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SARS Epidemic: A Global Challenge

SARS Epidemic: A Global Challenge. Bong-Min Yang, PhD & Sung-il Cho, MD, PhD of School of Public Health Seoul National University. Why significant global issue?. Multi-country outbreaks Spread through air travel and human migration Causative agent still unknown Severity of illness

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SARS Epidemic: A Global Challenge

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  1. SARS Epidemic: A Global Challenge Bong-Min Yang, PhD & Sung-il Cho, MD, PhD of School of Public Health Seoul National University

  2. Why significant global issue? • Multi-country outbreaks • Spread through air travel and human migration • Causative agent still unknown • Severity of illness • Impacts on clinical and public health services

  3. David P. Fidler (2004) • “SARS was a crisis, but victory was achieved”

  4. Political Impact • Multinational organizations, particularly WHO, become to have increasing influence on global governance • After successful control, much credit given WHO for initiation and coordination of surveillance, research and control measures • WHO Initiated • Global Alert (12 March, 2003) • Travel Advisory (15 March, 2003) • Enhanced global surveillance • Global Outbreak Alert and Response Network (GOARN) • Specific Global Networks (Lab, Case management, Epidemiology)

  5. Political Impact 2 • Importance of global cooperation to an outbreak of infectious disease is fully realized • It validated the value of global public health networking • Weakness of China’s public health infrastructure was revealed • China first downplayed the extent and the risk of the infection, then joined the international network to control • Afterward, Chinese public health infrastructure was strengthened a lot • Case reporting structure established • Strengthened emergency response system • Provide funding for prevention of SARS

  6. Economic Impact • Direct costs • Medical treatment costs, and costs of some equipment and supplies for prevention • Indirect costs • Travel/airline • Tourism • Trade/investment • Shrunk consumer confidence • Global indirect costs estimated to be around US$80 billion (McKibbin, 2003)

  7. Estimation of the impact of SARS on selected Asian Economies Source: ERD of ADB using OEF model, staff estimates

  8. Korea’s exports have decreased, but not much

  9. Lessons Drawn • Importance of • early detection • quarantine and surveillance • informing the public in time, and correctly • Supporting basic and specific research • Increasing public health capacity: manpower and facility • Promoting international cooperation and collaboration

  10. SARS Situation in Korea • No death related with SARS • 3 probable cases • 17 suspected cases • Mostly those who visited China • Overall 65 reports for assessment

  11. Korean Strategies for SARS Prevention • Early detection of imported cases • Quarantine • Surveillance • Prevention of secondary infection • Medical facilities • Protection of health care personnel (mask, etc.) • Isolation of patients • Information and education • Hand washing • Laboratory capability • Support laboratory diagnosis

  12. SARS Management System Headquarter Chair: Minister of Health Communicable Disease Task force Chair: NIH director SARS Control Team Emergency Response Team Chair : Municipal/Provincial vice mayor Municipal/Provincial health director Local SARS Control Team Local Emergency Response Team Chair: Vice district chair District health officer

  13. Questionnaire Examination (fever etc) Isolation room Patient care Special investigation Assessment Isolation Follow-up Suspected Cases Information Quarantine • Identify passengers from high risk areas • Collaborate with immigration office • Examine air crews • For travelers • For visitors and immigrants • Media • Travel agencies

  14. Quarantine Activities • Check body temperature for travellers from China (5,000/day) • Examine aircrafts (45 planes and 7,000 persons/day) • 20,000 passengers/day screened, using infrared automatic body temperature thermometer

  15. Patient Surveillence • Case report network • Education of health care workers • Monitor emergency rooms • Networking of infection specialists

  16. Public Information and Education http://dis.mohw.go.kr/sars_index.asp

  17. Tasks Underway after SARS Epidemic • Establish infrastructure for communicable disease control • New establishment of CDC • Strengthen public health care sector • Networking of quarantine office and CDC • Strengthening response capacity for emerging disease • Global monitoring • Laboratory capacity and research • Emergency response preparedness

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