The outbreak of a mysterious new coronavirus spreading from the Chinese city of Wuhan is prompting comparisons to the deadly SARS outbreak of 2003.
Officials from the World Health Organization (WHO) are set to meet for a second time on Thursday as they try to decide whether to declare the latest outbreak a global health emergency. Since the first reports of it emerged at the start of the month, hundreds have been infected and more than a dozen have died.
“Five or six” people in Canada are also under observation over concerns they may have been exposed to the virus, according to Health Minister Patty Hajdu.
But despite similarities in the origins and spread of the outbreaks, the two decades between them mean there already appear to be critical differences in how the latest outbreak is being handled by public health officials — and how the risk is communicated to the public.
“This is a completely different era — 2020 is just completely different than 2003 on several fronts,” said Dr. Isaac Bogoch, an infectious disease specialist at Toronto General Hospital.
There’s no proof yet that this latest virus will be as deadly as the SARS pandemic, which killed roughly one in 10 people who contracted it.
Here’s a look at how the cases compare and what public health experts say could help reduce the chances of history repeating itself.
How did SARS spread?
We now know that the first cases of SARS — Severe Acute Respiratory Syndrome — appeared in southern China’s Guangdong province in November 2002.
At the time, it was an entirely new form of coronavirus, which, as the name suggests, is a virus and therefore cannot be treated with antibiotics.
It’s believed to be a mutation of a virus that originally infected only bats and civet cats (a delicacy in China) but then developed the ability to jump from animal to human, and then from human to human directly via infected droplets.
But recognizing the extent of the illness proved challenging, as the Chinese government initially hid the full numbers of those infected despite calls from international epidemiologists for it to come clean about what they called a “coverup.”
Over the course of several months, the virus spread via infected travellers to 26 different countries, with the WHO issuing an alert about the outbreak in March 2003 and urging airports and travellers to be alert.
Still, there weren’t any rules for how airlines should decontaminate from suspected cases until a month after that alert had been issued.
In Canada, the first cases came from travellers from Hong Kong and led to thousands of quarantines in Toronto as the city became the epicentre of the Canadian outbreak, which included 438 cases and resulted in 44 people dying.
Of the roughly 8,000 people infected over the course of 2003, 774 died.
How does it compare?
The new outbreak is similar in that it is also a coronavirus that causes fever and respiratory problems, including pneumonia.
It first emerged in the central Chinese city of Wuhan and has since been spreading into neighbouring cities, provinces and countries, with the first appearance confirmed on U.S. soil this week.
So far, public health officials have documented at least 600 people infected and 17 dead as a result of the virus.
Chinese officials have now locked down three cities, including Wuhan, a regional hub of about 11 million people, preventing people from entering in the midst of the major travel season currently underway as residents in China celebrate the Lunar New Year.
That quick response and acknowledgement of the spread of the outbreak is a clear contrast to how Chinese officials responded to SARS, said Bogoch.
He pointed to the “rapidity” of the response to the current outbreak on all fronts, including the genetic study of the virus and the involvement of the WHO.
“We know the World Health Organization has been involved very early on. The Chinese Centers for Disease Control has been active very early on, and there’s been a lot of communication and openness within different levels of Chinese government and also co-operation, communication between Chinese public health authorities and the rest of the world,” he said. “So, you know, it is a different world than SARS back in 2002 or 2003.”
After the 2003 outbreak, the WHO put together a list of lessons learned from public health officials’ attempts to contain the outbreak.
The organization came up with seven, some of which appear to already be happening in the case of the Wuhan virus.
First and foremost was the need “to report, promptly and openly, cases of any disease with the potential for international spread.”
“Attempts to conceal cases of an infectious disease, for fear of social and economic consequences, must be recognized as a short-term stop-gap measure that carries a very high price: the potential for high levels of human suffering and death, loss of credibility in the eyes of the international community, escalating negative domestic economic impact, damage to the health and economies of neighbouring countries and a very real risk that outbreaks within the country’s own territory will spiral out of control,” the list of recommendations reads.
The second and third recommendations dealt with “timely global alerts” both in terms of general public health and for the operators of means of transportation.
Already, some international airports are setting up additional screening for travellers arriving from China or who may display signs of illness.
In Canada, travellers will face extra screening at the international airports in Toronto, Montreal and Vancouver.
Those lessons also stressed the need for international collaboration among scientists and co-operation from the public in being vigilant for signs of infection, noting these things are vital to containing the spread of illness for which there is no vaccine.
The SARS outbreak also prompted changes in health-care systems around the world to improve the way new outbreaks are handled and shared publicly.
“As a result of SARS outbreaks, many long-standing and seemingly intractable problems that have traditionally weakened health systems are being corrected in fundamental and often permanent ways,” the WHO noted.
“New surveillance and reporting systems, methods of data management, mechanisms for collaborative research, hospital policies, procedures for infection control and channels for informing and educating the public are part of the initial positive legacy of SARS that will shape the capacity to respond to future outbreaks of new or re-emerging infections.”
The seventh recommendation stressed the need for health officials to get better at communicating risk to the public.
Bogoch said those are all points on which Canada seems to have made significant progress.
“I think the other point there is that Canada is also much better prepared now compared to about 17 years ago. So we have preparation and communication strategies involving all levels of public health at the federal level, at the provincial level, at the local level,” he said.
“Since the SARS epidemic, we’ve had several other major public health issues that are of global concern. We’ve had several Ebola virus epidemics. We’ve had H1N1. We’ve had the MERS virus as well … and our ability to co-operate between nations and communicate findings between nations is significantly better.
“So there are protective systems in place to really facilitate a co-ordinated response to infectious disease outbreaks.”