others
are buying vitamins to strengthen their children's immune systems, Americans
with no plans to travel to Asia are snapping up respiratory masks, and a
Wall Street economist has predicted a global recession, all linked to fears
about the new respiratory disease, severe acute respiratory syndrome, or
SARS.
In the absence of conclusive scientific information about the disease,
the public is grappling with it on its own, unapologetically laymen's,
terms. Rumors and angst about SARS, fueled by the Internet and a public
primed for biological apocalypse, appear to be accelerating faster than in
previous disease outbreaks and spreading more widely than the disease
itself.
"I think that SARS could be a potential pandemic," said Monty Tabor of
Halifax, Nova Scotia, who started an e-mail discussion group with the
admittedly alarmist title "SARS: the new plague."
The illness tops the "buzz index" on
Yahoo, the popular Internet search
engine, and rose to second place last week — after Al Jazeera — from No. 8
on the search engine Google's "zeitgeist" list. Countless Web sites are
posting news stories, personal accounts and speculation about the disease.
The variety of responses may reflect an abiding fear of infectious
diseases rooted in a time before inoculation vanquished arch-villains like
polio and smallpox, medical historians said.
The responses may also simply represent any given individual's best
effort to deal with a new unknown — even one that has not resulted in any
deaths in the United States.
"Whenever there is ambiguity, people will search for more certainty,"
said Kathleen Tierney, director of the Disaster Research Center at the
University of Delaware. "When people go to the Web they often get
conflicting information, which generates more searching and just intensifies
the process."
Public anxiety over a novel disease is a familiar pattern tracing from
the Black Plague through the West Nile virus, public health officials said.
Experts said much of the response, including people canceling trips to Asia,
is perfectly reasonable given how little is known about the syndrome.
Other responses are less rational. The Web site Spiritoftruth.org.nz
calculates that the entire United States population will be infected in
about 23 weeks if new cases continue to double every week (defying the
nature of how infectious diseases spread). An Internet site devoted to
collecting urban legends and rumors, Snopes.com, has been fielding a barrage
of e-mail messages about the illness, many of them anti-Chinese (that the
disease originated with people in Hong Kong eating dogs that had it, that
workers at Chinese restaurants have the disease, and so on).
A favorite Internet rumor, that the disease is the result of a genetic
engineering experiment run amok, fits the template of similar rumors that
circulated about AIDS and hantavirus. Perhaps easily dismissed as a standard
conspiracy theory, it may speak to a desire to predict and manipulate the
world that biological reality does not always provide.
"For a lot of people, it's more comfortable to believe that the C.I.A.
cooked something up in a secret lab somewhere and it got out than to realize
that new diseases come into being all the time," said Barbara Mikkelson, who
runs Snopes.com. "You can just fire the C.I.A., or get a better government.
What are you going to do about nature?"
As anxiety — or at least fixation — on the illness intensifies, public
health officials are seeking to calm fears and avoid the kind of panic
behavior that occurred in October 2001, when several letters containing
anthrax were sent through the mail. Some people ended up microwaving their
mail and sought to corner the supplies of the antibiotic Cipro at their
local pharmacies.
"You don't want people to hurt themselves in some other way in an effort
to avoid an infection like this," said Vicki Freimuth, associate director
for communications at the Centers for Disease Control and Prevention. "It's
critical that a credible source out there is giving information about what
we know so people don't turn to other sources that might be more alarmist."
The C.D.C.'s efforts include significantly stepped-up communication with
news organizations, which it hopes in turn will convey accurate information
to the public. As of April 1, the agency had held 1,300 interviews and eight
news conferences, set up for television outlets, which had complained during
the anthrax scare when the telephone conference calls were the chosen
communications mechanism.
Worldwide, health officials have reported more than 2,000 cases and more
than 80 deaths. But of the 100 suspected cases in the United States, no one
has died, and C.D.C. officials emphasize that most Americans do not have to
worry about catching the disease.
Such increased public outreach does not appear to have quelled the furor:
the agency's hot line is now fielding more than 1,000 calls a day, double
the number of just a few days ago and more than at any time during the
anthrax attacks.
Kimberly Wood, 40, of Hazleton, Pa., says that she has been absorbing all
the information she can about SARS, but that nothing has addressed her
concerns. She has been feeding her children extra vitamin C and has stocked
up on powdered milk and canned vegetables in case the disease comes to the
East Coast.
"I almost laughed at the people who were so worried about West Nile," Ms.
Wood said. "I don't worry about anything like this, but for some reason SARS
really got me. So I'm preparing, just in case."
Personal precautions vary by profession, geographical location and risk
profile.
A dental hygienist at an office on the Upper West Side of Manhattan is
asking her patients if they have traveled recently to Asia. If so, she asks
them to put off their appointments for a month.
The American Association for Cancer Research canceled its annual meeting
in Toronto, where several of the cases have been diagnosed. The flight
attendants union has demanded that airlines supply protective gloves and
masks to employees on flights to Asia. The island country of Mauritius, in
the Indian Ocean, has suspended its two weekly flights to Hong Kong for a
month.
Jack Androski, a sales analyst in Manhattan, settled for trucking in
antioxidants after returning from a vacation last week to find his roommate,
a personal trainer, had come down with a cough. "We had a long conversation
about it over the breakfast table," said Mr. Androski, 30. "We were like,
`Is this SARS?' But so far I haven't gotten it."
What drives some of the less-than-rational fears over the illness,
medical experts say, are both a lack of understanding among the public of
how infectious diseases are spread, and an enduring human suspicion, no
matter how much we may understand intellectually, of things we cannot see.
"There's something about germs and bugs being transmitted invisibly that
is a very powerful scary image for people," said Baron Lerner, a historian
of medicine and internist at Columbia University. "These diseases that pose
less of a threat to people than many things they do in their daily lives,
like riding a car, nevertheless cause anxiety above and beyond what is
warranted."
Most people may know that the number of deaths due to infectious illness
has dropped sharply, from over 90 percent before World War II to about 5
percent today. But for reasons that are themselves also largely irrational,
risks that are new and exotic also tend to draw more fevered concern than
those that are more dangerous.
"When a new strain of influenza, which kills on average 30,000 people a
year in the United States, appears, we don't see this kind of attention paid
to it," said Henry Miller, a fellow at the Hoover Institution at Stanford
University. "It's the psychology of risk perception. People have far less
concern about risks that they think they understand."
Ronald Arakelian, a doctor of internal medicine in Turlock, Calif.,
thinks his risk perception is just fine — and he has been calling every
health official in the state to voice his concern about SARS.
"I'm sitting out here in California, which is the epicenter of where this
could break out," Dr. Arakelian said. "The thing I'm trying to understand
is, is the government for whatever reasons, political or economic, going to
allow this deadly virus, and that's not an exaggeration, to spread
throughout this country? I'm not on the lunatic fringe, but am I panicky?
I'm probably the most panicky person here."