Winds of Change.NET: China and SARS -- A Chernobyl Event?

April 23, 2003

China and SARS -- A Chernobyl Event?

by Trent Telenko at April 23, 2003 2:32 PM

The fall of the Soviet Union was speeded by two events that completely undermined the faith everyone had in the system. The first event was the Chernobyl nuclear melt down. The second was the botched relief effort for the Armenian earthquake. Together they revealed to everyone the shear corruption and sloth of the Soviet system.

SARS by itself is doing everything those two Soviet disasters did and more. That seems to be the sub-text to this Washington Post article.

Given that SARS lives for more than 24 hours outside the human body in snot, sweat, spit, urine and fecal matter, there are a number of things people haven�t considered about total Chinese SARS infections, airline industry liability, and the economic fallout they will cause.

Continued...

First, the Chinese doctor -- Dr. Liu Jianlun -- labeled as a 'superspreader' who infected people in Metropole hotel in the Kowloon district of Hong Kong spent, according to the Toronto Star, three days on a bus going through Guangdon province _WHILE INFECTIOUS_.

Three days on a bus in South China means:

1) There were at a minimum of 40 people on the bus at any one time; and

2) In those three days there were 120-160 people getting on and off the bus that were exposed to SARS while the doctor was a passenger;

3) That bus was contaminated, and was a site for further infection, after the doctor left it and

4) Any bus stop this doctor got out and used the facilities, sneezed, coughed, sweat on fabric covered furniture in the lounge, or had his body products get into air conditioning filters was contaminated.

We know this for a fact because it already happened in the Metropole hotel with other SARS victims. What we don't know how many Chinese Dr. Liu Jianlun infected on the way to Hong Kong because the Chinese authorities are hiding the disease spread rather then doing an investigative follow up on the disease exposure chain The plausible exposure numbers from that trip alone involved tens of thousands.

The Chinese SARS infection count is at least two and as many as three and a half ORDERS OF MAGNITUDE larger than officials numbers given to the World Health organization (WHO). I think there are at least 250,000 and perhaps as many as three million SARS cases in China. The vast majority being unreported. Again, from the Washington Post:

"And, perhaps more worrying for China, there have been reports that SARS has spread much farther into the interior than local governments concede. Local doctors have reported cases and fatalities in Yunnan and Liaoning provinces, for example, although provincial authorities deny any cases.

Gao said he was worried about SARS spreading into rural areas, where the medical system is deteriorating and farmers lack awareness of the disease.

"Once the disaster spreads to these areas," he said, "the consequences will be especially grave."

The Chinese are lying because they don't know how to tell the truth to outsiders or to themselves. Chinese don't report diseases to the Government for a reason. When the Chinese Communists took over in 1949, they �wiped out� V.D. in China. The Communists told those infected by V.D. to show up at clinics or face execution. When the infected showed up, they were executed.

So, whether Chinese had V.D. or not, there was 'officially' no more V.D. in China. While some types of V.D. would kill you eventually. Chinese V.D. victims going for treatment by Communist health providers would get killed immediately, so the infected suffered in hiding. Relying on black market medicine if they were wealthy and connected, or on herbal folk remedies if not.

This culture trait of lying about infectious illness is so well set that WHO will never be able to stamp out SARS in China. The Chinese government seems to have realized this and just took action against its national health minister and the mayor of Beijing. THEY ALSO JUST CANCELLED MAY DAY CELEBRATIONS BECAUSE OF SARS.

The implication for the airlines flying to or in China is grim because any SARS victim who is sneezing or coughing on a plane using re-circulated air will turn it into a concentrated SARS exposure tube. Every surface will be contaminated with recirculated SARS particles.

The same is true to a lesser extent with commuter trains, or modern buildings with central air conditioning, because it is cheaper to recirculate heated or cooled air rather than bring in more outside air that must be environmentally moderated for an additional power cost.

