So far, the U.S. has been lucky. It has been nearly six months since the SARS outbreak emerged and more than six weeks since the illness spread from its birthplace in southern China to put the world on alert. Yet with more than 4,800 cases in at least 26 countries to date, a disease that has rocked Asian markets, ruined the tourist trade of an entire region, nearly bankrupted airlines and spread panic through some of the world's largest countries has largely passed the U.S. by. Hospitals and schools were shut down last week in Beijing, thousands of people were put under quarantine, and rumors flew through the capital that martial law was about to be imposed. But in the U.S., only about 40 people are believed to have severe acute respiratory syndrome, or SARS. The number of cases doesn't seem to be growing, and--most reassuring of all--as of last Saturday, not a single victim had died.
But if Americans think that they have dodged the biological bullet, they had better think again. As the truth about SARS comes out--slowly, due in large part to government cover-ups in the land of its birth--it is becoming clear that what is taking place in Asia threatens the entire world. Epidemiologists have long worried about a highly contagious, fatal disease that could spread quickly around the globe, and SARS might end up confirming their worst fears. Microbes can go wherever jet airliners do these days, so it is a very real possibility that the disease has not yet shown its full fury. "We don't know the reason that we've been lucky so far," says Dr. Julie Gerberding, director of the U.S. Centers for Disease Control (CDC), "but we're not taking any chances."
Americans should not count on their sophisticated health-care system to protect them. China may be relatively backward, but Hong Kong, with a modern medical system, has experienced about as many deaths as have been reported in the rest of China put together. And only a few hours' drive from Buffalo, N.Y., or Detroit, just across the Canadian border, a Western city that thought it had done just about everything possible to contain its outbreak keeps losing ground. A few weeks ago, Toronto believed that the epidemic was winding down. Now, with 20 deaths, it's the first place outside Asia to be put on a do-not-visit list issued by the World Health Organization (WHO)--a public humiliation that infuriated Toronto residents. ("I've never been so angry in my whole life," declared Mayor Mel Lastman.) Beijing and Shanxi province also joined the list last week; Hong Kong and Guangdong province, where the outbreak began, have been on it for weeks.
With fewer than 300 known SARS deaths so far, the worldwide toll is tiny compared with, say, the 3 million people who died of AIDS last year. But if SARS continues to spread, its numbers could skyrocket. Its overall death rate of about 6% is far lower than that of AIDS, Ebola or malaria, but if enough people catch the illness, even a low rate could cause a catastrophe. The Spanish flu epidemic of 1918-19 had a death rate of less than 3%, but so many people became infected that it killed more than 20 million people in just 18 months.