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How SARS terrified the world in 2003, infecting more than 8,000 people and killing 774

How SARS terrified the world in 2003, infecting more than 8,000 people and killing 774
How SARS terrified the world in 2003, infecting more than 8,000 people and killing 774 - Business Insider

In 2003, the world watched in terror as a new virus called SARS infected thousands and killed hundreds. Here's how it happened.

A man wearing a surgical mask in a Hong Kong street Friday, May 2, 2003, because of the outbreak of severe acute respiratory syndrome, stops to look at a magazine poster that has SARS as its cover story.A man wearing a surgical mask in a Hong Kong street Friday, May 2, 2003, because of the outbreak of severe acute respiratory syndrome, stops to look at a magazine poster that has SARS as its cover story.
A man wears a surgical mask in a Hong Kong street on May 2, 2003.
Lo Sai Hung / AP
  • In the first half of 2003, a deadly disease known as Severe Acute Respiratory Syndrome spread from China into 28 other countries.
  • SARS infected a little more than 8,000 people, and killed 774 people. The majority of these cases were in Asia.
  • The disease is back on people's minds as a new novel coronavirus spreads across the globe. COVID-19 has already killed more than 2,000 people — more than the total number who died from SARS.
  • Visit Business Insider's homepage for more stories.

SARS was stopped, but it wasn't easy.

Over about nine months, from late 2002 until July 2003, a deadly disease known as severe acute respiratory syndrome, or SARS, spread from China into 29 countries. It infected 8,096 people, and killed 774, mostly in Asia.

Unlike HIV/AIDS, which took 20 years to cover the globe, or Ebola, which reared its head sporadically, SARS was a swift and terrifying pandemic.

One of the main reasons it had such a large and quick impact was that China failed to notify the World Health Organization until February 2003, several months after the SARS virus was first discovered.

Later, China downplayed the number of SARS patients in Beijing. The real number was 10 times as much as previously disclosed. It wasn't until a prominent local doctor wrote to the international media that the real number came to light.

After the international embarrassment, thousands of people were quarantined in homes or hospitals, schools were closed, borders were monitored, and the pandemic was taken seriously.

SARS is relevant now, 17 years later, as the world faces another deadly virus — the novel coronavirus now called COVID-19, which has infected at least 75,000 people, and killed more than 2,100.

Here's how SARS seemingly came from out of nowhere, and ended up killing hundreds of people in seven months.

In 2003, masks became a symbol of terror as the world dealt with its first pandemic of the 21st Century — SARS, or severe acute respiratory syndrome.

Wearing protective masks, Hong Kong residents line up to get free masks on a Hong Kong downtown street on Friday, March 28, 2003,
Wearing protective masks, Hong Kong residents line up to get free masks on a Hong Kong downtown street on Friday, March 28, 2003,
Vincent Yu / AP

Source: WHO

It began with a businessman who fell ill in Foshan, China. He had pneumonia-like symptoms, but the people who treated him quickly fell sick, too.

An Italian patient of Vietnamese origin, suffering from the pneumonia-like Severe Acute Respiratory Syndrome (SARS), breathes via a respirator in Hanoi's National Institute for Clinical Research in Tropical Medicine, April 3, 2003.
A patient suffering from the pneumonia-like Severe Acute Respiratory Syndrome (SARS), breathes via a respirator in 2003.
Reuters

Sources: The New York Times, The Atlantic

It's thought that he caught the SARS virus from a wet market in southern Guangdong Province.

A man sits in his stall beside caged dogs in a market selling wild animals for dishes in Guangzhou in south China's Guangdong province, in this May 26, 2003 photo.
A man sits in his stall beside caged dogs in a market selling wild animals for dishes in Guangzhou in south China's Guangdong province, in this May 26, 2003 photo.
STR / AP

Source: Business Insider

By February 9, 305 people had contracted SARS in the region, and five people had died from it.