The only sure way -- AKA the bullet proof, American legal liability protection way -- to get every dark, damp or dirty nook and cranny on an airliner disease free is to take the interior of the plane apart, dump anything that has fabric as medical waste and put the remaining fixtures into a 15 minute high temperature steam bath. Replacing the seats, paneling and disinfecting the environmental control system of the plane is going to cost a mint. You would have large amounts of expensive in the West human labor involved.

American juries are not going to believe airlines that use foreign aircraft depots to do the work. Many of which are located in South East Asia.

It will be cheaper for air carriers operating in America to simply abandon Trans-Pacific-to-China air routes to non-U.S. operating air carriers rather than face the American Trial Lawyer Association. Or rather from facing their insurers exercising fiduciary responsibility to cancel air line policies, so as to avoid facing ATLA. If you have no insurance against normal business risks, you will not be allowed to operate in the USA by Federal regulators.

An FAA air directive requiring non-intercourse with China, refusal of service for recent visiters to China or bio-decontamination of planes for SARS may be put in place at American air carrier insistence. This would be both an attempt to reduce their legal liability and a move to assure the public that they can fly in safety on non-Chinese flights.

This outcome depends strongly on how badly the business class public is frightened into telecommuting instead of flying.

If the SARS scare affects the airlines that badly, you will also see the same problem with shipping containers from China. The simple fact is that any container could have been used by sick Chinese illegal immigrant stowaways via bribed Chinese and local port officials.

Sooner or later a de facto if not a de jure American quarantine of China is coming. China's agricultural sector is a breeding ground for new diseases. China's government hides the fact of new disease outbreaks from itself as well as the outside world. At least until these disease outbreaks are spread by the air transportation system to the rest of the world and the Chinese can no longer deny it.

The economic impact of this when the rest of the world acts to quarantine China (and not just for SARS) in self-defense is going to be immense. The Chinese economy lives of rapid exports to the West. Losing the ability to rapidly market its goods to its competitors because of medical security obstacles means China is no longer the lowest cost manufacturer in the world. The Asian "Tiger" economies will regain their edge on China. Places like Vietnam, which don't have China's "lie about disease" cultural meme, may in fact replace China as the world's low cost manufacturer.

As it loses its economic edge, China will also lose its clout in the USA as the American business "China Lobby" gets mugged by the economic reality of SARS and other Chinese diseases. No American business profit equals no political clout on Capitol Hill or in the White House.

The Communist Dynasty in China lives solely on it's reputation of delivering the economic goods. If it loses that. Just what does it have left in the way of legitimacy with the Chinese people? That is why SARS is China's "Chernobyl Event."

Update:

There is an op-ed piece in the LA Times today with a nearly identical title by James M. Goldgeier: Will SARS Be the Chinese Chernobyl?

From the article:

"Just as Chernobyl's effects were not felt until further opportunities to speak out and mobilize became available � thanks to the Soviet government's political and economic modernization program � the effect of SARS on the hold of the Chinese Communist Party may not be known immediately.

But any regime claiming a monopoly on truth can ill afford to raise questions in its society about its ability to provide for the health and well-being of the population.

To date, the Chinese Communist Party has avoided the Gorbachev approach of allowing greater freedom in society simultaneously with its economic modernization program. Because the economy has been growing, it has been easier to block demands for greater openness, and the party has been able to transfer power from one Communist leader to the next.

But evidence that the government cannot be trusted with the lives of its people may provide dissidents with the ammunition they need to raise questions.

In a few years, we may look back on SARS as China's Chernobyl."

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Comments

#1 from Joe Katzman at 3:08 pm on Apr 23, 2003

Hmm, would be interested in calculations that led you to the 250,000/ 3 million figure. And what is the "official" figure now?

Lots of factors in play, from rate of infection from exposure (what %age of the tens of thousands?) to cure rate to spread. China is fertile ground because it's such a tightly packed society with questionable health care. I've seen the "Dark Winter" bioterrorism scenarios, so I know these things can grow pretty fast... but some level of showing the reasoning would be helpful.

