A global virus is also a local story. The severe acute respiratory syndrome has reached Calcutta, and has immediately become part of the usual medical-bureaucratic mess such public health contingencies inevitably create in this part of the globe. Unfortunately for the medical authorities in West Bengal, the irreversible moment of error can be precisely identified. A SARS suspect was released by the Infectious Diseases Hospital in Calcutta, allowed to roam free for a couple of days and be treated without any warnings at another city hospital — and all this before his test reports came in from Pune. He did test positive though, and what followed this revelation led to further mishandlings. The World Health Organization has issued clear directives regarding the handling and discharge of suspected and confirmed victims, including strict quarantine rules and other forms of surveillance and containment to check local transmission. Health authorities in Vietnam and Toronto have followed these directions to very good effect. But Calcutta’s first steps could prove to be a lethal stumble. Not only was an unconfirmed discharge a bad mistake, the failure to set up a local testing centre, because of inefficient and indecisive red-tape, could also allow more such mistakes. Quick diagnoses would greatly reduce the spread of the virus.
Providing correct and essential information to the public is also a must. A lot would depend on how much people know about the virus and about how to protect themselves from it. This is the responsibility not only of the government, particularly the medical and municipal authorities, but also the individual hospitals treating or preparing to treat SARS cases. These hospitals have to maintain transparency with their doctors, nurses, staff, other patients and their families, keeping them posted with clear instructions and information. This will also control panic born out of ignorance, and forestall attitudes which lead to the ostracization of victims, suspects and their families, by hospital staff as well as neighbours. But specific forms of behaviour in public places will also have to change. The spread of SARS could be considerably reduced if Calcuttans were forced to realize the link between contamination and such unthinking and perfectly acceptable practices as spitting, urinating, expectorating, unrestrained sneezing and a general unwillingness to use a handkerchief in blowing one’s nose in public. SARS could become a serious crisis of public health, which is as much a matter of considerate behaviour as of good doctors and responsible health ministers.