Global scare dissolves with the end of SARS

The surgical masks are gone. Now a weekend stroll down Singapore's Orchard Road - a three-mile stretch that serves as Southeast Asia's Rodeo Drive - is once again no easy task. Navigating the tide of humanity as it charges from store to store requires a deft touch to avoid collisions.

There is perhaps no better sign that the outbreak of severe acute respiratory syndrome (SARS), the mysterious virus that emerged from southern China late last year, is over. In cities like Hong Kong, Singapore, Taipei, and Shanghai, no new infections have been reported for weeks.

Toronto, one of the last two cities on the World Health Organization's (WHO) list of SARS hot spots, was removed from the list Wednesday, and Taipei is expected to be removed by Saturday.

"This is a great achievement for public health in what we hope is the final phase of the global emergency," David Heymann, WHO executive director for communicable diseases, said in a statement.

Though WHO officials say they are happy with the way the outbreak has been handled - and have learned lessons about the extent to which hospital workers can spread a disease worldwide - there are also indications that the risk of SARS was overblown.

To date, the disease has infected 8,445 people worldwide, yet fewer than 1 in 10 died as a result (see chart). The total number of deaths pales in comparison to other diseases.

In Singapore, for instance, 32 people have died from SARS, compared to roughly 1,800 deaths a year attributed to pneumonia. Compared to historical pandemics, SARS is even less fearsome. The global flu outbreak of 1918 was estimated to have killed more than 20 million people, and as recently as 1968, a flu pandemic that hit Hong Kong the hardest killed more than 33,000 people.

A big part of the reason SARS scared so many is that its causes were at first mysterious, and to scientists like Dr. Hitoshi Oshitani, the WHO's Asia regional adviser, still remain perplexing.

Unlike the flu, SARS isn't transmitted through the air, doctors say. It requires more direct contact with bodily fluids for communication. That makes SARS difficult to catch and will probably make it easier to contain if it rears its head again.

Dr. Oshitani says that more than half of the people infected worldwide were either healthcare workers or people in close contact with healthcare workers, and better precautions will be taken to limit the spread of the disease should it recur.

"There is no ongoing large cluster of cases, anywhere in the world,'' says Dr. Oshitani. "But we still don't know some of the aspects of this disease, so we have to maintain our vigilance at least until the end of this year."

"We're confident that we can do much better next time,'' he adds.

The outbreak seems to have burned itself out almost everywhere at the same time, from city-states like Singapore that have been praised for its model response to the outbreak, to China, which sought to cover up the extent of the problem when it first emerged there. One of the reasons may be seasonal.

"In the summer there is less transmission than during other parts of the year," says Megan Murray, an Infectious Disease Epidemiologist at the Harvard School of Public Health in Cambridge, Mass., of flu-like viruses. "Influenza peaks in the winter and falls in the summer." Although scientists are unsure of why this may be, humidity and the length of days are possible reasons, she says.

Most travelers and residents of the Asian cities hit by the virus are putting it out of their minds. In airports from Jakarta to Hanoi, regional airlines have begun to restore canceled flights. Late last month Hong Kong's Cathay Pacific said it would resume 170 weekly flights that it had canceled in May due to the outbreak.

On Monday, United Airlines said it planned to resume flights on Aug. 1 that were halted earlier this year. It will restore daily flights to Hong Kong and Shanghai from San Francisco, and will add one flight per week from Chicago to Beijing.

That brings a smile to the face of Willie Beng who runs a store in the basement of Lucky Plaza shopping center that specializes in merchandise that can fairly be described as "Asian schlock": fake silk robes with embroidered dragons on the back, skull-caps with attached braids, and Chinese character pendants.

Mr. Beng says business was "miserable" two months ago, but that he's seen a steady stream of tourists - mostly from within Asia - in the past few weeks.

"From where I'm sitting the worst is past," he says.

The view is the same in the Gucci store a few blocks away, where a saleswomen says wealthy customers from Indonesia and Taiwan have been returning over the past month. After a brief conversation, she excuses herself to help a Japanese tourist in a cowboy hat and dangling amber earrings select a $500 wallet.

The early retail indicators are vital for cities like Singapore, where tourism generates $6 billion annually, 5 percent of its economy. The Singapore government lowered its 2003 economic growth forecast to 0.5 percent from 2.5 percent because of SARS. Over the weekend, Singapore Health Minister Lim Hng Kiang said the government has spent nearly $300 million grappling with the disease to date.

The April issue of the Far Eastern Economic Review estimated that the disease cost the region $11 billion, with Hong Kong being the hardest hit.

Wednesday, China's official news agency said that the SARS outbreak cost 7.2 million rural migrants job opportunities in cities, but the Chinese economy should still grow by 8 percent this year. A total of 348 deaths and 5,300 infections were attributed to SARS on the mainland, the most of any country worldwide.

• Teresa Méndez contributed to this report from Boston.

Of the 813 SARS-related deaths worldwide, 95 percent occurred in Asia.

China 348

Hong Kong 298

Taiwan 84

Canada 39

Singapore 32

Vietnam 5

Malaysia 2

Philippines 2

Thailand 2

South Africa 1

Total worldwide 813

Source: AP