I was narked to read in my local paper at the beginning of this week a quote from a local public health spokesman to the effect that ‘we are in the midst of a major epidemic and Ontario has lost control’ … followed by the usual mealymouthed exhortations against excessive concern. At medical school our instructors drummed into us that we have to watch our language. To the specialist ‘epidemic’ means essentially that we’re seeing a rise above background levels of a disease. To the layperson, ‘epidemic’ means ‘we’re all going to die!’ And as for Ontario losing control, not at that point. There was no evidence that it had got out into the community, that there are any chains of transmission that did involve contact with SARS patients in hospital – whose disease in turn could be traced to Asia. Whether that will change, with an eighth person dying of SARS in Toronto yesterday, and ongoing emergence of new cases and suspect contacts, remains to be seen.

An article by Jan Wong in the Globe and Mail Saturday summarized the information that has belatedly emerged from China about the initial spread of the disease. She attributes the release of the information to the WHO having issued a travel-advisory, thus bringing the problem to the attention of the travel and tourism industry. Up until then the official position of the Chinese government was ‘no problem, everything’s fine’ …

The Canadian Medical Journal and the New England Journal of Medicine both have pages dedicated to SARS, monitoring the outbreak and its response. The NEJM has an ongoing plot of cases and deaths, and an early release of an editorial by Julie Louise Gerberding from the CDC that describes the impressive international collaboration and Internet-wide information sharing involved in identifying and containing the outbreak – and also wonders whether the fast response will be fast enough. At this stage, we don’t know. But at least with SARS all the ingenuity and all the heroes are on the same side.