The first cases of SARS occurred in the Guangdong province of China in November of 2002 and then spread to Vietnam, Hong Kong, and Canada in February 2003 (Marley, et al,2004). In the end SARS infected around 10,000 individuals and killed approximately 1,000 people. This epidemic was not as devastating as it was predicted to be.
Developmental Milestones/Developments to Date:
Current Assessment/State of the Field:
During the epidemic the Center for Disease Control, the Department of Health and Human Services, and the Institute of Medicine looked to reform health laws since the majority of these laws were out of date. Since some laws dated back to the 19th and early 20th century, many of these laws did not cater to certain infectious diseases. Lawrence Gostin during a hearing in 2003 stated that “with these laws being so outdated, we do not have clear criteria for action or procedural due process.” It was also noted that it would become difficult for states to work together to fight SARS since they have different health laws.
Tsang, Kenneth, W., et al., “A Cluster of cases of severe acute respiratory syndrome in Hong Kong,” THE NEW ENGLAND JOURNAL OF MEDICINE, Vol. 348, Iss. 20, May 2003, pg 1977
Quarantine, Contact Tracing, SARS
Gerberding, Julie L., “SARS: How effective is the state and local response?“, Hearing before the Permanent Subcommittee on Investigations, May 2003, pgs 10-12.
- “As of May 2003 globally there was 7,700 cases of SARS and 643 deaths.
- “The epidemic in the United States was controlled by methods of isolation and quarantine.”
- “Furthermore active monitoring done by health officials on people exposed to SARS have been occurring in hospitals or at their homes.”
- “Communication has been critical at the local and state levels”
- “We have learned from SARS that the United States can respond quickly to define the virus, develop tests, and sequence it.”
- “The question is are we quick enough to contain it if we end up having a highly infectious person who sets off a cascade of transmission.”
- “Containment of SARS has been successful even in developing countries.”
- “The perceived weakest link is that SARS could spread so entire public health system needs to be strengthened.”
Biosecurity, Developing Countries, SARS, Quarantine
Osterholm, Michael T.,”SARS: How effective is the state and local response?“, Hearing before the Permanent Subcommittee on Investigations, May 2003, pgs 14-16.
- “There is a critical need for our country to prepare its homeland security against human-made and Mother Nature-made biological attacks.”
- “There is a growing threat of emerging infections and use of biologic agents as a form of terrorism.”
- “Federal agencies such as the Department of Heath and Human Services, and Department of Homeland Security have been responding to such threats.”
- “The United States has fortunately been lucky as compared to places like Toronto, Canada, who has seen the worst of the SARS pandemic.”
- Their country is experiencing impacts on mortality rates, as well as economic and social impacts.”
- “SARS is a disease transmitted via respiratory route that has now seeded itself in a sufficient number of humans which could make elimination impossible.”
- “It is imperative that we coordinate the roles of Federal, State and local agencies.”
- “We also need to understand the capabilities of our health care delivery systems and the private sector in responding to this problem.”
Bioterrorism, Pandemic, SARS, Quarantine, Canada, Homeland Security
Gostin, Lawrence O., “SARS: How effective is the state and local response?“, Hearing before the Permanent Subcommittee on Investigations, May 2003, pgs 36-38.
- “The CDC, the Department of Health and Human Services, and the Institute of Medicine have recommended the reform of public health laws due to the fact that these laws are extremely out of date.”
- “Some of these laws date back to the 19th and early 20th century and as a result they have a number of serious problems.”
- “These laws have ineffective powers for novel infectious diseases.”
- “Some of these laws may even be in violation constitutional laws because most of these laws were passed before the Supreme Court’s modern constitutional era.”
- “With these laws being so outdated, we do not have clear criteria for action or procedural due process.”
- “These laws are also inconsistent, and in the midst of dealing with an epidemic it will be hard to work with other states when every state has different laws.”
- “After September 11th, the CDC asked the Center for Law and the Public’s Health to draft an emergency powers act which is known as the Model State Emergency Health Powers Act.
- “This act has taken a role as a checklist that twenty-two States and the District of Columbia use.
- “We still need more states to adopt this act or we will run into serious conflicts.”
- “A public heath law is currently being drafted that would apply to SARS and any other infectious diseases.”
- “The Board on Health Promotion and Disease Prevention came out with a report called “The Future of the Public’s Health in the 21st Century” which states that public health infrastructures have major issues to tackle.”
- “These places have insufficient laboratory structures, workforce development, surveillance capacity, and data systems.”
- “The reason for this is that the US spends less than 5 percent of its health dollars on public heath.”