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Trivializing SARS (Shades of AIDS)

Thomas Keske tkeske at attbi.com
Sun Apr 6 22:32:51 EST 2003


Dr. Marc Siegel, associate professor of medicine at New York
University, wrote a column entitled "Hysteria spreads faster than
SARS", appearing the Boston Globe.

In the article, Dr. Siegel is trying to set himself up as the
expert, the calm voice of reason, who patronizingly "educates"
and reassures the hysterical, ignorant, hypochondriac public.
In reality, what he has to say is blatantly illogical and

Concerning SARS, Siegel says "In reality, this is a garden variety
respiratory cold virus, nothing sexy, nothing sinister.  The flu
kills 20.000 - 30,000 people in the United States alone every
year; this bug appears to have killed fewer than 100 in six
months... It's unsettling to consider that all this attention to SARS
may take attention away from influenza and other proven killers."

He goes on to ridicule Asians who are wearing face masks in
public, saying that this "does not offer them much more than
psychological protection."

It doesn't take a medical degree to see what is wrong with
his "logic".  This is the same kind of nonsense that we saw
with the AIDS epidemic.  Conservatives would argue that
too much attention was lavished on AIDS research, saying
that more people died of cancer and heart disease.  While
that was true in sense, it missed a simple point: that AIDS
was *contagious*, with an exponential growth curve, while
while cancer and heart disease were not.

The truth was, conservatives did not want to spend a nickel
on AIDS, because it mostly affected gay men, whom they
loathed.    When it became unfashionable to express openly
a desire for the annihilation of the gay population, conservatives
became a bit more devious and subtle, trying instead to
pit one disease against another, as if it were a zero-sum game,
and trying to act as if selfish gay bullies were being cruel
to cancer patients.

At least, with Seigel's case, it is not closet bigotry that
is the motivation, but more likely a case of having more ego
than good sense.

It is very true that there are only 100 known SARS deaths,
versus 20,000- 30,000 deaths from flu, but that is hardly
the point.   Ordinary flu does not kill somewhere between
3% and 10% of the people who are infected.   If it did,
we would be living in a very different, and much smaller
world. For SARS, the night is still very young.

Those 30,000 deaths represent what *percent* of the
total people who are infected?  Probably most the
U.S. population catches cold or flu at least once every
couple years.   If every 1 in 30, or 1 in 20, or 1 in 10 were
dying, it would look almost like a Biblical scourge.

 How many of those ordinary-flu deaths were also among persons
of  already-compromised health, and among the elderly?

AIDS did not seem like a very big deal, when there were
just handfuls of cases of a "rare, gay cancer."  Political
motives and social agendas on both sides got in the way
of sound reasoning.  Sometimes, people would downplay
AIDS, how low the chances were of getting infected,
compared to other things, such as getting killed in an
auto accident.     They looked only at the current moment,
not the likely future.

We are told that SARS is casually contagious, but
has a higher fatality rate than the 1918 flu that was
devastating for much of the world.  It is not "hysteria"
to understand the potential seriousness of the situation.

The face masks in Asia are almost surely not a perfect
or even a highly effective measure, but in high risk
areas, it is probably at least a small measure of protection,
better than nothing.    To ridicule this is irresponsible.

The kind of arguments offered Dr. Siegal's article fly
so much in the face of common sense, that it seems almost
like deliberate, game-playing, Devil's advocacy and
propaganda.  Surely, the man is too intelligent, not to see
the flaws in what he is saying.   These points are not
exactly subtleties.

It is like listening to a conservative, closet-racist, arguing that
death penalty does not discriminate against blacks, because
 "more whites than blacks get executed."     They know perfectly
well that the real measure is not absolute numbers, but
proportional percentages of populations.  They are not ignorant
of this simple point.  They are propagandists, trying to hoodwink
whoever is naive enough to fall for one of the oldest and cheapest
sleights-of-hand in the book.

This example comes to mind, because the Boston Globe
did indeed also run such an article, rehashing that very line,
by conservative propagandist, Jeff Jacoby.

In the case of Siegel's article, the likely ulterior motive is
also transparent:  "Reassure the public at all costs,
buy some time.  We don't want anything distracting from
our support for the war."

It is entirely possible that SARS is a natural epidemic,
not biowar, not a hoax perpetrated to allow mass-roundups
and suppression of civil rights, not a Muslim attack
on the West, not a Western attack on Red China.   Not that
any of those possibilities do not also merit contemplation.

 It is entirely possible that SARS will be a flash-in-the-pan,
disappearing on its own, as mysteriously as it came,
with little to show for it.

Why do viruses come and go, or show the behaviors
that they do?   Experts can make educated guesses, but
in many cases cannot know for sure.  Predicting an
epidemic is much like trying to predict the weather, or
the economy, or the stock market.   It is too complex and

The course depends on how infectious the disease agent
might be, the mechanisms by which it can spread,
how deadly it is, how long it takes to incubate, how
easy or difficult it is to build immunity, how effective
are treatments or preventative measures.

 Most viruses tend to adapt to their hosts.  A virus strain can
effectively mutate out of existence, just like it mutates
 into existence, at least in terms of its capacity for causing
deadly disease.

Be all that as it may, based on what we know *today*,
it is wise to treat SARS as one of our highest-level
health emergencies.   This is no less of a sound judgement,
regardless of what unpredictable course that the epidemic
might take in the future, even if it should prove to be
harmless.   The point is, we have reason to believe that
it is *potentially* a crisis even worse than the beginnings
of AIDS.

There is no reason that we cannot react with perfect calm
in this assessment.

It is the most sound course to prepare for the worst, and react
with the same degree of seriousness, as if we were
trying to prevent a repeat of the 1918 epidemic.

I can lend personal testimony as to why the public should
sometimes be skeptical of "expert" medical opinion.
When I was a toddler, only 2 1/2 years old, my aunt
discovered a funny-looking cloud in my eye.   My mother
took me for an examination.   The good doctor patronized
my mother for being a worry-wart, explaining that this
was nothing for concern, that some children even had
eyes of two different colors.

It would have ended there, if my Mom had not been
skeptical and gone for a second opinion.   The cloudy
appearance was cancer.   I would have been dead
long ago, never writing this article, had it not been
for a healthy skepticism of a doctor's opinion.

Question authority, including medical authority,
including government authority.   Your life might
just depend on it.

Tom Keske

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