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Aired April 23, 2003 - 20:30   ET


ANNOUNCER: A deadly virus on the loose, the world on alert.

DR. JULIE GERBERDING, CDC DIRECTOR: We still have no capacity to predict where it's going or how large its ultimately going to be.

ANNOUNCER: Over two dozen countries hit by SARS so far. Who's next? And is there a way to stop it?

As the disease spreads, so does fear.

UNIDENTIFIED MALE: I've been walking around with my t-shirt over my nose like this.

UNIDENTIFIED MALE: You walk around with your t-shirt...


UNIDENTIFIED MALE: A handkerchief. I put it over my face.

ANNOUNCER: Should you be afraid?

China, ground zero for the SARS epidemic, more than 2,000 case alone. At first, officials kept the spread a secret, a deadly secret.

PETER HUMPHREY, RISK ANALYST: Whose initial reactions to a crisis are: Cover it up, muzzle the media, and hide the facts.

ANNOUNCER: Why did the Chinese cover it up?

LIVE FROM THE HEADLINES: SARS, a special report.


PAULA ZAHN, CNN ANCHOR: It is called severe acute respiratory syndrome, and it literally takes your breath away. It all started five months ago, people getting sick and dying from this very strange disease.

Medical correspondent Elizabeth Cohen explains how the SARS story unfolded.

(BEGIN VIDEOTAPE) ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT (voice-over): This is where it started, November 2002, Guangdong Province, China, reports of what was then called then called mystery pneumonia.

Then, in December, January, February, the disease spread to neighboring Hong Kong and to Vietnam. March 15, the World Health Organization issues a global alert. SARS is also in Canada, the U.S., parts of Europe. By April, Antarctica is the only continent left untouched by SARS, a disease with no treatment, a disease that starts with a cough and a fever and can get out of hand very quickly.

GERBERDING: We have still no capacity to predict where it's going or how large it's ultimately going to be.

COHEN: And how bad is it? One-hundred and eighty-seven deaths in China alone, where the epidemic has been particularly bad, because they kept it secret for so long. In Hong Kong, 321 people got sick in just one apartment complex.

In Canada, with 324 sick people and 14 deaths, there have been large-scale quarantines. Hospitals have closed. There are warnings about SARS being spread on public transportation.

(on camera): So, how does SARS spread? Well, do you remember what your mother told you about covering your mouth when you sneeze? Well, if someone were sitting right here next to me, and I had SARS and I didn't cover, I could get them sick from the infectious droplets coming out of my mouth. Now, what about the rest of the people in this room? Could the air carry those droplets to them? Experts aren't sure.

And what if I sneezed and then touched the chair and then someone else came by later and touched that same spot and then touched their own face? Could they get sick? Well, since the virus that causes SARS has been known to live on surfaces for at least a few hours, SARS could possibly spread that way.

(voice-over): With all this bad news about SARS, the ease with which it spreads, the hundreds of health care workers who have gotten sick from their patients, the depths of fear, there is hope. In a matter of weeks, scientists identified the virus that causes SARS and mapped out its genes. That will help them find a treatment.

And isolating sick people the minute they're diagnosed has meant relatively few patients in the United States, only 39 and no deaths. But the World Health Organization warns, if SARS remains out of control in parts of Asia, given the way people travel today, SARS could be a global problem for a very long time.


COHEN: Here's something else the Centers for Disease Control is doing to stop the spread of SARS in the United States. Everyone who comes to this country from China, Vietnam and Singapore, everyone's given this yellow card and it tells people in several languages that they may have been exposed to SARS while they were traveling, and if they get a fever and a cough, they need to go see their doctor -- Paula.

ZAHN: Thanks for all the information, Elizabeth Cohen.

The most successful viruses are not necessarily the most lethal. Some patients live at least long enough to pass the virus along. SARS has a particularly sinister trait, hitting hard at those fighting it. Those would be health care workers.

Medical correspondent Dr. Sanjay Gupta now joins us now from our newsroom in Atlanta with more.

Now, I know you're a doctor that doesn't like to alarm people. Give us your perspective on how dangerous you think SARS is.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Well, there is some initial data now, Paula, actually, two months at least worth of data, looking at who's recovering and who's not and what percentage of people.

And what they're find is, about 95 percent, a large percentage of people, are actually recovering from SARS. About 5 percent of people or so have gotten very sick and even died. Now, 10 to 20 percent of people who develop SARS are getting very sick, to the point where they need to be in an intensive care unit. They're required to be on a ventilator for quite some time. So it can be quite problematic.

But, really, the numbers are in the favor, much in the favor of people recovering from this. So that's a little bit of perspective sort of long term how people might do from this.

ZAHN: Let's talk specifically what we're seeing in our country: in the United States, 39 probable cases, 190 suspected cases of SARS. How worried should the average American be?

