SARS Epidemic: A Global Challenge Bong-Min Yang, PhD & Sung-il Cho, MD, PhD of School of Public...
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Transcript of SARS Epidemic: A Global Challenge Bong-Min Yang, PhD & Sung-il Cho, MD, PhD of School of Public...
SARS Epidemic: SARS Epidemic: A Global ChallengeA Global Challenge
Bong-Min Yang, PhD & Sung-il Cho, MD, PhD
ofSchool of Public Health
Seoul National University
Why significant global issue?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
David P. Fidler (2004)
“SARS was a crisis, but victory was achieved”
Political ImpactPolitical 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)
Political Impact 2Political 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
Economic ImpactEconomic 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$80 billion (McKibbin, 2003)
Estimation of the impact of SARS on selected Asian Economies
Economies
Estimated reduction in annual GDP
growth if SARS lasts for 1 quarter in
2003(percentage point)
Estimated reduction in annual GDP
growth if SARS lasts for 2
quarters in 2003 (percentage
point)
Estimated reduction in GDP
level if SARS lasts for 1
quarter in 2003 (US$ billion)
Estimated reduction in GDP
level if SARS lasts for 2
quarters in 2003 (US$ billion)
2003 2003 2003 2003
East Asia 0.4 1.0 8.8 20.0
The PRC 0.2 0.5 2.3 5.8
HK, China 1.8 4.0 3.0 6.6
Korea 0.2 0.5 1.3 3.0
Taipei, China 0.9 1.9 2.5 5.3
Southeast Asia 0.5 1.4 3.2 7.7
Indonesia 0.5 1.4 0.7 2.0
Malaysia 0.6 1.5 0.5 1.3
Philippines 0.3 0.8 0.2 0.6
Singapore 1.1 2.3 1.0 2.0
Thailand 0.7 1.6 0.8 1.8
Source: ERD of ADB using OEF model, staff estimates
Chart 4
Korea’s exports have decreased, but not muchKorea’s exports have decreased, but not much
Lessons DrawnLessons 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
SARS Situation in KoreaSARS Situation in Korea
No death related with SARS– 3 probable cases– 17 suspected cases
Mostly those who visited China Overall 65 reports for assessment
Korean Strategies for SARS Korean Strategies for SARS PreventionPrevention
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
SARS Management System
Headquarter
Chair: Minister of Health
Communicable Disease Task force
Emergency Response Team
Municipal/Provincial health director
Local Emergency Response Team
District health officer
Chair: NIH director
SARS Control Team
Chair : Municipal/Provincial vice mayor
Chair: Vice district chair
Local SARS Control Team
QuarantinQuarantinee
Questionnaire
Examination (fever etc)
Isolation room
Patient care Special
investigation
Identify passengers from high risk areas
Collaborate with immigration office
Examine air crews
For travelers
For visitors and immigrants
Media Travel
agencies
Follow-up Suspected Cases
InformationAssessment Isolation
Quarantine ActivitiesQuarantine 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
Patient SurveillencePatient Surveillence
Case report network
Education of health care workers
Monitor emergency rooms
Networking of infection specialists
http://dis.mohw.go.kr/sars_index.asp
Public Information and EducationPublic Information and Education
Tasks Underway after SARS Tasks Underway after SARS Epidemic 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