This page examines both the actual and perceived risk from SARS (Severe Acute Respiratory Syndrome) vs that from 'ordinary' flu, and what I perceive to be the failure of both the media and public health authorities to put these risks into simple perspective for the public. A note of caution: I have no medical qualifications, nor am I an epidemiologist.
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SARS, Flu, and risk perception
Is an inordinate degree of attention being paid to SARS, as opposed, for example, to flu?
I shall add additional comments as new developments or ideas occur, in chronological order below, as follows:
___ 1. As of 13 Apr 03.
___ 2. As of 26 Apr 03. SARS in perspective
As of 13 Apr 03, thirteen people have died in Canada during the past five weeks from SARS (Severe Acute Respiratory Syndrome), assuming that the first death occurred on or about 17 Mar 03; see CMAJ below. That is a death rate of 2.6 per week in Canada. This is a disease having flu-like symptoms, for which no specific virus has yet been identified; however, see SARS test days away below. There is no cure or vaccine. It appears to be spread by airborne particles and close contact. It has gained much media attention, with admonitions to wash hands, and -- in the case of hospital personnel -- to wear face masks. Most of the transmissions have occurred within hospitals. Voluntary and enforced quarantines are now in effect. Public health officials caution, however, that the wearing of face masks by the public in general is too alarmist, and not warranted by the relative risk. They advise that frequent hand-washing, prompt reporting of suspect cases, and quarantine, where indicated, is sufficient. I agree. Nonetheless, public awareness and fears have been aroused in many people, and -- in my opinion -- to an inordinate extent in some cases. I shall try to outline why. See CBC News.
According to Health Canada, from 500 to 1,500 people in Canada die each year from influenza or its complications; in other words, from 10 to 29 per week. The corresponding figures for the USA are 25,000 per year, or 481 per week (see MPR). In the USA, only about 63 percent of Americans over 65 are vaccinated for the flu. I shall try to find the corresponding figure for Canada. Health Canada advises that flu vaccinations are 70 to 90 percent effective.
Given these figures, I impute the following conclusions:
___ 1. It is illogical that so much fear and attention is associated with SARS, as opposed to that relating to flu, which kills at least four to eleven times as many people per week in Canada.
___ 2. I find it odd (if not somewhat remiss) that both the media and public health authorities have not made known a conclusion similar to that in 1 above.
___ 3. It is odd that many of those who do not bother to get flu shots (which are free of charge in Canada (and in the USA, under Medicare)) are, I presume, more afraid of contracting SARS than the flu.
It seems to me that this illustrates, once again, a wide discrepancy between actual and perceived risk by the public, and a failure of public authorities to publicize these relative risks in clear perspective. It is laudable that we wish to prevent an epidemic of this new disease SARS; however, equal attention should be directed to the fact that ordinary flu presents a greater risk, at present, than does SARS. The same might be said in relation to the perceived vs actual risk of nuclear power. See my site, at the following:
Nuclear Green. Why we need to counter irrational opposition to nuclear power.
As of 26 Apr 03: SARS in perspective
Here are a few rates of deaths in Canada, per week, based upon data from the Statistics Canada source Canadian Statistics.
Pneumonia and influenza: 8,032 per year = 154 per week.
SARS: 19 per about (5+5/7 = 5.71) weeks (since first such death in Canada on about 17 Mar 03) = 3.3 per week.
Purists can argue,of course, that this comparison is not totally realistic because, unlike other diseases, SARS is not dispersed throughout communities. Fair enough. However, even if we were to assume that the population of the Toronto area, of, say, 2 million people, were potentially exposed to these contagious diseases, the death rate from pneumonia and influenza would still be about
(23.7 per 100,000 per year) * ( 2,000,000/100,000 ) = 474 per year = 9.1 per week.
Therefore, one might well ask why the World Health Organization (WHO) should be singling out Toronto as a risky destination because of SARS, whereas the greater threat is from pneumonia and influenza, for which there also appears to be no cure. If there were a cure, why are people dying from pneumonia and influenza?
MPR Cutting the death rate in half: http://news.mpr.org/features/200208/08_schmitzr_flushots-m/
By Rob Schmitz, Minnesota Public Radio, Aug. 8, 2002
. . . The numbers are staggering. Every year, 65 million people in the US get the flu. Half of them will seek medical treatment. Of those, 300 thousand are hospitalized.