Your analysis of the consequences is excellent - but that analysis depends on the level of severity of SARS in China. To save Trent the calculations, has anyone else seen anything like this already performed elsewhere?

#2 from Joe Katzman at 3:39 pm on Apr 23, 2003

This UPI article gives a number of official figures, and also discusses the risks and whether SARS can be controlled in China.

Number of official cases in China apparently sits around 2,000. Hong Kong is probably a better bellweather, since the factors you mention as discouraging reporting don't apply nearly as strongly. They're at 1,500 cases, which may be underreported but probably not by a factor of 10. Take that and go through similarly exposed metroplitan populations, and I could see 25,000 cases... but not 250,000. At least, not right now.

#3 from valchn at 3:55 pm on Apr 23, 2003

After reading your blog I wondered if you and your readers were familliar with Chinese hospitals. Unfortunately I have much first hand experience. I'm not saying this is the way all hospitals are run in China. But this is a combination of my experiences in the 6 or 7 hospitals I have been treated at. They are roughly all the same, depending upon their size. As you walk into the hospital the first thing you notice are the scores of people who are sitting in all of the waiting room chairs with IV drips in their arms. I don�t know how many people are in a score but tens seemed like too little and hundreds was too much.

The first thing to be done is to stand in a line to give the hospital my information. Then they give me a card and a booklet to be filled out by the doctor. I then line up at the window to pay to see the doctor. Next I take the receipt that shows I've paid and line up to see the doctor. The doctor examines me and handwrites orders for an x-ray and to have blood samples taken. Then you guessed it, it is time to go and wait in line for blood to be taken�the person taking the blood doesn�t wear protective gloves or a mask�they put the samples in this state of the art machine and give you the data to take back to the doctor. Next it is off to the x-ray area to wait in line again. They have absolutely no precautions, no leaded vests, etc. and I�m surprised that anyone working there can have children. But the machine seems to be very modern as per the blood machine. Too bad I don�t know any technical terms, at least I didn�t call it a blood thingy. They give me the documentation of what they see, and back I go to wait in line to see the doctor. The doctor looks at everything and handwrites all of the orders for dispensing and administering the medication. Keep in mind that there are at least 10 of us packed into this little room�there is no privacy, no masks, no gloves, and the doctors don�t wash their hands in between patients.

The thermometer that is used under the arm is never washed. The first time I almost stuck it in my mouth. A quick grab by the doctor saved me. The other 40 who are waiting to see the overworked doctor are crowded around the outside of the door for their opportunity to push through to take a number, which is on the desk beside the doctor. It is all done by numbers not at all by who needs help the most. Nervous relatives are jockeying to place their loved one�s medical folder closest to the doctor.

When the doctor is finished writing, off I go to wait in line to pay for the medicine from the Pharmacy. Then I take that receipt to the Pharmacy and wait in line to get the medicine. Then I go back to the doctor and she sends a nurse to mix the medicine and hook me up to the IV. Then it is just sit and wait for the four hours required to let it drip into my body.

During this time I look around and see sons carrying their mothers and fathers, husbands carrying their wives, brothers carrying their sisters on their backs to get to the doctor. Wheelchairs and gurneys usually aren�t available. I�ve never seen anyone at the hospital alone. There isn�t such a thing as going to a doctor�s office like we would in the U.S. Most doctors work in the hospitals.

In some hospitals they have few patients and so they have you lay on a bed while the IV is dripping. The standard of cleanliness is that you use the same bed each time you come. This makes it so that only four or five people use the same sheets and pillow during the week. I�m not certain they are even cleaned after that unless they are soiled. Often the people who would wait with me would lie down on the empty beds. No matter how many times I�ve been stuck with a needle I�ve yet to see any of the medical personnel wear gloves�or wash their hands.