GUPTA: Well, I think that the sort of the -- what I've been hearing from most people who have really been following this along is that it is of great concern.

And it's important to point out that this started with one individual. One individual actually took this disease and they actually brought it into a country. And it's since then spread. It's now in 27 countries, 35 states around this country. It did start with one individual. And that can be so important. This is what someone from the World Health Organization had to say about that.


DICK THOMPSON, WORLD HEALTH ORGANIZATION: One individual can have a significant impact. It was one individual that brought the disease into Hong Kong. It was one individual who brought the disease in Toronto. So one individual can have an enormous impact on public health system, especially on hospitals. And that's why we pay so much attention to it.


GUPTA: And a lot of attention is being paid to it now, Paula.

But you and I have talked about so many different health topics over the past couple of years. There is some perspective that's important: 36,000 people die every year from the flu. That is something we know how to control. That is something we know how to treat. Today, 44 people died of AIDS. Over 1,400 people died of cancer. Over the last month, seven people dived of West Nile virus.

These are all important stories, too -- obviously, a lot of attention being focused on SARS right now. But, again, the perspective is important in terms of these other numbers.

ZAHN: Sanjay, it just occurred to me, I haven't had a chance to welcome you back from your very long trip to Kuwait and to Iraq. You did some superb work.

GUPTA: Thank you very much, Paula. It was very interesting personally and professionally.

ZAHN: I bet. Thanks, Sanjay.

GUPTA: Thank you.

ZAHN: Still ahead: The virus crosses a continent and lands at the doorstep of the United States. We're going to talk to a doctor in Canada who spent more than a week under quarantine.

And it is spreading faster than SARS. It can get to you no matter where you are. It is fear and we're on its trail right after this.


ZAHN: Very good advice there on that graphic board.

Outside Asia, Canada has more probable SARS cases than any other country, 135, with 14 fatalities.

Dr. Donald Low is at the epicenter of Canada's SARS crisis, literally. He was quarantined for more than a week when he was exposed to the virus. He is chief of microbiology at Mount Sinai Hospital in Toronto.


First of all, how are you feeling? What's your prognosis?

DR. DONALD LOW, MOUNT SINAI HOSPITAL: The prognosis, I hope is good.


ZAHN: Did you end up having it or not?

LOW: No, no, but the 10 days of isolation was enough for me. ZAHN: Tell us a little bit about the fear factor here. I'm sure, when people hear the large numbers we're talking about, some 7,000 folks being quarantined, it's got to send some shockwaves out there.

LOW: Yes, it really has had an effect on the city.

You have to recognize, this is a hospital problem, basically. But you can imagine the ripple effect into the community, people being afraid to come downtown. Hotel occupancy rates are down. And there's no reason for that. There's no threat in the community. But it's the unknown. And people are learning more about this. And people are anxious. But we have to keep telling people they got to get on with their day-to-day life, that we're looking after this and we're looking after it primarily in the hospital. It's really a hospital problem.

ZAHN: Well, let's talk about that for a moment, because I guess you must consider yourself pretty lucky, although I know the quarantine was no fun for you. But talk about the vulnerability of health care workers in general.

LOW: Well, that's the most disturbing part of this for all of us, is to see our health care works being affected first. And when we had our first cases appear in a hospital on March 7, what happened was, other patients ill before they were recognize as having SARS. And that just amplified the problem, so that we saw, in some cases, one individual resulting in 20 health care workers becoming ill.

I admitted in a two-day period in a temporary ward that we established 14 health care workers from one hospital that had come down with this. Once we defined what the problem -- we recognize we had, we were dealing with this new pneumonia, thought we were instituting the right precautions to protect our health care workers, we have still seen occasional cases where health care workers have gotten sick.

ZAHN: And tell us a little bit about the challenge of what you do with people who are breaking the quarantine. What do you think should happen to those folks?

LOW: Well, that's another -- it's the exception. It is the exception.

But we have one example where a man who was under quarantine, was symptomatic, was getting paid by his employer to stay home, decided to go into work against advice. And not only did he take that infection into the workplace, but infected another co-worker, who today remains in an intensive care unit.

ZAHN: And even though this is such a mysterious illness, when you were quarantined yourself, I want you to be honest with us about what that experience was like. Was there a period of time where you thought you were going get it?

LOW: Well, we were all sort of at the epicenter. And the colleague that I was exposed to, she came down with the illness. And we were fearful for her. She was very sick. She just went home yesterday, after being in the hospital for 2 1/2 weeks.

And when you see a close friend develop pneumonia due to this disease -- and pneumonia is not the typical presentation in somehow acutely ill in one or two days and then getting better. This is somebody who remained sick for over 10 days, developing new infiltrates on a chest X-ray. It's quite disturbing. And, obviously, people and health care workers are concerned for their health.

