SARS — Fear over reason

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The specter of contagious disease often engenders a primal reaction based on fear, with resultant irrational behavior. SARS is no exception. Only a few weeks ago, New York's bustling Chinatown became a ghost town as a result.

Another example of fear overcoming reason also emerged last week, from a most unlikely source: the University of California at Berkeley, which at first pulled the summer-class welcome mat for students from selected parts of the Far East. Although UC officials over the weekend partially rescinded the ban, allowing some 80 students from the affected areas to attend summer classes in the core academic program, another 500 students are still being blocked from taking English as a second language through UC Extension.

It appears that the highest officials at UC Berkeley were simply not paying careful attention. Despite the persistent spread of SARS in China and, to a lesser degree, in Taiwan, there is much good news to report about the epidemic.

Efforts to contain the spread of the virus have been largely effective, and the number of new cases is on the decline. There are around 60 probable cases of SARS in the United States, with no deaths here so far.

Indeed, the dictum from Berkeley sounded strangely reactionary and, at worst, appeared xenophobic, even racist. Summer students from regions deemed to harbor the threat of SARS China, Taiwan and Hong Kong were denied admission. Interestingly, students from Canada, which continues its battle with SARS, are still welcome. The real risk of contagion from either Asian or Canadian students is exceedingly low.

UC Berkeley's decision made no sense from any medical perspective. Certainly, this selective denial of admission is not based on valid public health principles. New caseloads are down in Hong Kong, and the late outbreak in Taiwan is also coming under control. Screening by questionnaire and temperature monitoring, as well as commonsense hygiene measures, are bringing the epidemic under control everywhere, it seems, but in rural China. What appears not to be under control is fear.

If health concerns were actually uppermost in the minds of UC Berkeley administrators, a reasonable approach might have been to quarantine any students from regions with continuing SARS activity for up to 14 days. (The university effectively did that Saturday, identifying several dwellings that can used for students who need to be isolated.) Even more logically, each individual student could be evaluated as to the real likelihood that he or she might be a SARS carrier, and dealt with appropriately.

The true irrationality of the Berkeley doctrine is illustrated by the following two items: none of the other University of California sites (nor any other institute of higher learning) has echoed the Berkeley ban; and regular (not summer) students returning from SARS-affected regions will not be excluded, only monitored.

Neither the California Department of Health nor the federal Centers for Disease Control recommends the exclusion of selected Asian students. The civil rights group Chinese for Affirmative Action has branded the university's decision as discriminatory.

Such hysteria can and will cause unintended, counterproductive ramifications. The best way to keep the disease under control is for public health authorities to monitor all cases and contacts, and get those possibly infected into quarantine and those who are sick into isolation in the shortest possible time. Giving the impression that there is a high risk of contagion from anyone attempting to enter the United States from several Asian regions will echo around the world. People who may have early symptoms of SARS will be fearful of seeking urgent medical care, under the impression that they will be met with overzealous measures and deprived of compassionate treatment, due to such unwarranted hysteria.

UC Berkeley's experience shows that this is clearly not a policy we should be adopting. Let's continue doing what we always have done: Make sure immigrants, student or otherwise, are free of contagion as best we can. In the event of an epidemic of potentially deadly, contagious illness, such as SARS, let the public health authorities, who have done an excellent job dealing with this threat, guide us in efforts to control the disease with measures that have proved effective.

Gilbert Ross, M.D., is medical director of the American Council on Science and Health, a public-health, consumer-education organization based in New York City.