A  doctor takes the temperature of a passenger before he boards a plane at Baiyun International Airport in Guangzhou, capital of south China's Guangdong province in 2003.
A doctor takes the temperature of a passenger before he boards a plane at Baiyun International Airport in Guangzhou, capital of south China's Guangdong province in 2003.
Xinhua Zhang Yiwen / AP

Sources: New Scientist, CNN

Doctors had never seen the virus before. What was confusing and prompted doubts was that, at the beginning, SARS looked like pneumonia.

A slide of a SARS lung tissue sample is shown on Tuesday, April 1, 2003, on a HDTV at a Center for Disease Control in Atlanta.
A slide of a SARS lung tissue sample is shown on Tuesday, April 1, 2003, on a HDTV at a Center for Disease Control in Atlanta.
Erik S. Lesser / AP

Source: History.com

The symptoms were similar — coughing, fever, body aches, difficulty breathing, fatigue. SARS spread through the air, by coughing or sneezing.

Primary school students wear masks to protect themselves from getting the killer pneumonia virus in Hong Kong March 24, 2003.
Primary school students wear masks to protect themselves from getting the killer pneumonia virus in Hong Kong March 24, 2003.
Bobby Yip Pictures / Reuters

Sources: The New York Times, The New York Times

It was also, as CNN described, a "super spreader," meaning one person could infect many others. And, worryingly, there was no known cure.

Arriving passengers help themselves to free vitamins, mostly Vitamin C or ascorbic acid, being provided by the Government at the Ninoy Aquino International Airport south of Manila Tuesday April 15, 2003 to help prevent them from catching the severe acute respiratory syndrome or SARS.
Arriving passengers help themselves to free vitamins, mostly Vitamin C or ascorbic acid to help prevent them from catching SARS.
Bullit Marquez / AP

Source: CNN

To the world, it seemed like SARS came out of nowhere, but that wasn't entirely true. China had an information blackout, and waited until February to disclose cases of SARS to the World Health Organization. In the coming months, China would be criticized for failing to be open about the virus.

Three security guards wearing masks run out to prevent photographs from being taken at the entrance to the sealed off Ditan Hospital in Beijing, Friday, April 25, 2003.
Three security guards wearing masks run out to prevent photographs from being taken at the entrance to the sealed off Ditan Hospital in Beijing, Friday, April 25, 2003.
Greg Baker / AP

Source: The New York Times

There were a number of reasons for the delay. But the economy was a major one. Cholera in the early 1990s cost Peru $770 million, while India lost about $1 billion in tourism when it had a bout of the plague. China didn't want its economy to take a hit.

A masked employee cleans a table at an empty restaurant Monday, May 26, 2003 in Beijing.
A masked employee cleans a table at an empty restaurant Monday, May 26, 2003 in Beijing.
Eugene Hoshiko / AP

Sources: The New York Times, Washington Post

In late February, an unusual case in Vietnam stumped a local doctor. He had heard about the outbreak in China, but wasn't sure he was dealing with the same thing. Then, 10 staff members contracted the virus, and his "doubts would balloon into dread," the Wall Street Journal wrote.

Karl Nicholson, a professor of infectious diseases, reviews SARS data collected from two hospitals in Hanoi, March 20, 2003.
Karl Nicholson, a professor of infectious diseases, reviews SARS data collected from two hospitals in Hanoi, March 20, 2003.
Doan Bao Chau / AP

Source: WSJ

On February 21, SARS went global, after an infected doctor working in Guangdong province checked into Hong Kong's Metropole Hotel. The virus spread to 16 other guests, who then dispersed around the world. Room 911, where he stayed, became a museum after the outbreak, and the building was renamed Room 911.

A hygiene worker wearing a protective mask passes Thursday, March 20, 2003 by Metropole Hotel in Hong Kong
A hygiene worker wearing a protective mask passes Thursday, March 20, 2003 by Metropole Hotel in Hong Kong
Anat Givon / AP

Sources: WHO, History.com

Having SARS in an international hub like Hong Kong was an infectious disease expert's "worst nightmare," The New York Times wrote at the time.

