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http://www.nytimes.com/2003/04/17/health/17SARS.html?ei=5070&en=cc113d02b45ee03c&ex=1052020800&pagewanted=print&position=

In U.S., Fear Is Spreading Faster Than SARS

By DEAN E. MURPHY
 

his article was reported by Jennifer 8. Lee, Dean E. Murphy and Yilu Zhao and written by Mr. Murphy.

SAN FRANCISCO, April 16 — The rumors have been frantic and virtually impossible to contain.

In this city's Sunset District, word spread that the owner of a popular dim sum restaurant was gravely ill with severe acute respiratory syndrome, or SARS. In San Gabriel, a suburb of Los Angeles, a flurry of anonymous e-mail messages said the police had closed an Asian supermarket and a restaurant because of SARS outbreaks.

In Seattle, there was talk that two cashiers at a grocery store had come down with the disease. And in Honolulu, people said a worker at a roasted-meats shop in Chinatown had been infected.

None of the reports were true, but the truth did not matter much. Business fell off as thoroughly as if there were a boycott. In San Francisco, even shops near the dim sum restaurant were shunned until a top county health official appeared on the sidewalk on Monday assuring people that the neighborhood was safe.

Along the West Coast, a region whose identity is defined in large measure by its economic and cultural ties to the Pacific Rim, as well as in other parts of the country like New York City, a psychology of fear has taken hold, particularly in Asian immigrant communities.

The fear about SARS, the mysterious respiratory disease first reported in China, has spread even though no one in the United States has died from the disease. Health officials have seen only limited local transmission in the nation, and the number of probable or suspected cases in the United States is expected to be lowered from 199 to about 30 because of a tighter definition of the disease.

Still, health officials and community leaders say some of the highest levels of anxiety are being reported in states like New York, California and Washington with the most SARS cases or sizeable Asian-American communities.

"We have a large Asian population and a lot of them are going crazy right now," said Dr. Laurene Mascola, chief of the acute communicable diseases control unit for the Los Angeles County Department of Health Services. "We are busy trying to educate people, but the worried mind doesn't always hear. You have to get rid of the anxiety before the thoughts sink in."

The concerns have serious consequences for parts of the American economy. Airlines are cutting back flights to Asia. Travel agents are seeing drops in business. Some delegations are cancelling trips to overseas trade shows. And Chinatowns in cities like New York and San Francisco are suffering, with some businesses reporting a 90 percent drop in revenue from this time a year ago.

Some store and restaurant owners complain of irrational and galling ethnic stereotyping and attribute losses to frightened out-of-town tourists keeping away from Asian-American establishments. But many say the bigger problem is that the Asian-American community is turning upon itself in fear.
 

No Lines in Chinatown

In New York's Chinatown, at dinner hour recently, Jijie Hong, the owner of Shanghai Cuisine, sipped tea and pored over a Chinese-language newspaper in the half-empty restaurant. There used to be lines to get in for dinner every day, he said.

Now only non-Asian customers are coming, Mr. Hong said, not the white-collar, immigrant Asian workers who used to fill the restaurant after work.

"The Americans are more individual-oriented," Mr. Hong said. "If John thinks Chinatown is fine, John will come. But for the Chinese, they act in groups."

Health officials and business people say the Asian immigrant communities are more attuned to what is going on in Hong Kong and China, where they have family and business ties. Trans-Pacific travel, calls and e-mails blur the distinction between what happens here and what happens there.

Much of the speculation about the San Francisco dim sum restaurant, for example, was spread through e-mail correspondence from Hong Kong, the authorities said. Many immigrants in the United States, moreover, are getting their information about SARS from Web sites in Hong Kong, where the authorities are much more alarmed about the disease's spread.

"We have a lot of people who are Web-savvy and bilingual and getting information that is not under our control," said Dr. Susan E. Fernyak of the San Francisco Department of Health. "That is making it much harder."

Public officials are trying to calm the fears. In New York City Mayor Michael R. Bloomberg had lunch today at the Sweet and Tart restaurant in Chinatown with several Chinese business leaders, and made sure that one camera after the next recorded his enjoyment of bay scallops with corn.

Then Mayor Bloomberg held a news conference to emphasize that fear of SARS was hurting business in the neighborhood.

