SARS disappeared in 2004, beaten by isolation and quarantine rather than drugs
SARS killed about one in nine of the 8,422 people recorded as infected by June 2003, yet no new case has surfaced anywhere since 2004. No drug ever proved effective against it. What stopped it was old-fashioned public health: isolating the sick, tracing contacts and quarantining them before they became most infectious.
The disease was caused by SARS-CoV-1, the first identified SARS-related coronavirus. The earliest known patient fell ill on 16 November 2002 in Guangdong, and Chinese officials did not inform the WHO until February 2003, a delay that drew international criticism and a later official apology. Canada's GPHIN monitoring system had picked up reports of a flu outbreak on 27 November 2002, but because it presented findings only in English or French, an English report on the Chinese-language items did not appear until 21 January 2003.
Travel then did the rest. A Guangdong doctor, Liu Jianlun, took a room on the Metropole Hotel's ninth floor in Kowloon in February and infected 16 guests, who carried the virus to Canada, Singapore, Taiwan and Vietnam. In Hanoi, the Italian WHO physician Carlo Urbani recognised the danger after staff fell ill treating an American businessman, alerted the WHO, and later died of the disease himself. The WHO issued a global alert on 12 March 2003, and local transmission followed in cities from Toronto to Ulaanbaatar.
Symptoms resembled flu, with fever, aches and cough, often progressing to pneumonia after an incubation of four to six days on average. Patients were most infectious when severely ill, usually in the second week, so people isolated before day five rarely passed it on. Death rates varied enormously with age: under 1% for those under 24, over 55% for those 65 and older, and more men than women died. Care was supportive, with oxygen and ventilation; ribavirin, widely given, seems to have done little.
In the 2010s Chinese scientists traced the virus, by way of Asian palm civets, to horseshoe bats living in caves in Xiyang Yi Ethnic Township, Yunnan. Vaccines were developed, including one the CDC stockpiled according to Anthony Fauci in 2017, but none was needed, and a researcher said in 2016 that funding for a field-ready shot had dried up. Some survivors in China suffered lasting lung fibrosis and bone damage. In December 2019 a second strain, SARS-CoV-2, emerged.
Source: SARS
