As was argued above, contagion is historically associated with generating profound levels of affect (i.e. fear and anxiety) within affected populations, particularly in the face of a novel pathogen which generates great uncertainty and inhibits effective risk assessment. Uncertainty and fear result in suboptimal decision making which may in turn result in very real damage to a country's material interests. The SARS epidemic provides a vivid illustration of this dynamic, as the emergence of the novel, virulent, and transmissible SARS coronavirus generated profound levels of anxiety and significant economic damage throughout the countries of the Pacific Rim. This fear was compounded by the fact that public health officials originally suspected that SARS might be a novel and virulent strain of influenza.
As a novel pathogen, SARS presented an enigma to public health personnel who were largely unaware of the symptoms, routes of transmission and effective prevention of transmission during its outbreak. This uncertainty resulted in diagnostic delays, misdiagnosis, and also put health-care workers at considerable risk. Infected health-care providers infected accounted for 21 percent of all cases, ranging from a mere 3 percent of reported probable cases in the United States to 43 percent in Canada. Witnessing that nurses and doctors were unable to protect themselves from the infection, the public developed a highly exaggerated estimate of their personal risk of being infected. Surveys conducted in Hong Kong during the period of contagion indicate that respondents experienced profound levels of negative affect, and psychological stress, as a result of the contagion.17 Echoing the contagionist responses of the past, Beijing's draconian measures to control the flow of information, and persistent delays in reporting data, only served to magnify the levels of fear and anxiety afflicting the general population. By late April 2003, in a replay of the contagion-induced flights so common in the years of plague and cholera, an estimated million people (about 10 percent of the population) had fled Beijing for other parts of China.18 They would soon find themselves unwelcome even in their hometowns, perceived as vectors of pathogen transmission. In the countryside, worried villagers set up roadblocks to restrict the entry of refugees from Beijing, and a series of riots against rural quarantine centers were also reported in May 2003.19
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