ZAHN: Well, we're glad to hear you're OK. And we know you're out there on the front lines with a lot of your fellow colleagues out there. And we wish you tremendous luck and hope you find out a lot more about this disease in the days to come. Again, thanks for joining us, Dr. Low.

LOW: Thanks, Paula.

ZAHN: Certainly, a central fear is that the virus will simply move south from Canada into the United States.

Though there has not been a single SARS death in the United States, among 39 suspected cases, Jason Carroll reports, fear sometime spreads faster than facts.


JASON CARROLL, CNN CORRESPONDENT (voice-over): In New York's Chinatown, signs of trouble: "Afraid of SARS? Don't be. Support Asian restaurants." It's a slogan the owner of Bokai (ph) Restaurant wishes more would take to heart. Chivi Engo (ph) says fears of SARS nearly cost him his business.

(on camera): But things look pretty good now.

UNIDENTIFIED MALE: So far, so good. It seemed like it picked up a lot compared with two weeks ago.

CARROLL (voice-over): Several weeks ago, a rumor spread that Engo had contracted SARS on a trip to Vietnam and had died. He says trying to stop that rumor was like trying to stop the wind.

UNIDENTIFIED MALE: I have to be in front of my restaurant to tell people that, hey, I'm alive, you know?

CARROLL: Engo can laugh a little now that the truth is out, but some faces in this neighborhood show there's still the perception something is wrong.

UNIDENTIFIED MALE: I'm walking around with my T-shirt open, my nose like this.

CARROLL (on camera): You walk around with your T-shirt.

What do you do?

UNIDENTIFIED MALE: I walk around with a handkerchief. I put it over my face. CARROLL (voice-over): It's not just Chinatown. It's the same on a subway in Queens.

UNIDENTIFIED FEMALE: Everybody is constantly aware of these things.

CARROLL: At airports in New York.

UNIDENTIFIED FEMALE: Safety's sake. You never know what's going to happen.

CARROLL: Los Angeles.

UNIDENTIFIED MALE: I don't want to take a flight to anywhere around Asia, because of SARS.

CARROLL: And Seattle.

UNIDENTIFIED FEMALE: I bring the mask and kind of medication and all kinds of washing things with me.

CARROLL: The travel industry, already hurting from terrorism fears, now faces SARS. Jodi Tang's (ph) agency deals primarily in travel to China. How is her business?

UNIDENTIFIED FEMALE: Mostly 80 percent down.

CARROLL: Tang says her relatives in China, like most American experts, say there's little need to worry about SARS within the United States. Even so, Tang wipes down her desk and greets new customers at arm's length.

UNIDENTIFIED FEMALE: Just like this. I don't want too close to them. I don't know where they come from.

CARROLL: Doctors say most people in the U.S. don't need such precautions. SARS is still found mostly in China. Most U.S. patients contracted it overseas, after having had close contact with an infected person.

Don Lee (ph), a Chinatown activist, says education is the best way to ease fears of SARS.

UNIDENTIFIED MALE: The lesson learned here is to say, let's go to get information and news from reliable sources.

CARROLL (on camera): Get the facts?

UNIDENTIFIED MALE: Get the facts, simply get the facts, and not be fearful of these rumors.

CARROLL (voice-over): A point Engo hopes more of his former customers will remember.

(END VIDEOTAPE) CARROLL: Of all the probable SARS cases in the United States, just two are from the New York City area. Community leaders here in Chinatown say they just want people to use their common sense. They say Chinatown is just as safe as any other town -- Paula.

Jason Carroll, thanks so much.

Now, the agency on the front lines of this medical battle in the U.S. and also internationally: the Centers for Disease Control and Prevention, the CDC, more simply put.

Dr. Julie Gerberding is the CDC director. She joins us now from Atlanta.

I know how busy you've been today. Thanks for carving out a little time for us tonight.

GERBERDING: Glad to be here you.

ZAHN: First off, you saw some of the people Jason talked to and how they're afraid, even though they're not likely to have much exposure to health care workers who might have had exposure to this virus. Are people wasting their time and their money in the United States to buy these face masks?

GERBERDING: Well, we understand how fearful a new disease really is. And so my sympathy goes to people who are struggling to put this into perspective.

But right now, this still is a rare problem in this country . We know that there are certain people who are at risk because of their travel history. But most us have very little to worry about at this point in time. I don't think we have any evidence at all that people on the streets need to be wearing masks or be concerned about face-to- face contact with anyone at this point in time.

ZAHN: And yet one of the more alarming things you said in a news conference earlier today I think that caught all of our attention was the phrase when you said that you have no capacity to predict where SARS is going. That has got to continue to make people feel very vulnerable.

