History

According to the political scientist Yanzhong Huang, the first SARS case "is thought to have occurred in Foshan, a city southwest of Guangzhou in Guangdong province, in mid November 2002."8 The index case was the physician Liu Jianlun, who inadvertently fomented a global chain of transmission when he traveled to Hong Kong and stayed at the now infamous Metropole Hotel. Liu then infected other travelers who subsequently spread the disease throughout the Pacific Rim countries. On March 12, 2003, the World Health Organization issued a global outbreak alert and initiated international surveillance efforts to track the contagion. By that point the pathogen had spread throughout the countries of the Pacific Rim, with the greatest incidence of cases in China (5,327), followed by Hong Kong (1,755), Taiwan (665), Canada (251), Singapore (238), Vietnam (63), and the United States (33), respectively.9

Effective response to the epidemic was initially compromised by both psychological factors (fear, confusion, and denial) and bureaucratic ineptitude and corruption in China. Political elites in Guangzhou and Beijing conspired in a deliberate attempt to suppress knowledge of the epidemic in both the domestic and international arenas. Health officials in Beijing ordered that reports on the proliferation of the pathogen be classified as "top secret," such that the disclosure or discussion of the outbreak constituted a direct violation of national secrets.10 The burgeoning epidemic generated profound levels of fear among the general Chinese population and warnings about the virus filtered out to the global community via the Internet. Despite such leaks, Beijing persisted in its attempts to mislead the WHO, as on February 27 the Chinese Ministry of Health declared the epidemic to be officially contained. In fact the disease continued its rapid proliferation throughout the population of Beijing.11 The Chinese fa├žade disintegrated on April 4, when the head of China's Center for Disease Control publicly apologized to the Chinese people, and to the international community, for failing to inform the public about a highly contagious and often lethal new pathogen.12 The full extent of Beijing's duplicity became clear on April 9, when Jiang

Yanyong, a prominent member of the Communist Party (and a physician), publicly accused the government of covering up the extent of the epidemic in Beijing.13

On April 16 the WHO took the unprecedented step of publicly chastising Beijing for misleading the global community as to the true extent of SARS infection throughout that country.14 Two days later Beijing announced a national "war" on the virus, and ordered all Communist Party officials to reveal the true extent of the epidemic or be held accountable for their deliberate obfuscation. On April 2), the Party leadership demanded the resignation of the Minister of Health, Zhang Wenkang, and the Mayor of Beijing, Meng Xuenong, for their complicity in the conspiracy.15 This move was seen as an attempt to deflect blame from senior party officials for their role in the crisis. On July 5, 2003, the WHO announced that the SARS epidemic had been effectively contained. Despite the fact that the international community successfully contained the spread of the virus in a relatively brief span of time, the medical community insists that it represented a significant global threat. The physician Thomas Tsang commented: "I think there was a possibility of being a global pandemic if the appropriate control measures were not taken."16

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