One rule of thumb never move the nightstand�it is sure to gross you out. Last time I moved one so I could set down my bowl of noodles. I learned the hard way that the medicine makes me throw up unless I eat. Behind the nightstand were old chopsticks and wrappers and some spilled food and a bunch of dust bunnies that had been breeding like crazy. The last room I was in also had a leak in the radiator and so it would send out a fine mist of oily water into the air and onto the floor. But the thing that strikes me the most is the restroom. Okay maybe not the most, I was pretty stricken with them taking off peoples� clothes in front of the window where everyone walking past could see and with many other people in the room who were not medical personnel. But it rates right up there.

Everyone carries toilet paper with them because most restrooms don�t provide it. Before walking into the restroom I always say ni hao, and wait, the people rarely shut the restroom doors because usually there aren�t any and in this hospital the restroom is used by both men and women. When I have assured myself that I won�t be embarrassed I walk in. The floor is usually wet, because they mop up whatever splashes outside of the squattie with a mop. (A squattie is a toilet that is an oblong porcelain bowl in the floor.) Disinfectant is not used and it is the same mop used since the hospital opened, so I tread carefully, I would not like any part of me other than the bottom of my shoes to touch this floor. I examine both stalls to see which one is less filthy. I open the plywood door and hang up the IV on the rusty nail. If any part of the room has been cleaned it has been years. There is a basket in the corner of the stall to put in the tissue. It is usually spilling over onto the floor. It is difficult to do the chore with a needle in one hand so I always try to wear what I call my hospital outfit, a jogging suit which suits the situation perfectly. Then it is off to wash the hands. There is a trough with a few metal spickets and no soap. So I do the best I can with the cold water and off I trot back to the bed.

All of that to say the sanitation practices in the hospitals are not conducive to preventing the spread of germs. Other habits that people hold which promote the spread of germs is the sanitation practices in restaurants (although the restrooms are usually a step higher than those in the hospital), the custom of everyone using their chopsticks to eat from the same dish, lack of sanitation concerns when it comes to the food supply, spitting everywhere...inside and outside...(it is bad for health to not do it), and blowing the nose into the hand and then giving the hand a quick shake to fling the offensive matter onto the ground. While walking or riding my bike I pay careful attention to how close I am to someone�you never know what might happen next. In the big cities they are trying to outlaw spitting in certain areas. I think it will be difficult for this country to control any type of infectious disease, unless there is intervention from up above.

#4 from corsair the rational pirate at 4:27 pm on Apr 23, 2003

That was something nice to read while eating lunch. Thanks for more info than I will ever need as any plans I had to visit China have now been... Well, I was going to say "flushed down the toilet" but I guess that doesn't make sense in this situation.

So let me just end this with "ewww".

#5 from Trent Telenko at 4:27 pm on Apr 23, 2003

Joe,

Hong Kong and China's statistics are reported seperately by the WHO. Hong Kong has roughly as many "official cases" as the whole of mainland China.

Main land China had SARS for months before the first case appeared in Hong Kong. A two order of magnitude difference is the minimum you can safely say SARS is being under reported in China.

Hong Kong is densly populated and has lots of sealed modern buildings, so SARS would spread more quickly there than in rural China.

The problem is Shang High (sp?) and most of coastal Guangdon province are just as densly populated and they have closed the schools for two weeks in Beijing to slow the spread of SARS.

What does that suggest to you?

#6 from Tom Holsinger at 4:30 pm on Apr 23, 2003

Joe, official Chinese medical statistics aren't worth the electrons used to write them.

The 250k figure for China overall was my estimate based on recent Hong Kong statistics of 1k known there. SARS started in one part of south rural China, spread to nearby cities, went from there to other rural areas in south China, to other Chinese cities, and to Hong Kong. It was first officially reported by Western doctors in Hong Kong MONTHS AFTER IT STARTED SPREADING. By then it was all over cities in southern China and was out of control.

I am familiar with the math from graphing potential smallpox epidemics. 250k is reasonable. I don't know where Trent gets his 3 million from, but we're at most two months away from that.

