens that there was nothing to be worried about. It took about 4 months for the country to officially tell the WHO that there was an abnormal new infection. This delay probably resulted in more loss of lives and political prestige for China.
Fast forward 17 years and the response couldn’t have been more different. The WHO was informed about the new disease in its primitive stages on December 31, and China Central Television confirmed that it was a coronavirus by January 9. Two days later, Chinese scientists (who have yet again benefited from China’s economic rise) shared the genetic sequence of the new virus online. The government also seems to be proactively trying to contain the spread of the virus, locking down over 15 cities, home to a total of 46 million people. These steps have led the WHO to praise China for its transparency and swift action.
While these policies might have been implemented quickly on a national level, some argue that local officials slowed response efforts. A New York Times article talks about how China’s “rigidly hierarchical bureaucracy discourages local officials from raising bad news with central bosses whose help they might need.” In other words, local bureaucrats might have been afraid of escalating the issue early on, fearing political repercussions. This theory might hold water considering that reported cases have skyrocketed after President Xi Jinping demanded that all parts of the Chinese government “put people’s lives and health first,” on January 20.
4. Governments have learnt from the SARS outbreak
Many comparisons have been drawn between the SARS and Wuhan coronavirus outbreaks, and rightfully so. The genetic sequence of the new coronavirus was “80 percent similar” to the SARS virus. Even the symptoms are similar – with both leading to fevers, coughing and shortness of breath. Thus, the lessons learnt from the SARS outbreak could be useful for an effective response to the Wuhan coronavirus.
Singapore’s experience with the SARS virus, showed the importance of early surveillance and quarantine. 5 super-spreaders (people who are more likely to infect others as compared to a typical infected person) accounted for 103 of the 205 probable SARS cases because of a delay in identification. As such, a “wide-net” surveillance and quarantine policy has been employed this time, with the 14-day compulsory leave of absence for returning travellers from China, and mandatory quarantine for Hubei travellers.
Another key finding was that intra-hospital transmissions were a major cause for SARS’s spread. This meant that when patients were brought from one hospital to another to be diagnosed, they infected other patients and healthcare workers. To counter this issue, it seems as if transfers between hospitals are being minimised this time around, with patients being warded in the hospital of diagnosis. Compulsory use of personal protective gear and masks are also being enforced for all healthcare workers.
While Singapore and the world as a whole is better prepared to deal with crises like these, it’s important to note that there are many variables at play. We don’t know how long a vaccine is going to take to develop, or if the virus is going to mutate. We don’t know the extent to which it is going to spread, or even the mechanics of transmission. Thus, even though signs point to a less devastating outbreak, it’s important that we stay cautious and alert.
This article will be updated as the situation evolves.
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