Column

What’s the real public health crisis?

Here is the latest public health directive: TRAVEL DIRECTIVE WITH REFERENCE TO SARAS AFFECTED REGIONS

All travel planned over the next 30 days to mainland China, Hong Kong, Singapore, Taiwan, Europe, North and South America, Australasia or indeed anywhere is cancelled forthwith until further notice. The status of travel to these destinations will be reviewed and advised regularly.

This directive is justified by the risk posed by the Severe Acute Road Accident Syndrome (SARAS) epidemic to:

• People travelling in motor vehicles
• People in personal relationships with people travelling in motor vehicles

Over a million people a year are killed in road traffic accidents. Consequently, people must avoid roads until the epidemic subsides. Public health authorities can sit back and watch avoidable death and contagious grief no longer.

Here is the thinking health professional’s alternative public health alert:

RATIONALITY DIRECTIVE WITH REFERENCE TO SARES AFFECTED REGIONS

All public health statements and press releases planned over the next 30 days are cancelled forthwith until further notice. The status of these declarations will be reviewed and advised regularly.

This directive is justified by the risk posed by the Scaremongering Anti-Responsible Expert Syndrome (SARES) epidemic to:

• Impressionable individuals
• Those who have to share the world with people who jump whenever they are told to

As a result of SARES, airlines and hotels are facing bankruptcy, people in Asia are wearing face masks in the street against an apparently hard-to-catch virus and airports are screening passengers for high temperatures. Hospitals with suspected Severe Acute Respiratory Syndrome (SARS) cases are refusing entry to relatives of terminally ill patients, and public authorities are quarantining hundreds of people against their will.

SARES may not have killed as many people as SARS, and will never kill anything like as many as SARAS, yet it continues to cause untold damage to people’s emotional and intellectual health.

Rationality requires perspective:

• 30,000 children die each day from diseases caused by poverty
• Three million people a year die from air pollution
• More than one million people die on the roads each year
• There are 1,500 air crash deaths annually
• As of 11 June 2003, there had been 789 deaths from SARS worldwide since 1 November 2002

So why should SARS paralyse us with fear? Perhaps it will become a global pandemic. Perhaps it will wipe out millions. Perhaps our very survival as a species hangs on implementing the most draconian public health measures we can think of. Or perhaps not. Perhaps SARS has been over-reported. Perhaps the definitive cause of the syndrome will remain unknown. Perhaps it will dwindle in the sunlight of the Northern hemisphere summer. No one knows.

Given what is suspected about SARS’ viral aetiology, and given the syndrome’s currently very minor placing in the ‘bad things that might happen to me’ league table, public health professionals ought to discuss it in a balanced fashion, encouraging people to make informed risk comparisons.

Collective hysteria, xenophobia, and unrealistic anxiety are health problems in themselves, and they have been inflated by public health experts issuing dire and irresponsible warnings about the so-called SARS crisis.

The real public health crisis is the existence of an unaccountable and over-excitable body of self-appointed experts with a chronic addiction to public pontificating. I recommend firm and immediate action to prevent the epidemic assuming plague proportions.