And 25,000 people die.
The vast majority of deaths are among the elderly. The vaccination is widely available, and Medicare provides full coverage for it. But a study by the Centers for Disease Control shows that only 63 percent of Americans over 65 were vaccinated for the flu last year. . . .
Just last year, the Centers for Disease Control and Prevention surveyed 6000 physicians nationwide. 10 to 15 percent of them admitted not strongly recommending flu vaccinations to their patients. . . .
Poland says if more doctors took fifteen seconds out of each appointment to recommend flu shots, it could save thousands of lives every year.
Health
Canada
Online: http://www.hc-sc.gc.ca/english/
. . . Health!Canada
Does the flu shot work: http://www.hc-sc.gc.ca/english/feature/magazine/2000_11/flu.htm
. . . . . . A flu vaccination is 70 to 90 per cent effective in preventing the flu in healthy adults, and about 70 per cent effective in preventing flu with fever in children. . . .
. . . . . . From 500 to 1,500 people in Canada die each year from influenza or its complications. . . .
Health!Canada, November 2000
CMAJ -- Severe Acute Respiratory
Syndrome (SARS) Update: http://www.cmaj.ca/misc/sars.shtml
Canadian Medical
Association Journal (CMAJ)
eCMAJ is tracking ongoing developments in the global outbreak of severe acute respiratory syndrome (SARS) for both clinicians and patients. Check here for the latest updates on the situation in Canada and around the world.
This site has graphs of deaths and cases in Canada and worldwide. First death in Canada appears to be on about 17 Mar 03.
CBC
News
Canada's SARS death toll rises: http://www.cbc.ca/stories/2003/04/01/sars_new030401
Canada's SARS death
toll rises
Last Updated Wed, 02 Apr 2003 10:23:39
TORONTO - The number of Canadian deaths from severe acute respiratory syndrome rose to six Tuesday . . .
Preparing for Influenza Pandemics - 2: http://www.influenza.cpha.ca/english/resources/pandemic/pan2.htm
Health Indicators 82-221-XIE: http://www.statcan.ca/english/freepub/82-221-XIE/01201/defin3.htm
Statistics Canada
-- Health system performance
National Story -
canada.com network:
http://canada.com/national/story.asp?id=ED4A6929-B434-4DD6-B3B1-49588436E132
SARS test days away: scientists
By Janet Steffenhagen The Vancouver Sun April 14, 2003
A reliable diagnostic test for SARS is expected within days after B.C. scientists who worked around the clock for a week to identify the genetic sequence for the deadly virus implicated in the disease made a breakthrough discovery just before dawn Saturday.
"It shouldn't take a week," said Dr. Caroline Astell, who led the project that involved 30 scientists at the Michael Smith Genome Sciences Centre, part of the B.C. Cancer Agency. . . .
Astell noted there are almost 300 suspected SARS cases in Canada, with Toronto the hardest hit. . . .
As of Sunday, 13 people had died in Canada after contracting SARS, and Health Canada reported 283 suspect or probable cases. Ontario had 97 probable and 135 suspect cases, while B.C. had three probable and 36 suspect cases.
Internationally, there have been 2,960 cases of SARS and 119 deaths.
The sequencing of the coronavirus believed to be responsible for severe acute respiratory syndrome (SARS) is also expected to help with the development of anti-virals to treat SARS and, ultimately, a vaccine, although that could be years away, Astell said in an interview Sunday. . . .
Dr. Paul Gully of Health Canada said developing a SARS test would be a huge step forward but suggested there are still questions about whether the coronavirus is the cause of SARS.
. . . Late last year, the centre discussed whether it could make a contribution in the event of a bioterrorism attack, for example, and concluded it could. . . .
The centre has . . . posted its coronavirus findings on its Web site (http://www.bcgsc.bc.ca) to aid researchers around the world.
© Copyright 2003 The Vancouver Sun & Canadian Press
GSC - GSC: http://www.bcgsc.bc.ca The Canada's Michael Smith Genome Sciences Centre was founded in 1999 by Dr. Michael Smith, PhD (1932 - 2000). He won the 1993 Nobel Prize in Chemistry for his foundation work in gene science.
Canadian Statistics - Selected leading causes of death by sex, Canada, 1995: http://www.statcan.ca/english/Pgdb/health36.htm
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