An airport guard wears a surgical mask to protect himself from severe acute respiratory syndrome, or SARS, as he walks past an advertisement featuring a world map and a slogan that reads: "Wherever you roam", Saturday, April 12, 2003, at Hong Kong's Chek Lap Kok international airport.
An airport guard wears a surgical mask to protect himself from severe acute respiratory syndrome, or SARS, as he walked past an advertisement featuring a world map.
Anat Givon / AP

Sources: The New York Times

International travel made it difficult to contain SARS. Infected people could get through customs, and into another country, before they presented symptoms of the virus.

Passengers from Japan wearing protective masks get off their plane Thursday April, 17, 2003 at Pudong International Airport in Shanghai, China.
Passengers from Japan wearing protective masks get off their plane Thursday April, 17, 2003 at Pudong International Airport in Shanghai, China.
STR / AP

Source: The New York Times

On March 15, SARS was finally taken seriously. The WHO labeled it a worldwide health threat, describing it as an unnamed virus spreading through Asia. There were concerns it could be as serious and deadly as the influenza pandemic of 1918-19.

David L. Heymann, executive director of World Health Organization (WHO) programme on Communicable Diseases, gestures as he speaks during a press conference at the United Nations in Geneva, Switzerland, Tuesday, April 1, 2003.
David L. Heymann, executive director of WHO program on Communicable Diseases, gestures as he speaks during a press conference at the United Nations in Geneva, Switzerland, Tuesday, April 1, 2003.
Laurent Gillieron / Keystone / AP

Sources: The New York Times, The Guardian, The New York Times, The New York Times

By April, SARS had spread from China to 25 other countries, including Canada, Hong Kong, and India, infecting nearly 3,500 people and killing 182.

Wolfgang Preiser, a member of WHO, reviews some documents at out-patient department of fever at Shanghai Pneumonology Hospital Thursday, April 24, 2003 in Shanghai.
Wolfgang Preiser, a member of WHO, reviews some documents at out-patient department of fever at Shanghai Pneumonology Hospital Thursday, April 24, 2003 in Shanghai.
Eugene Hoshiko / AP

Source: The New York Times

Yet it still wasn't clear, according to The New York Times, whether it would turn into "a global wildfire, or cool down."

Shanghai residents attend a seminar on the Severe Acute Respiratory Syndrome (SARS) in China's financial hub April 10, 2003.
Shanghai residents attend a seminar on the Severe Acute Respiratory Syndrome (SARS) in China's financial hub April 10, 2003.
China Photo ASW / Reuters

Source: The New York Times

A clearer picture of the virus began to emerge in April when whistleblower Jiang Yanyong, a prominent doctor in Beijing, sent a letter to international media, informing them that at least 100 people were being treated for SARS in Beijing.

Military surgeon Jiang Yanyong is seen in a Beijing hotel room Monday, Feb. 9, 2004.
Military surgeon Jiang Yanyong is seen in a Beijing hotel room Monday, February 9, 2004.
Hu Jia / AP

Source: The New York Times

On April 20, the Chinese government admitted there were 10 times as many SARS cases as reported in Beijing — 339 cases, rather than 37. To make amends, China's health minister and the mayor of Beijing were both dismissed.

Chinese tourists all wearing masks walk down a commercial district in Beijing in a group Wednesday, April 23, 2003.
Chinese tourists all wearing masks walk down a commercial district in Beijing in a group Wednesday, April 23, 2003.
Ng Han Guan / AP

Sources: The Guardian, Washington Post

The announcement caused panic. Thousands left Beijing, just a day after the WHO advised against traveling to Beijing or Shanxi province.

People wear masks as protection against the SARS virus as they wait to buy tickets at the Beijing Railway Station Wednesday, April 23, 2003.
People wear masks as protection against the SARS virus as they wait to buy tickets at the Beijing Railway Station Wednesday, April 23, 2003.
Greg Baker/ AP

Source: Washington Post

One Beijing resident named Shi Chuanquan told The New York Times, "This virus is invisible and untouchable, which makes it really scary."

