Readings & Audiovisual

I think the gut reaction of many Hong Kong was that "oh no, it is SARS again", probably because the memory from when the disease plagued Hong Kong 17 years ago is quite vivid and painful for many of us. But the side effect of that is that people reacted quickly to see the virus from Wuhan by saying you should wear a mask in public whilst government officials were seen on TV not wearing a mask. Other knowledge such as cleaning a home with bleach solution, maintaining good hand hygiene are also from 17 years ago and people are putting this knowledge to good use. Anot

This report is the third instalment of the ‘Social Science in Epidemics’ series, commissioned by the USAID Office of U.S. Foreign Direct Assistance (OFDA). In this series, past outbreaks are reviewed in order to identify social science ‘entry points’ for emergency interventions and preparedness activities. The aim is to determine tangible ways to address the social, political and economic dynamics of epidemics and to ensure that interventions build on the social and cultural resources of the communities they aim to support. This report explores lessons about the social dimensions of past and recent influenza epidemics and the emergence of SARS-CoV.

The emergence of Severe Acute Respiratory Syndrome (SARS) in China’s Guangdong Province in the winter of 2002 was an exemplary spillover event: it marked the passage of a lethal pathogen from nonhuman to human animals and was widely heralded as the first “plague” of the twenty-first century. The SARS coronavirus seemed to burst out of nowhere and demonstrated pandemic potential from February 2003 when it diffused globally via Hong Kong. After SARS was officially declared contained by the World Health Organization (WHO) on 5 July 2003, there were a few isolated cases but none since 2004

This article traces the early evolution of the H1N1 pandemic as it played out in China′s Pearl River Delta in the spring and summer of 2009, as local public health professionals there tried to contain the virus when their American counterparts did not do so. My informants′ difficulties in escaping their perceived status as a source, rather than a victim, of dangerous viruses; their use of disease control tactics that were portrayed abroad as excessive, unscientific, and unsophisticated; and their fatalism about reforming their local system of governance; all frustrated their ambitions. At the same time, the gulf between their reactions to H1N1 and the reactions across the Pacific suggests the need for a more serious global debate about what local places in all parts of the globe should and should not be prepared to do in the name of pandemic preparedness. [SARS; H1N1; pandemic; China; preparedness]

This article explores the disease-associated stigma attached to the SARS victims in the post-SARS era of Hong Kong. I argue that the SARS-associated stigma did not decrease over time. Based on the ethnographic data obtained from 16 months of participant observation in a SARS victims' self-help group and semistructured interviews, I argue that the SARS-associated stigma was maintained, revived, and reconstructed by the biomedical encounters, government institutions, and public perception. I also provide new insight on how the SARS-associated stigma could create problems for public health development in Hong Kong. As communicable diseases will be a continuing threat for the human society, understanding how the disease-associated stigma affects the outcomes of epidemic control measures will be crucial in developing a more responsive public health policy as well as medical follow-up and social support service to the diseased social groups of future epidemic outbreaks.

The appearance and spread of severe acute respiratory syndrome (SARS) on a global level raised vital legal and ethical issues. National and international responses to SARS have profound implications for 3 important ethical values: privacy, liberty, and the duty to protect the public's health. This article examines, through legal and ethical lenses, various methods that countries used in reaction to the SARS outbreak: surveillance and contact tracing, isolation and quarantine, and travel restrictions. These responses, at least in some combination, succeeded in bringing the outbreak to an end. The article articulates a set of legal and ethical recommendations for responding to infectious disease threats, seeking to reconcile the tension between the public's health and individual rights to privacy, liberty, and freedom of movement. The ethical values that inform the recommendations include the precautionary principle, the least restrictive/intrusive alternative, justice, and transparency. Development of a set of legal and ethical recommendations becomes even more essential when, as was true with SARS and will undoubtedly be the case with future epidemics, scientific uncertainty is pervasive and urgent public health action is required.