IMO the crucial propaganda event would be cancellation of the Bejing Olympics because of an out of control SARS epidemic in China. If that happens, Trent's scenario is plausible.

SARS is rapidly mutating into less lethal and more contagious types. IMO it will won't be a major threat, save to the immune-impaired, in about 12-18 months.

But this will happen over and over until China is effectively quarentined as Trent suggests. The world will be much safer if such newly developed diseases rattle around in China for the 12-18 months it takes to mutate into less lethal varieties.

#7 from Trent Telenko at 5:24 pm on Apr 23, 2003

>I don't know where Trent gets his 3 million
>from, but we're at most two months away from
>that.

Tom,

The math works if you assume the Chinese are lying more extensively than anyone wants to admit.

I don't think the index #1 case in the article who's Toranto Star link I dropped is really the first case.

I think SARS was around a few months longer than that in the rural areas before the official index #1 case.

#8 from B. Durbin at 6:03 pm on Apr 23, 2003

valchn: A score is twenty. ("Four score and seven years ago" = eighty-seven years.) And randomly, a fortnight is two weeks, and a league is three miles.

#9 from John Thacker at 8:15 pm on Apr 23, 2003

As a side note, airlines used to bring in new air on the airplanes, but don't anymore. Sure, it was expensive (that's why they stopped), but in the old days, they didn't have a choice. Why not? Because smoking was still allowed, and smoking made the quality of recycled air so bad that they had to bring in fresh air and heat it.

#10 from Jack M at 8:49 pm on Apr 23, 2003

Maybe I wasn't reading carefully enough...if SARS can only live 24 hours outside of the human body, can't you just park the plane on the other side of the airport for a few days rather than doing the biohazard cleaning?

#11 from Trent Telenko at 11:06 pm on Apr 23, 2003

>...if SARS can only live 24 hours outside of the human...

The term used by the doctors is "at least" 24-hours.

Given the lack of knowledge on SARS, it may be possible that it can survive in airconditioning systems like Legionaire's Disease.

#12 from Michael Walsh at 1:13 am on Apr 24, 2003

China's one-child policy has produced the 200 million man army of the Apocalypse. SARS may be the impetus to stop trading with the West and start taking what is wanted by force?

#13 from Mike Friedman at 1:27 am on Apr 24, 2003

Can we all get real?

First off, Trent, SARS is a virus, not a bacteria, like Legionaire's disease so it can't live anywhere except inside cells of a host organism. So fantasies about it setting up shop in an airconditioning system are just that - fantasies.

Next, all the airlines flying to infected places have already announced that they are no longer recycling air. Think they are total idiots?

Next, unless Mr. Valchn was way out in the boonies or dead broke his description of a Chinese hospital is ludicrous. All the major cities have high quality hospitals charging high quality prices. And any foreigner from a modern country who spends a significant amount of time in China but is unhealthy enough to need to go to a hospital frequently enough to become an expert is frankly an idiot.

Finally, no one is going to abandon trans-pacific routes or stop using Chinese shipping containers. The most that might possibly happen is replacing all the seat covers, etc. Sterilizing the planes is idiotic because anyone going to / coming from SARS infected areas will be / was exposed anyway. Sterilizing or not using containers is totally unnecessary because a ship from Shanghai or Yantian to Long Beach takes (if I remember correctly) 2 weeks, ample time for the SARS virus to die.

#14 from E. Nough at 3:58 am on Apr 24, 2003

Mike, Mr. Valchn may very well be native Chinese, who happens to have lived in the U.S. for a bit.

But more to the point, it makes no difference that foreigners and VIPs in China have access to proper medical care. The majority of the people do not; many in the rural areas lack access even to the abysmal hospitals that Valchn describes. His point is that ordinary Chinese hospitals (and many other places) are breeding grounds and transmission hotbeds for the virus, which is not at all surprising.

