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The first case of the Severe Acute Respiratory Syndrome (SARS) was reported in china in November 2002. Some sources suggest that the virus might have originated from small mammals and later infected the human population. The disease is said to have first started in parts of China then eventually spread to the whole world. The rapid spread of the disease resulted in both the affected and unaffected nations being put on high alert, thereby sparking the need for collaborations to facilitate its total eradication.
SARS is caused by a coronavirus referred to as SARS-associated coronavirus (SARS-CoV) (CDC). The disease first broke out in Guangdong province in China and later spread to neighboring regions and eventually infecting a total of 8,098. A recorded 774 of these succumbed to the infection, according to the World Health Organization’s reports. The disease has an incubation period of about 2 to 3 days hence many of the infected people could not establish when they got infected.
In highlighting its symptoms, infected patients exhibit high fever with temperatures exceeding 100 degrees Fahrenheit (›38.0 degrees Celsius). Others include a feeling of general discomfort, headache and body aches. Mild respiratory symptoms are also exhibited by some patients. Cases of diarrhea were also reported on 10-20 percent of the patients. Patients then tend to develop dry coughs after 2 to 7 days of infection while pneumonia was developed by a majority of the patients. (CDC, web)
The disease is seemingly spread by close contact between people. Its transmitting virus is transferred by respiratory droplets that are produced in the event of a cough or sneeze by infected parties. These droplets are spread by being propelled through the air for short distances then eventually get deposited in the mouth’s mucous membranes, or those of the nose and eyes of nearby people. Transmission of the virus can also happen when a person comes into contact with contaminated surfaces or objects, caused by infectious droplets, followed by them touching their mouths, noses or eyes. Also, the SARS virus is airborne, thereby implying that it can cover vast areas.
Close contact in the context of SARS transmission refers to an individual having lived with and/or having cared for a SARS patient. Coming into contact with a SARS patient’s respiratory secretions or body fluids also exposes individuals to the disease. Activities that can be considered as close contact comprise of sharing utensils used for eating and drinking, kissing or hugging, directly touching someone and talking to someone who is at a very close distance, for instance within 3 feet.
The spread of contagious diseases has to be contained by the application of various strategies. One of such strategies is isolation. This is the act of separating persons with specific illnesses that are infectious from the rest of the population. It gives room for specialized healthcare to be delivered to the ill. It also helps in protected the uninfected from the risk of contracting these diseases.
In the U.S SARS patients were isolated for them to receive the right care, thereby helping to curb the spread of the virus. Hospitals care for the critically ill patients while those who exhibited mild illness received care from their homes. It was advised that the patients who received care at home should remain at home for 10 days for the fever to be resolved. This was on the condition that they avoid contact with other people.
Some countries recorded limited transmission of the virus during the outbreak in 2003. Therefore there was no recommendation for quarantine. However, exposed persons who were not symptomatic were advised to self-monitor as well as remain in home isolation and undergo medical evaluation to keep track for any signs of the SARS-CoV symptoms.
Some epidemics have given proof that corona viruses have the ability to cross the barrier of species. This is evident in the incidence and spread of SARS-CoV. The emergence and in some cases reemergence of such viruses can be pointed to urbanization and the ever increasing mix between animals and human beings in areas that are densely populated (Lau & Chan, 2015). Corona viruses are also known to be highly mutative as well as possessing a high rate of recombination. This aspect allows them to cross the barriers of species, and also makes them highly adaptive to their new hosts.
Animal sources of the SARS-CoV epidemic were traced back to the Chinese wildlife markets where the virus was intermediately hosted by small mammals called civets. Horseshoe bats were also found to be the primary reservoirs (Ge et al., 2013). The human SARS-CoV virus’ immediate ancestor is believed to have disappeared although corona viruses related to SAR-CoV can be found in bats both from China and the rest of the world. However, vigilance has to be upheld since there is a significant probability for SARS reemerging hence measures need to be put in place that limit the mixing of civets and bats, among other animals, in the markets.
SARS epidemic increased interests to hunt for other corona viruses. Only two corona viruses were known before the outbreak of SARS (Lau & Chan, 2015). These are the human corona virus (HCoV)-229E and the HCoV-0C43. Additional two others were discovered after SARS. It was established that they had probably been in circulation among humans long before their discovery.