A Chinese traveller wearing a mask sits near sections of the waiting lounge that has been closed off due to a slump in passenger numbers at a train station in Beijing Thursday, May 22, 2003.
A Chinese traveller wearing a mask sits near sections of the waiting lounge that has been closed off due to a slump in passenger numbers at a train station in Beijing Thursday, May 22, 2003.
Ng Han Guan / AP

Source: The New York Times

Schools were closed down. More than 1.7 million students in Beijing were sent home.

Chan Cheong-chap, teacher of Yan Chai Hospital Wong Wha San Secondary School leads a virtual class with a computer in an empty classroom Thursday, April 24, 2003.
Chan Cheong-chap, teacher of Yan Chai Hospital Wong Wha San Secondary School leads a virtual class with a computer in an empty classroom Thursday, April 24, 2003.
Vincent Yu / AP

Sources: The Guardian, Washington Post

Measures at airports increased, including random temperature checks.

A thermal camera monitors the body temperature of passengers arriving from Taipei against the possible infection of the flu-like Severe Acute Respiratory Syndrome (SARS) at Incheon International Airport, west of Seoul in 2003.
A thermal camera monitors the body temperature of passengers arriving from Taipei against the possible infection of the flu-like Severe Acute Respiratory Syndrome (SARS) at Incheon International Airport, west of Seoul in 2003.
Sung Yeon-jae Yonhap / AP

Source: Japan Times

Because SARS was spread through coughing and sneezing, surfaces like the insides of planes were wiped down. Beijing's council also closed public spaces like swimming pools and movie theaters, where the virus could easily spread.

Three cleaners of Cathay Pacific Airways disinfect a plane in Hong Kong, south China, Thursday, May 15, 2003.
Three cleaners of Cathay Pacific Airways disinfect a plane in Hong Kong, south China, Thursday, May 15, 2003.
Huang Benqiang Xinhua / AP

Sources: WHO, The New York Times

Quarantines became a staple. In Beijing, crime-scene tape was wrapped around an entire block, keeping 2,000 health employees contained and cut off.

Three women crouch inside the closed gate of the People's Hospital of Peking University in Beijing Friday April 25, 2003.
Three women crouch inside the closed gate of the People's Hospital of Peking University in Beijing Friday April 25, 2003.
Greg Baker / AP

Source: The New York Times

People stocked up on basic household goods like cooking oil and rice, as well as masks.

Employees of South Korea's Hanjin Shipping Company pack masks for the company's overseas staff as a precaution against possible infection by the deadly disease, SARS, at the company office in Seoul, South Korea, Thursday, April 3, 2003.
Employees of South Korea's Hanjin Shipping Company pack masks for the company's overseas staff as a precaution against possible infection by the deadly disease, SARS, in April.
Yun Jai-hyoung / AP

Source: The New York Times

Even though Beijing had about 14 million people, meaning the number of infected people was comparably low, it was taken seriously, and the impact was felt everywhere.

Children attend ballet lessons wearing masks to protect themselves from severe acute respiratory syndrome, SARS, in Hong Kong Sunday April 27, 2003.
Children attend ballet lessons wearing masks to protect themselves from severe acute respiratory syndrome, SARS, in Hong Kong Sunday April 27, 2003.
Vincent Yu / AP

Source: The New York Times

The news continued to be grim. In Hong Kong, SARS spread through an apartment building by way of bathroom drainpipes. According to the Washington Post, it was a "disturbing new confirmation of the microbe's versatility."

A guard stops photographers from entering one of the blocks near Block E of Amoy Gardens apartment complex, in Hong Kong, while a health worker goes in, where 237 people have been sickened with SARS.
A guard stops photographers near Block E of Amoy Gardens apartment complex, in Hong Kong, while a health worker goes in, where 237 people have been sickened with SARS.
Anat Givon / AP

Source: Washington Post

Quarantines popped up in other countries. Here, a nurse talks to her relatives through a webcam in Taiwan in late April. Taiwan was the third worst hit country, with 83 deaths.