#15 from Donovan Janus at 4:32 am on Apr 24, 2003

According to a special aired by CNN a few night ago, SARS is not airborne, and more importantly, requires close physical contact with a person carrying the virus to contract it as well (hence the fact that so many health workers in China have it).

Still seems like more of a local problem to me, rather than a global.

#16 from Richard A. Heddleson at 4:46 am on Apr 24, 2003

CNN said SARS is not airborne? Well I'm relieved to hear that from a reliable source.

#17 from David Vasquez at 5:07 am on Apr 24, 2003

"seems like more of a local problem to me..." - Donovan Janus

4,400 people infected in 26 countries is a local problem?

Here are some hard numbers for you to chew on:

Country: Cases, Deaths, Recovered
-------------------------------------------
China: 2,305, 106, 1231
Hong Kong: 1,458, 105, 522
Canada: 324, 15, 129
Singapore: 186, 17, 110
Vietnam: 68, 5, 53
USA: 39, 0, 0 �
Taiwan: 38, 0, 21

plus 19 other countries...

Source: http://www.msnbc.com/news/885653.asp?0ct=-30h

By the way, the fatality rate has risen from 4% to 5.9%.

#18 from David Vasquez at 5:37 am on Apr 24, 2003

"All the major cities [in China] have high quality hospitals" - Mike Friedman

You sound more like a propaganda spokesman for the discredited Chinese health ministry than someone with an informed opinion.

My wife is from Shenyang, the capital city of Liaoning Province (42 million people), and as an assistent nurse in one of their hospitals, she saw many of the same conditions described by Mr. Valchn, including lack of sterile equipment and gloves, bringing your own toilet paper to the restroom, used toilet paper sitting in baskets (I still gently remind her once in a while to flush used toilet paper down the toilet instead of throwing it in the basket), and doctors not washing hands between patients.

And yes, the thermometer story is likely true - my wife bought a thermometer the other day and nearly fainted when I tried to stick it under my tongue - she explained that thermometers are not always cleaned between uses, and are only used under the arm or in the rectum.

As for the dirty restroom floors in the hospital, that is also quite believable - my wife has a custom of having separate shoes for each room, to avoid tracking what is in one room into another - a practice that I believe she learned due to living with dirty floors. Many Chinese people have an extreme aversion to putting their bare feet on the floor, and it's for a good reason - I doubt this is genetic.

Mike, you are grossly mis-informed if you think the hospitals in China are modern and clean.

#19 from iceman at 12:46 pm on Apr 24, 2003

I read somewhere on the net on how you can get the airlines to turn on the airpacs (airpacs are units that heat fresh outside air) this units cost a lot of money and fuel to run and airlines have been shutting them off to save money and have been doing this for years.

insist that all the airpacs be turned on so that the maximun about of fresh air comes into the passenger cabin.

note that the pilots get maximum fresh air to maintain alertness.

you will be able to tell by smelling the air coming in the vents above the seats.

ask the cabin attendants if all the airpacs are turned on and have a crew member come out and confirm that all the airpacs are turned on.

Tell them that you have a breathing condition and need fresh air and you are worried about the SARS virus as well as others

You will be able to notice the fresh air immediately.

If they wont do it then tell them you are going to ask for an oxygen bottle. They will not want you sitting there with an oxygen bottle so they will usually turn it on.

There are many other diseases that are spread in the airlines confined spaces and recirculated air makes this worse.

#20 from Trent Telenko at 2:47 pm on Apr 24, 2003

>First off, Trent, SARS is a virus, not a
>bacteria, like Legionaire's disease so it can't
>live anywhere except inside cells of a host
>organism. So fantasies about it setting up shop
>in an airconditioning system are just that -
>fantasies.

You have a distinct point. You caught me out with fuzzy thinking.

Be that as it may, the issue with SARS is what we don't know, what we suspect about it, and how we are going to act on that knowledge.

It is suspected but not known that SARS is another Chinese multi-species disease caused by Chinese agricultural practices that put people, birds, pigs and fish and the waste products of them all in close proximity.

