SARS Future Still Not Clear
U.S. 'Lucky So Far;' CDC Readying Quarantine Plans
May 1, 2003 -- With no SARS treatment or vaccine in sight, U.S. officials are quietly preparing for a worst-case scenario. These plans include isolation of suspected patients and quarantine of their contacts.
A panel of a dozen SARS experts last night met at Atlanta's Emory University to discuss the world's latest epidemic. Each scientist -- nearly all from the CDC -- is working on a different aspect of the disease. The title of the program: "The Global Emergence of SARS: Quarantine Today, Vaccine Tomorrow?"
At the end of the three-hour program, an audience member finally asked the most important question: What's going to happen? All heads turned to James Hughes, MD, director of the CDC's National Center for Infectious Diseases.
"That is the $64,000 question," Hughes says. "I think the jury is still out on what is going to happen in the next couple of months, let alone the next couple of years."
SARS could, of course, just fade away as winter ends and the days become warm. It's happened with other diseases. Flu, for example, has its season. But that may not happen with SARS.
"This is brand new to people," Hughes notes. "I'm not sure we can count on getting help from temperatures warming in the summer months. This is as good an example as anything imagined in the Institute of Medicine's recent report on emerging microbial threats. Global vigilance and rapid response is absolutely critical."
Part of that response may be quarantine. It's the oldest known public health measure. It means keeping people who have been exposed to a disease separate from people who have not been exposed. President Bush recently added SARS to the short list of diseases for which U.S. citizens can be quarantined -- by force, if necessary.
Marty Cetron, MD, deputy director of the CDC's quarantine division, says luck and hard work by public health officials have kept SARS from spreading in the U.S. But he warns that we are just one "super spreader" away from this.
"It is not just the circumstances in Asia that allow SARS to spread," he says. "Toronto is a sobering reminder that these things are close by. What do we need to be ready for? One of the things we are doing is gearing up states and our other public health partners to think about how to implement isolation and quarantine procedures in the U.S. What about residential care facilities, hospital care facilities, the different levels of care needed? How can this be accomplished in cities with large numbers of apartment dwellers? Those are the kind of conversations and dialogs and modeling going on. Whether we will be prepared fast enough remains to be seen."
Quarantine would apply to well people who were exposed to someone suspected of having SARS. People could be confined to their homes, Cetron says, but might also be confined to special facilities.