Editorial: Looking back on SARS
2009; Wiley; Volume: 18; Issue: 5 Linguagem: Inglês
10.1111/j.1365-2702.2008.02676.x
ISSN1365-2702
Autores Tópico(s)COVID-19 Pandemic Impacts
ResumoI made my first visit to Hong Kong in July 2003, the same year as the SARS (severe acute respiratory syndrome) outbreak and the month after Hong Kong had been declared a SARS-free zone (http://news.bbc.co.uk/1/hi/world/asia-pacific/3011724.stm; retrieved 13 October 2008). Many memories are conjured up by the visit: in the UK there was a moderate amount of hysteria about any proposed visit to Hong Kong and even visits by fellow academics being cancelled, which shows that even well informed academics – with the facts ‘at their fingertips’– cannot get things into perspective. The facts are simple: Hong Kong has a population of nearly 7 million people; 298 deaths were attributable to SARS and these were largely the very young, the very old or those otherwise medically compromised (http://news.bbc.co.uk/1/hi/world/asia-pacific/3011724.stm; retrieved 13 October 2008). Other memories include the common use of surgical face masks to, purportedly, prevent the acquisition or the spread of respiratory infections. Whoever produced and distributed surgical facemasks in Hong Kong must have seen their sales rise dramatically; there was even the amusing sight of ‘designer facemasks’, with faces and patterns on them, typical of the entrepreneurial spirit in Hong Kong. The use of facemasks persists despite a lack of evidence for their effectiveness (http://findarticles.com/p/articles/mi_qa4130/is_/ai_n15705038; retrieved 13 October 2008), especially over prolonged use in a generally hot and humid climate. Nevertheless, the use of facemasks, like most such rituals, indicated that something was being done and that individuals were doing something. I never visited Hong Kong prior to SARS, but I believe that the ubiquitous habit of spitting in the street ceased overnight which was, at least, aesthetically beneficial; other countries could learn from this. However, I refer above to some relatively superficial aspects of SARS. It is easy to be amused by people who overestimate the risk of being infected themselves or by the perpetuation of needless practices, but the effect that SARS had on the people of Hong Kong was profound. Always meticulous about personal appearance, cleanliness and hygiene, the people of Hong Kong instituted practices such instructions on hand-washing in public toilets; the regular disinfection of commonly and communally touched surfaces (e.g. elevator buttons) which have also persisted for five years and show no signs of abating. It is unlikely that such public health initiatives would persist, for example, in the UK for more than a few months. The people of Hong Kong are determined to prevent another outbreak of SARS or any similar infectious disease and papers published in JCN in the past four years demonstrate this. The first SARS paper to appear in JCN came from the Nethersole School of Nursing at Chinese University of Hong Kong (CUHK) (Thompson et al. 2004) and this was significant as CUHK is located in Shatin, where SARS originated, and its nursing and medical schools use the Prince of Wales Hospital which was in the front line of dealing with SARS. Therefore, this paper comes from an institution where colleagues and students came into direct contact with SARS. Despite the relatively small number of deaths from SARS the fact that many thousands of people were infected and required hospital care should not be forgotten and, as Thompson et al. explain, this left nursing staff exhausted, stressed and demoralised. In a similar vein, and also from CUHK, a paper by Lau and Chan (2005) explored the role of the nurse manager during SARS and pointed to the promotion of ‘emotional stability’ of nursing staff as a major part of the job alongside ensuring safety. Chung et al. (2005), from the Hong Kong Polytechnic University also referred to the emotions experienced by nurses caring for SARS patients – because of uncertainty – and the support such nurses require. While there was an emphasis in some of the early papers about SARS on the impact on nursing staff, researchers also evaluated services provided and Chung et al. (2004) published their evaluation of a helpdesk established by the Hong Kong Hospital Authority for patients and relatives. The relatives found the service helpful in reducing anxiety generally but not as helpful in providing specific information about their sick relative. More recently, Siu et al. (2007) investigated the use of a traditional Chinese practice of qigong by chronically ill patients during the SARS outbreak. These were not people suffering from SARS but, nevertheless, they found the practice of qigong– a set of breathing and movement exercises, with possible benefits to health through stress reduction and exercise (http://en.wikipedia.org/wiki/Qigong; retrieved 13 October 2008) – helpful in reducing anxiety about SARS. Clearly, there is a desire that SARS never returns. However, if it returns, there is an even greater desire to be prepared and more recent publications in JCN have focused on evaluating systems of care delivery (Chan et al. 2006, 2008), preparing for a pandemic influenza based on lessons learned from SARS (Chan & Wong 2007) and lessons learned from SARS in terms of nursing care models (Chan & Wong 2007). Severe acute respiratory syndrome was, possibly, a unique event in the world and it may have attracted more publicity and concern than it merited. However, such events serve to focus attention on issues that may, otherwise, have been ignored and, in the case of SARS, this has led to concern in Hong Kong for nurses’ morale and mental health. In addition, it has spurned research into care delivery and other programmes of research, not reported in JCN but which I am aware of through visiting the Special Administrative Region, into infection control. It will be interesting to see, more than five years after the event, if SARS produces any more papers for JCN.
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