"There are some people that are worried because of SARS," he said. "But there are only 10 cases in all of New York City, not one of them was contracted locally and I think people should not worry about it. I don't worry about it, my family doesn't. It's a great time to come to Chinatown. You can get a table, the food's spectacular."

Still, overcoming the public anxiety, at least so far, has proved nearly impossible, from the strip malls of Monterey Park, Calif., where an elderly Chinese woman this week cleaned her restaurant silverware with sanitary wipes, to the wharfs of Tacoma, Wash., where longshoremen recently refused to unload a ship that they thought carried a crew infected with SARS.

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Some recent travelers to Asia even say they are facing pressures from friends and business associates to quarantine themselves upon their return, even though they show no symptoms of any illness.

Kate Zhou, an associate professor of political science at the University of Hawaii, said that after she returned from a recent trip to China, half of her students did not show up for class. When she produced a clean bill of health from her doctor, attendance went back up.

Meanwhile, in San Francisco's Chinatown, the owner of a ginseng shop said his wife now buys groceries in suburban Marin County to avoid unnecessary contact with fellow Asian-Americans.

"I am just wringing my hands and shaking my head as I listen to all that is happening," said Rose Pak, a community leader here in Chinatown, whose office has been flooded with calls. "If you haven't been seen for two weeks, people inquire if you have SARS. Even educated professionals tell me they are afraid to go out. You tell them that it is junk, and they look at you, `Well, Rose, it is better to be safe than sorry.' "
 

A Presumption of Quarantine

It was in March that the World Health Organization issued an alert calling SARS a "worldwide health threat" and intense news coverage of the disease began. Since then travel to Asia has dropped significantly. Last month, 10 percent of all flights between the United States and Asia for the April schedule were cancelled, with more service cuts announced since then.

Cathay Pacific Airlines dropped one of its two daily flights to Hong Kong from Los Angeles. Other planes are flying with only a sprinkling of passengers.

Many people who still travel say that their biggest headaches come when they return home and feel compelled to enter a self-imposed quarantine of one to two weeks.

Health officials in the United States insist the isolation is unnecessary unless the traveler exhibits symptoms of SARS and a doctor recommends it, but in some cases the professional advice has fallen on deaf ears.

One quarantine is under way in Seattle, where a trade delegation returning from Shanghai was met with enough suspicion to keep a few delegates away from work.

The group had debated whether to cancel the trade promotion trip, but concluded that Shanghai was sufficiently far away from China's SARS hotspots in Guangdong Province, about 1,000 miles to the south. Even so, about 10 of the 100 people booked to make the trip dropped out.

No one got sick, but worries about SARS prompted about a third of the participants to wear surgical masks on the return flight. They also discussed a voluntary quarantine, but decided against it because Seattle health officials said it was not necessary.

Back in Seattle, though, concerns among co-workers led several employers to ask the participants to work from home. Among the telecommuters is a business columnist at The Seattle Times, Stephen Dunphy, who had covered the delegation. "It was like, `Steve, if you don't mind, it would make us all feel more comfortable,' " Kerry Coughlin, a spokeswoman for The Times, said.

Mr. Dunphy did not object, but noted that there had been more reported cases of SARS in the Seattle area than in Shanghai. One night this week, he sneaked into the office to pick up some materials he needed.

"I just did it at a time when no one was here," Mr. Dunphy said. "If they are concerned, I am going to respect that."

Most voluntary quarantines have involved individual travelers, like Shengyi Liu, who decided last week to isolate himself in his one-bedroom apartment in Oakland, Calif., after hearing the worries of friends and relatives.

Mr. Liu, a railroad consultant who had spent a month traveling in China on business, got the first indication that something might be wrong when a friend picked him up at the airport and insisted on keeping the car windows rolled down.

Once at home, his wife, Yanni Zhao, worried about him interacting with their 2-year-old son, Dominic. Mr. Liu said he tried his best to stay away from the boy, but found it impossible. His wife eventually relented, though she has been pumping her husband full of Chinese herbal medicine.

"One of my friends warned me not to let him come back home until seven days later," Ms. Zhao said. "But I felt like it was too cruel to do that. After all, we are a family."

So Mr. Liu has stayed in the apartment, letting his friends and relatives decide for themselves if they want to risk visiting him.

Mr. Liu said that he feels fine, but that he often replays his travels in his mind, wondering whether he had any encounters with the disease. On the return flight, he sat next to a man who began to sneeze.

