Putting SARS in Perspective: A Communication Challenge
SCOTT C. RATZAN
While war raged in Iraq, consuming televisions and front
pages of newspapers throughout the world, a more personalized and immediate
threat traveled around the globe. SARS— Sudden Acute Respiratory
Syndrome—became a new household acronym, with thou-sands concerned
about their personal health from this atypical pneumonia.
As of this writing, SARS is believed to be caused by a
Coronavirus originating in China. While it spread unabated and was termed
an epidemic, cases were identified with nearly 100 deaths, including
the World Health Organization (WHO) physician who characterized and
named the disease. In Hong Kong, one of the endemic regions, about a
third of the 2,400 cases in Asia were identified with people presenting
with the basic symptoms of fever, headache, body aches, and a dry cough.
This sounds like a large number, but it merely doubles the usual number
of cases of atypical pneumonia symptoms expected in the Hong Kong population
during a similar period of time. Luckily, SARS does not seem to have
a high mortality with a rate close to the norm for certain populations
with pneumonia in the region. Was this fortunately weak pathogen sent
as a warning signal? Are all cases of potential pneumonia or respiratory
disease categorized as
SARS?
Clearly, there is a real threat here as SARS pneumonia
has spread in clusters. Perspective and political pressure are necessary
for the appropriate response to ultimately advance the prevention and
treatment of atypical pneumonia in the epicenter—China. Surveillance
and epidemiological measures require a functioning public health system
along with honesty and transparency. Media and communication in China
that follow the Chinese heralded mantra, ‘‘[news reporting]
close to reality, close to the masses and close to life,’’
are key to an informed public that would respect good decisions to protect
the public health through appropriate measures.
Meanwhile, outside China, the international media fulminates
with the day-to-day increases of the disease and the threat to the Southeast
Asian economy due to fear of exposure. It has been a challenge for the
WHO, along with other credible counterparts, to place SARS in perspective
by exhibiting clear concern, caution, and the means for controlling
the spread of SARS. Unnecessary focus and fear of exposure can divert
attention from communicating the challenges we face each day—prevention
of deaths from non-communicable diseases, prevention of other infectious
diseases as well as
diseases of poverty—such as HIV/AIDS, Malaria, TB, and diarrheal
disease—and the most obvious acute preventable health threat, deaths
due to armed conflict.
Academically, we know that there are a number of major
obstacles in the way of achieving effective health communication between
expert advisers, officials, and decision-makers. These include the growing
lack of public trust in experts (particularly scientists), policy-makers,
and politicians. Oftentimes we blame the messengers, while we do not
acknowledge the lack of competence of many experts, public officials,
and health intermediaries in effective risk communication techniques.
Furthermore, the proliferation of the range of sources—from traditional
media to the scaremongers—presents policy-makers, decision-makers,
and citizens with information of questionable
credibility and value.
With each ‘‘new’’ outbreak and health
crisis, we have an opportunity to use this teachable moment to enhance
rather than detract from our trustworthiness as health communicators.
SARS may increase public health hygiene, if we can stress the need for
hand washing, explain the infectious nature of disease and vector control,
and reinforce the value of public health and epidemiologic measures.
However, if we are not careful, we could instill a fear that diverts
attention and resources from the larger threats to our health and well-being.
It is incumbent upon all of us as health communicators
to design strategies and messages that resonate with those wanting information
at the lowest common denominator, but also tailored in different formats
to satisfy the concerns of patients, caregivers, physicians, health
intermediaries, and others who demand more. SARS is yet another
exigent issue to remind us of the hazards we face; it is not whether
another health threat develops, but when it will occur.
Scott C. Ratzan MD is Editor-in-Chief of the Journal of Health
Communication: International Perspectives.
