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SARS Epidemic 2003 - One doctor's perspective

A True Story

With all the scare about the Swine Flu, it has made me recall what it was like, working in a hospital in south-east Asia during the SARS (Severe Acute Respiratory Syndrome) period. This was a near pandemic in 2002/2003, with 8,096 known infected cases, 774 deaths worldwide. It was a disease which affected individuals in some 37 countries around the world.

In March 2003, when the SARS epidemic was in its infancy, my father died suddenly whilst holidaying with my mother in New Zealand. My mother was shattered. By the time logistics for transporting my father home to Melbourne for his funeral were sorted out, SARS had just reached its epidemic height in South East Asia.

At that time, I was working in a major teaching hospital in Singapore. The stringent requirements there included the formation of two radiological teams by my colleagues & me. Each team would be on duty & on call for two weeks without a break. This would be followed by two weeks of rest & this then repeats itself.

Each team must not meet the other, for the fear of cross-infection. Every day, we had to take our own temperatures, at first it was once a day, then twice, then thrice a day at the height of the epidemic. This would be entered into a computer database and sent to cyberspace, where someone would analyse the details. Any hospital employee who became ill during this period had to report his symptoms and diagnosis to the hospital immediately. Privacy was no longer a consideration.

We all had to attend workshops to be fitted with surgical masks and lectures were given on how to glove, gown & attend to patients suspected of having SARS. Details of this were entered into yet another database. On the days we were at work, we had to change into hospital scrubs at work, wear a NIOSH-95 mask when we were in contact with patients or with our colleagues. We then had to de-glove and de-gown when our shift came to an end.

There was always the subconscious fear that, being at the forefront, we could be struck by SARS anytime and without any warning. Knowing that a colleague was hospitalized in intensive care for SARS during this period did not instil the sense of heroism in any of us.

You see, while we may be doctors, underneath it all, we too are humans, and SARS does not differentiate between doctor and non-medical man-in-the-street.

When my mother returned home to Melbourne, Australia, after my father's death, she was in pieces & needed companionship day and night. To keep my mother company, every fortnight on a Friday evening, I would take the overnight plane from Singapore, transit through Kuala Lumpur, Malaysia (because of the lateness of my airticket bookings, I could not secure any direct flights) to go to Melbourne. I would then return by the Sunday night plane, arrive in Singapore by Monday morning and report to work that same day. These multiple transits meant that I had to pass through more thermal scan points at the airports than others would, be x-rayed more times than others would.

As SARS was at its height then, some of my many fears each time I boarded the plane were:-

•  What if I was already infected with the SARS organism, transmitted to me at work? Perhaps, I was undergoing my incubation period without feeling unwell? Would I be spreading this disease to my mother in another country?

•  What if someone on the plane was ill & infected me, and unbeknownst to me, I took the virus to my mother when I saw her in Melbourne?

•  What if I became ill in Melbourne & I couldn't return to Singapore to work? I would be letting down all my colleagues. The two teams I mentioned were made up of everyone in our department & we were already short-staffed. As there would only be half the numbers of radiologists at work at anytime, if any of us became ill, we would be even more short-staffed than we already were.

•  What if I became ill in Singapore and could not travel to see my mother every fortnight, as I had promised her?

•  What if our hospital escalated its alert, banning all its employees from air travel?

The first half of 2003 was a stressful time for all of us. For me, it was stressful not only professionally but also personally. With time, the epidemic subsided, and with it, the fear that surrounded it subsided. With time, my mother found a different way to live & I didn't have to commute between Singapore and Melbourne again.

As the Mexican swine flu epidemic progresses, I do feel deeply for the medical and paramedical professions in Mexico as they try to work their way through this stressful time. I feel deeply for them as I too have experienced and witnessed their personal fear & uncertainty.

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