The World Health Organization (WHO) announced on 23rd September 2012 that it had discovered MERS-CoV corona virus that had fatally ended two patients. The patients had succumbed to this fast fatal mysterious disease in the Middle East (Zaki, van Boheemen, Bestebroer, Osterhaus, & Fouchier, 2012). At the time, the virus was established to be most probably related to the beta coronavirus lineage C prototype, tylonycteris bat coronavirus HKU4 as well as bat coronavirus HKU5 (pipistrellus). All these had been identified initially in Hong Kong.
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Research finding on the studies conducted to determine the origin and details of SARS has proved to be useful in tracing the sources of other mysterious diseases that are related to the coronavirus. It has since been established that various emerging viruses are hosted in bats. The findings of bat corona viruses related to MERS-CoV suggest that they could ultimately be the animal origin of the disease, with the intermediate hosts being camels. This is before the virus was able to infect humans by crossing the species barrier.
Diverse alpha coronaviruses and beta coronaviruses of lineage B, C and D have been found to have a reservoir in bats. China’s horseshoe bats naturally host the SARS-CoV-like viruses. However, the ultimate source bat species of the MERS-CoV has not yet been identified.
Animals too are susceptible to various corona viruses and virus outbreaks can also cause serious damages to the global animal population. Therefore, findings on viruses sparked by the outbreak of SARS have given scientists a deeper insight into these disease causing viruses as well as their animal hosts (Lau & Chan, 2015). This places them at a better place to deal with prospect outbreaks and the determination of the animal hosts and hence they are able to produce timely interventions to avoid the mass destruction of life.
The Political Impact of SARS across the World
The global spread of SARS was also accompanied by its repercussions in the political, economics and sociological spheres. These were majorly caused by the prospect of the disease spreading out in future. The collective efforts by nations to contain the SARS epidemic put unforeseen demands on both the affected and unaffected parties to pinpoint and report cases timely, work jointly with the Global Outbreak Alert and Response Network (GOARN) teams of experts comprising of scientists and medical personnel facilitated by WHO, and overlook their immediate economic interests. All these efforts would have collapsed had China failed to fully cooperate since it was the Centre of the epidemic.
Workshops of the time had resolved that the problems that China faced in dealing with the scourge were intrinsic of its organizational obstacles. Problems that were identified comprised of impediments to the channeling of information the hierarchies of the government, absence of coordination within the departments of the government that were fragmentized as well as the system in its politics where the worth of dealing with problems overrode any recognized value of the assistance from external sources. The identified systemic failings were deemed not to be exclusive of the epicenter of the epidemic and thereby came in the way of responding to matters of public health as well as other social problems in many other countries in the world.
Weaknesses in China’s infrastructure in public health were exposed by the epidemic, besides the insufficient state funding, insufficient surveillance systems and serious lack in facilities and medical staff that had the capacity to deal with outbreaks of infectious diseases. The Chinese government developed a Centre for reporting cases, improved the emergency response system, got rid of key officials who had initially failed to manage the crisis, notably the then Health Minister Zhang Wenkang and Meng Xuenong who was the Beijing mayor.
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The government availed funds for SARS prevention and control. These were efforts put in place in addressing the insufficiencies brought up by SARS. The government also sent out inspection teams through the State Council as a nationwide mobilization campaign. They were sent to the 26 provinces to scrutinize government records and identify unreported cases as well as to fire non-performing officials.
Following this new-found zeal, local government officials became fully involved in the anti- SARS campaign. They facilitated the sealing off of villages, university campuses .and apartment complexes. Thousands of people were quarantined as checkpoints were set up to administer checks on temperature. 80 million people got mobilized in Guangdong to clean up the streets and houses. Villages in the countryside were put on high SARS alert. Everyone leaving or entering these villages would be screened on road side booths that had been established for that purpose.
During the period of rapid transmission, governments and media were faulted for being unable to provide timely and consistent risk communication as well as addressing the risk in the proper context (Skowronski et al., 2005). Airport screening was deemed as being expensive with low yields and was termed as being insufficient. The low yield in detection could be pointed to the travel advisories that led to reduced travel to and from the affected areas; implementation of efficient airport screening before departures in countries hit with the SARS virus, as well as the fast decrease in new cases when screenings were finally introduced. Besides investments in screening at the airports or the detection of infectious diseases, further investments should have also been made in improving the capacity to screen and control infections at the entry points into the healthcare systems (Wilder-Smith, 2006).