GERBERDING: This is a dilemma, because this is brand new. We're still watching the epidemic unfold in China, in Hong Kong, and parts of the world where it's not contained. And yet we have some very hopeful information from some areas where there has been very limited spread outside the immediate health care environment or household context.

But we have to be honest and say, if we're lucky, this will be the beginning of a problem that we'll soon be able to contain and, soon enough, we'll have a vaccine and a treatment. But if we're not so lucky and this continues to spread outside of the immediate environment, we could be in for a real long race. And I think that's the thing that we're trying to balance. We don't know where we're going, but we want to make sure we're doing everything we can right now to contain this problem.

ZAHN: But given how quickly the numbers seem to be escalating, do you think it would be the responsible thing for the CDC maybe to broaden its travel advisory, or would that be overreacting?

GERBERDING: Well, we're trying to make our guidance evidence- based. We're also trying to be out in front of the problem, not looking back on what we should have done last week.

And I think where we are right now is appreciating the spread that is ongoing in certain parts of the world. We do have travel advisories to those areas. But in places where the epidemic is still linked to known travelers and their immediate context, there really is no hazard to travelers, so there's no sense to suggest that people not travel to those locations.

What we are doing is working very hard and communicating very closely with health officials in all these areas and particularly at the WHO, so that we can be right on top of any new transmission pattern or anything that would pose a new risk to folks here in the United States.

ZAHN: And, finally, Dr. Gerberding, I wanted to give you a chance to put this into perspective for people who have read a lot about this virus, people who are trying to be rational about the whole thing, saying they don't think they have come into contact with health care workers who could have been exposed to this or people who traveled to these regions affected by it. But they're still scared stiff.

GERBERDING: It's scary when we're dealing with a new infection. And I would just like to say, the best remedy for fear is information. Now, we're trying put credible information out in every way that we can, including our Web. We also recognize that many of the public health officials and the clinicians are excellent sources of the facts. And I would just encourage people to get informed, ask questions and use some common sense.

ZAHN: Well, that's probably the best advice of all.

Dr. Julie Gerberding, thank you very much for joining us tonight.

GERBERDING: Thank you.

ZAHN: We very much appreciate your perspective.

When we come back: With so many lives at stake, including their own, why did Chinese officials mislead the world about the spread of SARS? Some possible answers when we come back.

And, as we go to break, we leave you with some live pictures of Chinatown right here in New York City.


ZAHN: So how many lives would have been spared, how much money saved, if Chinese official had not initially concealed vital information about SARS? It's impossible to know, but the question remains, why the cover-up?

Here's Beijing bureau chief Jamie FlorCruz.


JAMIE FLORCRUZ, CNN BEIJING BUREAU CHIEF (voice-over): There are about half-a-dozen SARS patients under intensive care behind tightly- sealed windows in this Beijing hospital ward. Just how many other SARS victims there are in China remains a question. The health minister two weeks ago claimed the epidemic was under effective control, even while SARS was spreading across the country.

HUMPHREY: We often have seen, I think in cases like this, knee- jerk reactions from old-style communist cadres, Whose initial reactions to a crisis are: Cover it up, muzzle the media, and hide the facts.

FLORCRUZ: Chinese officials do that, just like in the imperial times, for fear of losing face or losing their jobs, like in the 1990s, when the AIDS epidemic first struck China. These poor Hainan farmers contracted HIV selling blood. But they suffered in the dark while officials covered up the epidemic for five years. This time, Chinese leaders acted more boldly by dismissing the health minister and the Beijing mayor for mishandling the crisis.

To contain SARS, a public information campaign is under way. Pharmacies sell traditional preventive medicine. But trying to bottle up the disease calls for big sacrifices. China has shortened the weeklong May Day holidays to curtail mass travel.

LI XIGUANG, TSINGHUA PROFESSOR: Just like after 9/11, the American people, immediately, they gathered around the American president, and so the whole nation are fighting against terrorism. And now the Chinese needed to unite against this terrible disease.

FLORCRUZ (on camera): Beijing says the government will spend as much as much as it takes to contain SARS. But to regain public confidence, experts say, China will have to institutionalize a modern and transparent reporting system.

Jaime FlorCruz, CNN, Beijing.


ZAHN: And before we go, we want to tell you about the World Health Organization doctor who first identified SARS, Dr. Carlo Urbani. We will never know how many people he saved with his work for that U.N. agency. What he did show us, though, is just how vulnerable health care workers are in this battle. Last month, SARS killed Dr. Urbani. He drew his last breath at the age of 46. Even as we speak, countless health care workers risk making the same sacrifice for the same reason: to save lives.

Thanks so much for joining us tonight. Please stay tuned now for "LARRY KING LIVE," right after a quick check of the headlines.

Thanks so much for joining us tonight. Hope you'll be back with us same time, same place, tomorrow night. Good night.


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