SARS: Panic or plague?

Misinformation spreads even faster than the virus itself.

Fear of an epidemic can travel and mutate even faster than the deadly disease itself.

During the early days of the SARS outbreak, an intensive-care specialist at a hospital in Hong Kong turned to mailing lists to distribute his stark, first-hand reports. "This pneumonia is out there in the community," Tom Buckley told the Critical Care Medicine mailing list in a widely-distributed message on Mar. 24. "The numbers are increasing daily, and a third hospital is being prepared for the influx. How big this is going to get is anyone's guess." Buckley warned: "HK Government is downplaying the whole thing presumably because of the economic implications."

Buckley was prescient. Since then, cases of SARS (Severe Acute Respiratory Syndrome) in Hong Kong have leapt fivefold, from 260 to a current total of 1,268 infections. Now the beleaguered community is shunned by travelers, its GDP projections are shrinking by the day, and surgical masks are as common as cancelled airline flights. Tuesday's death of nine SARS patients in Hong Kong, five of whom were younger than 45 years old, set a sad new single-day record.

SARS is the first epidemic of the Internet age, preying on the fact that as information becomes more communicable, rumors become more communicable too. A teenager's Web hoax claiming Hong Kong's borders would be closed prompted runs on canned foods and toilet paper. A supermarket owner in Sacramento spent two weeks arguing that, contrary to rumors, neither he nor his family is infected with SARS, and his stores are entirely safe. On Tuesday, a Sacramento city councilman tried to quell panic by bravely chewing a ceremonial Granny Smith apple from the produce section in front of reporters.

You can almost pity officials saddled with the competing incentives of distributing vital medical details while trying to stave off panic. So far the World Health Organization and the Centers for Disease Control have done a reasonable job, posting transcripts of briefings and daily casualty counts on their websites. This week the CDC placed online the entire nucleotide sequence of the virus suspected to be responsible for SARS. The WHO is coordinating the Global Outbreak Alert and Response Network, which links 11 research labs in what is probably the most aggressive international epidemiological effort since the response to AIDS.

A still-mysterious disease that spreads through unknown means may cause governments to overreact and unreasonably limit rights to privacy, property, and freedom of movement. President George W. Bush has signed an executive order triggering a 1917-era law that hands the Feds the power to appoint quarantine officers, create quarantine stations, and detain Americans "reasonably believed to be infected" with SARS. This power can be used carefully or wildly abused, and it's far too early to make predictions. The good news so far is that of about 200 cases of SARS in the U.S., there have been no deaths, and a chart prepared by the New England Journal of Medicine indicates that the worldwide SARS growth rate is closer to arithmetic than exponential.

Other perils exist. Politicians tend to view any crisis, real or illusory, as an opportunity for pork barrel spending and other dubious pet projects. It's no coincidence that a bill that Bush signed on Wednesday—ostensibly funding the war on Iraq—ballooned to $5 billion more than he had requested. Who would have guessed that "Assistance to Agricultural Producers Located in New Mexico for Tebuthiuron Application Losses" and handing the Federal Highway Administration an extra $3 million for administrative overhead helped to win the Battle for Baghdad?

State legislators are equally culpable. Take a proposal that goes by the unflattering name of MEHPA, the The Model Emergency Health Powers Act, which began appearing in state capitols soon after the anthrax scare of late 2001. It expands upon emergency authority that many cities and states already have arrogated themselves during times of crisis, making explicit what powers public health officials will have. Among them: Property and land can be seized as "necessary to respond to the public health emergency;" the state can also forcibly vaccinate Americans against suspected diseases, and quarantine those who refuse. No court order is necessary to detain someone; the language says: "The public health authority may temporarily isolate or quarantine an individual or groups of individuals through a written directive." Backing the proposal are the CDC, the National Governors Association, the National Conference of State Legislatures, and the National Association of County and City Health Officials.

Yet that's a positively Rothbardian approach compared to what some other nations may try if SARS continues to spread. Singapore's government has imposed strict rules on people quarantined on suspicion of having the disease. Among the measures is a requirement that surveilance cameras will be aimed at their doors, and after a first offense of breaking quarantine, the unlucky residents will be wired with electronic wrist tags. Toronto, the city outside of Asia that has been hardest hit by SARS, also is considering tracking bracelets for people who break quarantine rules.

In China, the communist government claimed for months that SARS was limited to a handful of cases. As recently as last week, Bejing officially, and implausibly, denied the existence of hundreds of SARS patients in hospitals already visited by Western journalists. Then on Monday, China Premier Wen Jiabao took the unusual step of saying that while progress had been made in limiting the spread of SARS, "the overall situation remains grave." (This is the same government that last year, in just one day, upped its official estimate of HIV infections from 30,000 cases to 1 million.)

In this climate of official deception, misinformation about SARS has been spreading so efficiently it would do the common cold proud. The Chinese seem unwilling to trust government proclamations, relying instead on rumors that have spurred demand for quack herbal remedies in Bejing. Residents of China's Shanxi province place their faith in steamed vinegar. And a New York Times article on Thursday showed that America is not immune from this 21st-century information contagion, saying that high levels of anxiety can be found in states like New York, California and Washington that have the most SARS cases or sizeable Asian-American communities. New York City Mayor Michael Bloomberg was worried enough about public panic to dine in a Chinatown restaurant on Wednesday, then hold a press conference about it.

Well, it might work. It might not. At a time when misinformation is catching, it may not be wise to bet against SARS.