Intended for healthcare professionals

Analysis And Comment Epidemics

What we have learnt from SARS epidemics in China

BMJ 2006; 333 doi: (Published 17 August 2006) Cite this as: BMJ 2006;333:389
  1. Nanshan Zhong, head and professor (,
  2. Guangqiao Zeng, associate professor1
  1. 1 Guangzhou Institute of Respiratory Diseases, Guangzhou, China
  1. Correspondence to: N Zhong, President, Chinese Medical Association, Guangzhou Instititute of Respiratory Diseases, 151 Yanjiang Rd, Guangzhou China 510120
  • Accepted 20 March 2006

China's experience with SARS has important implications worldwide, and may improve preparedness for an epidemic if bird flu spreads to humans

The mainland of China experienced three outbreaks of SARS between November 2002 and May 2004. The first outbreak resulted in a pandemic and caused huge financial loss and social panic, but rigorous policies and control measures that were established circumvented further pandemics. Such efforts mean that SARS is currently under control. However, these outbreaks revealed some problems in the health system and in public understanding of emerging infectious diseases. The lessons we learn while facing up to these events can improve our medical performance in the future for management of new epidemics, such as human avian influenza.

What have we learnt?

Lesson one: honesty is needed

In an emergent event, an information blackout makes absolutely no sense. The first case of SARS appeared in Guangdong province, China, in November 2002,1 but information about it was not broadcast on Central TV, the official Chinese television station, until February 2003,2 though rumours spread via cell phones and the internet. It was not until three months after the breakout of epidemics that a group of healthcare officials were sent to investigate. Before this, the absence of open news was an attempt to maintain social stability. But the silence led to panic buying of vinegar and some Chinese herbal drugs that were believed to help prevent this “mysterious” disease. Soaring prices for these goods extended to others, undermining the intended social stability. Things began to change when information, in the form of daily roundups on SARS epidemics and public education on disease prevention, reached the community.

Honesty is what matters. The public needs to know the truth; concealing what happens may lead to a panic rather than to social stability. Prevention and control of communicable diseases remains critical for the …

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