"I was so scared," Mr. Liu recalled.

Worriedly, he then turned to a visitor and asked, "But you think I look fine, don't you?"
 

Impact Greater Than Sept. 11

Some Asian business owners say the economic fallout of the SARS fears has struck them even harder than the Sept. 11, 2001, attacks and the general economic malaise that followed. Part of the problem is that Asian immigrants are staying away like never before, in some instances creating entirely new shopping patterns.

For the first time in years, Xiangjun Shi, a Chinese immigrant working at a downtown Manhattan investment firm, used a nearby barber instead of having his hair cut in Chinatown. Lunch has become ham-and-cheese sandwiches instead of stir-fried beef over white rice. "Now is the time for us to exercise some control over our cravings for Chinese food and keep away from Chinatown," Mr. Shi said, adding that he considered the area too risky.

In San Francisco, Raymond Chao, who owns the World Ginseng Center, said the one item that many Asian costumers still shop for in Chinatown is a medicinal root called galanga that some say wards off SARS. Mr. Chao sold out his stock of the root and has been unable to get anymore from his supplier in Guangdong Province.

"He just laughed and said, No way," said Mr. Chao, who said his overall business had dropped 90 percent in recent weeks.

Some overseas business relationships are also suffering, as business people cancel or delay travel to China. Irene Young, a travel agent in Castro Valley, Calif., who was born in China and has many Asian clients, said she was advising them to avoid Asia.

"I know it is bad for the travel business, but I am always honest with my clients," Ms. Young said. "The biggest problem is the unknown. There is nothing out there that says if you take some medicine, you will be fine."

An official travel agency for the Canton Fair, a major trade show in China for merchants selling Chinese goods, said more than 80 percent of bookings from the San Francisco Bay Area had been cancelled. The fair opened this week.

One of those who cancelled, James Fu, said the trade fair was crucial for his souvenir business. But he decided not to attend after customers at another business he owns, a beauty salon and spa in San Francisco's Chinatown, said they would stay away for at least two weeks after he returned home to make sure he was not infected.

"In the Chinese community, rumors are really damaging," Mr. Fu said. "I was worried about my business being affected."

The travel fears have even begun to affect product development for United States companies with production facilities in Asia. Gregor A. Berkowitz, vice president of Moto Development Group, a San Francisco company that advises makers of consumer and computer products in Asia, said Moto had cancelled all face-to-face meetings with managers in Asia. Instead, prototypes were shipped by overnight courier and discussed by telephone or through e-mail.

"There is a lot of contingency planning going on," Mr. Berkowitz said. "Certainly things are not happening as fast as they used to. We are not seeing significant progress on a number of programs."
 

Changing Behavior Out of Fear

To deal with the SARS fears, people are establishing new routines that make them feel like they are limiting their risk.

Jill Kawahigashi and her husband Richard Welch, of Fremont, Calif., are adopting a baby and expect to leave on May 5 to pick up the 7-month-old girl in central China.

Ms. Kawahigashi's parents have expressed concerns. But the couple, who started the adoption process three years ago, cannot imagine delaying the trip now.

"People understand — especially other parents — that nothing can stop you from picking up your child," she said.

Still, the couple are trying to figure how to travel smartly. They have already shortened the trip by canceling sightseeing tours. They have found a flight that does not go through Hong Kong. And they are considering advice from the American consulate in Guangzhou to send only one family member to pick up their daughter's visa.

At the Kin On Health Care Center in Seattle, a nursing home that caters to Asians, employees often wear gloves, but they are now being required to wash their hands for two full minutes when they start work. A photocopied handout reminds them to scrub the backs of their hands vigorously, between fingers and underneath fingernails. Anyone with a cough must wear a mask.

Amid it all, some people are also trying to figure out emerging social protocols. Is it rude to cross the street when someone nearby coughs? Can you disinvite a dinner guest who comes down with a cold?

Even friendly conversation is under review. Aimee Gerry — one side of her family is of Japanese descent — says she often jokes with her white friends about SARS. She said that if someone coughed, "people will point to the person and say, `SARS!' " But that kind of kidding is not well received among her Asian-American friends.

"I cracked a joke to my Korean friend, and he's like, `That's not funny,' " said Ms. Gerry, who lives near Los Angeles. "It's a totally different discussion for Asian-Americans. It's a topic of concern."

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