The crisis helped in the improvement of the co ordinations between departments and agencies, thereby speeding up the institutionalization process of the emergency responses teams in china. This made them better placed to handle contingencies regarding public health (Huang, n.d.). A joint anti-SARS team for Beijing city was created on April 17th. It comprised of members from the Ministry of Health as well as officials from the military. The SARS Control and Prevention Headquarters of the State Council were launched. It was a taskforce aimed at coordinating efforts of the nation in combating SARS. Wu Yi, the Vice Premier was made the head of the taskforce. The provincial, city and county levels also witnessed similar arrangements.
China released a set of Regulations on emergencies regarding to public health. Under this were serious epidemics, mass industrial and food poisoning, spreading diseases that were unidentified and other critical threats to public health (Xinhua News, 2003, web).
The political leadership of China was directly involved resulting in increased availability of program resources as well as resulted in more resources being mobilized. A national fund worth 2 billion Yuan (US$ 250 million) was launched on 23rd April. This was to be a finance base for poor urban residents and farmers infected with the virus. It was also meant for the Acquisition of medical facilities that were to be located in Central and Western China. The local governments complemented this budget by 7 billion Yuan (US$ 875 million) in additional funds. SARS patients were also able to receive treatment from wherever they were in the country.
These resolved efforts worked, as was evidenced by the declining momentum of the epidemic experienced from the month of May onwards. The travel advisory against Beijing was lifted on 24th June by the WHO. The last two patients of SARS were discharged from the Beijing Ditan Hospital. This implied that China had become Free from SARS from that time.
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Impact of SARS on the Chinese Economy
Asia bore the immediate effects of SARS, but global markets were also affected either directly or indirectly by the outbreak of the disease. Various agencies and expects have worked to estimate the cost that SARS accrued on the basis of near-term expenditures as well as losses experienced in the key sectors of the Chinese economy. These were the medical expenses, consumer confidence, travel and its associated services, and investment. The short-term global cost incurred due to the loss of economic activity as estimated by a model was put at $80 billion (McKibbin, 2003).
The model suggested that Hong Kong was affected by SARS short-term shocks because of economic dependency on tourism and travel among other services. Other considerable accrued in China on the short-term were due to a decline in foreign investment. The expectation of prolonged outbreaks of infectious disease coming from China also engulfing the whole region of Asia in an indefinite shock of disease transmission also affected the country in the long-run.
The challenges brought about by SARS highlighted the need for greater investments in infrastructure pertaining to public health. An enormous burden was placed by the outbreak on international health systems. These had already proved to be strained in addressing other matters like AIDS, malaria, tuberculosis among other problems.
The establishment of GOARN by WHO that was aimed at converging international resources as well as personnel, was a big step in the effort of dealing with outbreaks such as SARS. SARS was successfully contained through the combination of national actions that were facilitated by inputs by the international parties (Skowronski et al., 2005). This is a testimony of the quality of the approach in addressing future outbreaks.
Effect of SARS on the Community
SARS was the 21st century’s first novel infectious disease. Psychiatrists carried out researches to establish the psychological effects of the disease on patients and health care givers alike findings of the research portray close to two-thirds of the staff demonstrated psychiatric morbidity. Their scores on the tests given indicated that they had emotional distress. These were accompanied by feelings of stigmatization, fear of contagion, anxiety and uncertainty as well as boredom and loneliness (Threats et al., 2017).
Feelings of trauma were also reported on the survivors, and also those who had lost loved ones due to the epidemic. Families experienced economic instability in cases where the bread winners had succumbed to the disease. (Threats et al., 2017)
In several aspects, the SARS epidemic influenced significant improvements in the way the world responds to infectious disease outbreaks. It also portrayed the need for continuous need for investing in an efficient and effective response system which will be prepared for unforeseen outbreaks of infectious diseases. Many more lives could have been saved had the Chinese government announced about the outbreak of the deadly disease (Huang, n.d.). This highlights the need for governments to be transparent with their citizens in an effort to avoid unnecessary loss of lives due to lack of information.
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