APEC to look at tougher measures against SARS


SINGAPORE (AP) - Twenty cameras scan travelers as they arrive in the immigration halls at Singapore's Changi International Airport, translating them onto screens as ghostly outlines with blue, green and yellow skin. 

Attendants wait to whisk away anyone whose skin glows red on the screens - indicating fever - to a nearby nurse's station and then to a hospital isolation ward if they show symptoms of SARS. 

The thermal scanners, also in place at the island's ports, ferry terminals and land entry points, could be Singapore's first line of defence against a resurgence of SARS. 

Tougher mechanisms and tighter coordination to detect and deal with severe acute respiratory syndrome are expected to feature prominently on the agenda when leaders meet for the Asia-Pacific Economic Cooperation summit Oct. 20-21 in Bangkok, Thailand, as fears run high that the winter months could bring a second wave of the disease. 

APEC countries bore the brunt of the SARS outbreak. 

The five economies hardest-hit were APEC members - China, Taiwan, Hong Kong, Singapore and Canada, who between them accounted for nearly all global cases and deaths. 

After the first known cases in China in November 2002, SARS infected nearly 8,100 people before June when the World Health Organization declared it under control. The disease killed 774 of those patients. 

SARS shaved about US$18 billion from Asia's combined gross domestic product and cost Asian economies nearly US$60 billion in lost demand and revenues, according to figures released Sept. 30 by the Asia Development Bank. 

The GDP cost alone equaled about US$2 million for each person infected, the bank said. 

The relationship between public health and economics will be one of SARS' lasting lessons, ADB medical expert Joseph Hunt said.  

The most medically advanced countries suffered as much as the least developed, he said. 

"This has been a leveler,'' Hunt said. 

"Everyone has to get their act together - there can be no free-riders because the whole region suffers.'' 

Transparency and communication are keys to controlling the disease, Hunt said. 

In coming months eyes will be on China, where SARS first emerged nearly a year ago but was not reported until months later under international pressure. 

Chinese leaders publicly admitted they mishandled the outbreak and vowed to be more open in the future. 

Many, however, remain skeptical. 

"There may be a marginal improvement, but China's not going to turn over a new leaf overnight,'' said Rajeev Malik, a regional economist at JP Morgan Chase in Singapore. 

APEC leaders are expected to expand on a SARS action plan their trade ministers devised at a meeting earlier this year. 

It calls for common standards for screening travelers, better communication and cooperation in finding ways to fight SARS and other emerging diseases. 

In Singapore, hospital staff are being drilled and audited on emergency procedures in case a new SARS outbreak occurs, Minister of State for Health Dr. Bolaji Sadasivan said. 

SARS killed 33 people in the city-state, infected 238 and cost the economy about 1 billion Singapore dollars (US$588 million). 

Medical staff must now track their own temperatures, monitor fever clusters in hospitals and nursing homes and keep protective masks, gloves and suits at the ready, Sadasivan said. 

He said American, Canadian and Taiwanese medical officials cite similar preparations in their countries. 

"I can tell you that we're more prepared than before,'' said Dr. James Hughes, director of the National Center for Infectious Diseases Control and Prevention in Atlanta, Georgia. 

"I think the global community can handle SARS. I think lessons have been learned.'' 

Sadasivan described SARS as the biggest challenge he ever faced. When the disease first struck, there was no diagnostic test, and no one knew how infectious it was or whether quarantines could break the chain of infection, he said.  

The early data suggested that half the population was susceptible and that the mortality rate was 2 percent to 5 percent. 

"If SARS was truly unstoppable, we could have faced a situation where half of Singapore was sick with tens of thousands dying,'' he said.  

"We realized we had to take all possible measures to stop the disease.'' 

The speed of the outbreak was a wake-up call, agreed experts who spoke to The Associated Press, but it could have been much worse had it spread as quickly as influenza. 

"We just got hit by this one,'' Hunt said. 

"It could be a precursor for more (emerging viruses) to come. This is the first one that moved really rapidly.'' 

Health officials around the world are bracing for the return of SARS.  

The virus that causes SARS can survive longer in the atmosphere in low temperatures. Experts point to the 1918 flu pandemic in the United States in trying to predict how SARS could strike, Sadasivan said.  

That pandemic came in two phases with a winter recurrence, he said. 

Hughes has warned that even if SARS does not reappear, it will likely cause disruptions in the United Sates, as hospitals and clinics are swamped with suspected cases. SARS symptoms are easily confused with common flu, he said. 

Research for diagnostic tests, vaccines and antiviral treatments are under way but it could be years before they reach the market. 

In the meantime, countries like Singapore will have to rely on scanners to keep SARS from entering though their gateways, which were meant to bring in business and investment, but became entry points for the disease. 

"Because of globalisation, what happened yesterday in Hong Kong could affect someone in Ontario (Canada) the day after tomorrow,'' Hunt said. - AP 

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