Are we prepared to deal with SARS?

You''re surely asking "is Mumbai prepared to deal with SARS?" We aren''t 100 per cent ready, and although Mumbai probably won''t be ravaged by the virus, we should take it as a wake up call and build better systems like those found in other countries.
Already, approximately 6000 people around the world are infected, and over 350 people are dead because of SARS.The WHO stated that if SARS cannot be contained in China, then it cannot be contained.
Fortunately, most areas of China - including Guangdong province, the source of SARS - are reporting a diminishing number of cases per day.
Our central and state governments are working to allay fears, but screening airline passengers, and instructing citizens to wash their hands, wear a gauze mask and keep their neighbourhoods clean, isn''t enough.
Until the first week of April, the BMC didn''t have access to diagnostic kits required to determine SARS. And a shortage of ambulances disabled BMC health officials from shifting suspected passengers from Mumbai''s airports to hospitals.
SARS is a mutant virus, and in the near future, newer morphed diseases could spring up - we should be ready for them.
The BMC urgently requires a research centre like the London School of Tropical Medicine, which helps health officials evaluate trends illnesses, generate positive agents to fight viruses, create or identify drugs and initiate treatment.
Another great example of a research system can be found in New York City, where the department of health has a surveillance system that provides early warnings for disease outbreaks.
It analyses vast amounts of information such as emergency calls, hospital visits and drug purchases daily, filtering them for patterns that might have otherwise escaped unnoticed.
For instance, a borough of the city recently suffered a sudden, sharp increase in the number of people with fever and trouble breathing, many of whom visited a nearby hospital''s emergency room.
Suspecting SARS, city health workers immediately questioned doctors, nurses and patients about symptoms, travels and recoveries, making plans to isolate those infected. Although it was a false alarm, through this statistical process, the city was prepared to foresee and successfully handle an outbreak.
There is no vaccine for SARS. Hospitals only provide patients with supportive treatment like drugs to reduce fever or wheezing, antibiotics to prevent relapses and depending upon the case''s severity, oxygen by putting them on a respirator.
Mumbai''s VN Desai & Kasturba hospitals test suspected patients and send findings to the National Institute of Virology (NIV) in Pune for confirmation of the virus.
Since this procedure is time consuming, suspected patients who are being quarantined become restless, and in the case of Kasturba hospital, a wrongfully discharged patient flew to Delhi before tests confirmed he was SARS positive.
After this incident, Maharashtra''s health department decided that patients will be discharged only on the approval of the Director General of Health Services.
However, since a democracy dictates that the quarantine of SARS patients is voluntary, India cannot enforce quarantine procedures as assertively as communist states such as Vietnam and China (the WHO recently removed Vietnam from its list of SARS-affected countries).
The Kasturba affair could have been avoided if the BMC had a reference lab in the city, or upgraded the one in the hospital where the embarrassment occurred. It''s absurd that a crowded metro like Mumbai has to rely on Pune for its medical necessities.
The state government recently announced the setting up of a reference lab at Parel. Until it becomes operational though, the only alternative to the NIV is one of Ranbaxy''s specialty labs in Mumbai, where each test costs Rs 2500, an expensive proposition compared to the BMC''s pro bono check-up. The mortality rate from SARS is 3 per cent.
However, if SARS spreads virally, 3 per cent could mean millions of deaths in India - an unmanageable task for health officials to prevent. Such outbreaks are also accompanied by massive economic damage.