Effective detective work in epidemics

Ten years after the SARS pandemic, reviews have been published in Science about what people did to understand and stop the spread of the disease.  The first review I read emphasized molecular virology:

[A]s soon as [the SARS outbreak] emerged, dozens of labs around the world jumped into the fray. Working on parallel tracks, they tried to figure out the causative agent, where it came from, what made it so deadly, and how to stop it.

The virological detective work is fast-moving and exciting.  It does not all happen in the lab; it also involves visits to markets to find wild animals being sold that might harbor the evolving virus.  But the story does culminate in the lab:

In the end, what made SARS such a threat to human health turned out to be surprisingly and alarmingly simple. Thirty months after the causative agent was found to be a novel coronavirus…, scientists determined that what gave the agent the ability to infect and sicken humans came down to two key amino acid changes in a viral protein.

The second review I read describes tracking and containment efforts coordinated by WHO with less or more cooperation from national governments.  This concludes:

[I]n the end, 21st century lab science had little impact on the fight against SARS; the disease was stopped using 19th century hygiene measures. Diagnostic tests developed soon after the virus was isolated weren’t needed to manage the outbreak, and the sequence, completed by Canadian scientists on 12 April [only 4 weeks after WHO issues an alert on the disease] , had little direct impact. Scientists launched programs to develop antivirals and vaccines against SARS—and some of the work is still going on—but they never came to fruition; the direct need for them disappeared in July 2003, when the epidemic was declared over.

The virologists understand that the disease had been stamped out without knowing how the virus works.  Indeed, the elipses in the second quote were for the phrase “and 2 years after the disease had been stamped out.”  But their language–“causative agent… and how to stop it”–downplays the need for public health infrastructure to track and contain future pandemics, let alone the need for wider understanding and recognition of the links between political-economic changes and conditions that make outbreaks harder to track and contain.

Dennis Normile, Understanding the Enemy, Science 15 March 2013: 1269-1273.
Martin Enserink, War Stories, Science 15 March 2013: 1264-1268


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