If true, that makes SARS a multi-species disease. Just which species does SARS infect besides humans? Bacteria?!? (I sure as hell hope not) That has a direct impact on how we deal with the disease.

The Chinese are in charge of that investigation and we know they are lying for maximum internal political advantage.

We also known disease producing agriculture (the USA is not without sin here) combined with poor cultural hygene and rapid air transportation turns any nation with that combination into a "Typhoid Mary Nation."

That is the real problem with China. How is the rest of the world going to treat China if it will not change to deal with this problem?

#21 from Iagofest at 4:15 pm on Apr 24, 2003

Trent,

Don't worry about the SARS virus infecting bacteria. Those types of viruses are known as bacteriophages or phages and are completely harmless to humans. There's no way a phage could jump from bacteria to humans. Fowls or pigs to humans is a much shorter leap. If SARS were bacterial, it would be much easier to treat (with antibiotics). An antiviral has to be specific for the virus unlike broad spectrum antibiotics.

#22 from Trent Telenko at 7:58 pm on Apr 24, 2003

Iagofest said:

>Don't worry about the SARS virus infecting
>bacteria. Those types of viruses are known as
>bacteriophages or phages and are completely
>harmless to humans. There's no way a phage could
>jump from bacteria to humans.

Thank you for that bit of information.

Now all we have to do is worry over the Chinese government's mishandling of the situation.

Beijing seems to be in the midst of a full blown panic, if the articles the Gweilo Diaries is clipping are to be believed. And the trains out of Beijing are so unhygenic that anyone leaving with SARS is sure to spread it to other passengers and from there all over the countryside.

The interaction between rural Chinese AIDS victims and SARS is sure to be short and fatal.

#23 from Randall Parker at 8:57 pm on Apr 25, 2003

It is hard to forecast how SARS will play out in terms of the development of Chinese politics. Chernobyl has hardly the only factor that brought down the USSR. However, the effect of SARS is going to be far more extensive. I certainly think that A) Chinese government units are still hiding SARS cases and B) SARS has spread into areas of China so lacking in health care facilities that the government has no idea about the extent of SARS infection.

While SARS is no doubt spreading into rural areas keep in mind that the really isolated farmers are at considerably less risk because they don't spend as much time in rooms with other people. Also, as the weather warms people will spend less time inside and that will slow the spread of the disease.

As for a quarantine of China: Physical goods will not need to be embargoed because they are unlikely to serve as carriers for anything that can only survive outside a body for a day. The main problem is that business travellers will not go there. Tech support engineers, application engineers, design engineers, salesmen, managers, and a whole host of other skilled workers won't be going there to make things happen. Foreign direct investment will probably take a big dive.

I think SARS is probably going to cause a large world recession and it will probably kill millions of people. But there are ways to handle it to reduce the economic impact on the industrialized countries. The key tool we need is a very fast DNA-based test for the disease. Then people can be tested before they get on airplanes.

Once people can travel safely then business types and engineers and others can meet in safe zones. Industrialized island nations ought to be able to keep SARS out with enough testing.

I have been doing a lot of SARS coverage on FuturePundit that you can find in my Natural Dangers archive.

#24 from Mark at 7:19 am on Apr 26, 2003

Just for some info, I live in Northern China (ChangChun) right now. At the hospital the beds are not changed between patients, they did wear gloves and used a new needle when they took my blood, no thick lead vest protection when I got an X-ray (Do those things even help?),there are multiple people in the room waiting for the doctor while she is working on you, yes, everyone does carry toilet paper because there is none and it is put into a little basket next to the squater, and the first time I have ever seen (smelled) them use disinfectant anywhere was this Tuesday (April 22nd?) I assume because of SARS.

#25 from Russ Nelson at 3:22 am on Apr 27, 2003

Does anyone seriously believe that SARS isn't going to spread world-wide? I've already run the numbers on my blog.
-russ

#26 from jerald torres at 11:46 am on Sep 19, 2007

hoy?