A nurse quarantined in the sealed off Taipei Municipal Hoping Hospital talks to her relatives outside the hospital through a web cam set up in the hospital, Sunday, April 27, 2003, in Taipei, Taiwan.
A nurse quarantined in the sealed off Taipei Municipal Hoping Hospital talks to her relatives outside the hospital through a web cam set up in the hospital, Sunday, April 27, 2003, in Taipei, Taiwan.
Wang Fei-hua / AP

Source: CNN

Also in April, scientists cracked the genetic code of SARS. With that in hand, drugs and vaccines could be made. Yet it wouldn't be for another 20 months before a vaccine was ready to be used by humans.

Raymond Hui, a zoology student at the University of Hong Kong, whose team cracked the genetic code of the SARS virus, points at the screen of a genetic analyzer machine on Wednesday, April 16, 2003 in Hong Kong.
Raymond Hui, a zoology student at the University of Hong Kong, whose team cracked the genetic code of the SARS virus, points at the screen of a genetic analyzer machine on Wednesday, April 16, 2003 in Hong Kong.
Lo Sai Hung / AP

Sources: New Scientist, The New York Times

Headlines around the world continued to question how bad SARS would get. Newsweek's cover read, "SARS Can it be stopped?"

A man wearing a surgical mask in a Hong Kong street Friday, May 2, 2003, because of the outbreak of severe acute respiratory syndrome, stops to look at a magazine poster that has SARS as its cover story.
A man wearing a surgical mask in a Hong Kong street Friday, May 2, 2003, because of the outbreak of severe acute respiratory syndrome, stops to look at a magazine poster that has SARS as its cover story.
Lo Sai Hung / AP

On May 15, the Chinese government increased measures to beat SARS. It threatened to execute anyone who intentionally broke quarantine. About 11,000 people were confined to their homes or hospitals.

A man walks past a "No SARS" sign outside a restaurant in Beijing Tuesday May 6, 2003. The Chinese characters read "This place already disinfected".
A man walks past a "No SARS" sign outside a restaurant in Beijing Tuesday May 6, 2003. The Chinese characters read "This place already disinfected".
Greg Baker / AP

Source: Los Angeles TimesIrish Times, The New York Times

In Singapore, those who were suspected of being infected with SARS were monitored at home. Electronic bracelets alerted the police if they tried to leave.

Nurses clad in yellow hospital gowns and surgical masks stand by at Changi International Airport in Singapore, Tuesday, April 1, 2003.
Nurses clad in yellow hospital gowns and surgical masks stand by at Changi International Airport in Singapore, Tuesday, April 1, 2003.
Wong Maye-e / AP

Sources: The New York Times, CNN

All of the prohibitive measures began to pay off. In June, SARS started to slow down. WHO Director General Gro Harlem Brundtland said, "We have seen SARS stopped dead in its tracks."

Gro Harlem Brundtland, WHO director general, talks to reporters at Hong Kong's international airport, Thursday, June 19, 2003,
Gro Harlem Brundtland, WHO director general, talks to reporters at Hong Kong's international airport, Thursday, June 19, 2003,
Anat Givon / AP

Source: CNN

By early July, the WHO declared the outbreak was contained. In total, more than 8,000 people were infected and 774 died. It was stopped by isolating cases, good hygiene practices, as well as summer warmth and humidity.

A Chinese man holds up a banner welcoming the first foreign tour group to arrive at the Beijing airport after the SARS epidemic in Beijing, Monday, June 30, 2003.
A Chinese man holds up a banner welcoming the first foreign tour group to arrive at the Beijing airport after the SARS epidemic in Beijing, Monday, June 30, 2003.
Ng Han Guan / AP

Sources: The New York Times, CNN

Of those who died, China had 349 deaths out of its 5,327 cases.

A Chinese nurse tends to a patient recovering from the flu-like Severe Acute Respiratory Syndrome (SARS) at a hospital in Guangzhou, the capital of Guangdong province, April 17, 2003.
A Chinese nurse tends to a patient recovering from the flu-like Severe Acute Respiratory Syndrome (SARS) at a hospital in Guangzhou, the capital of Guangdong province, April 17, 2003.
China Photo / Reuters

Source: History.com

In the United States, only eight people were infected, and no one died. This was partly due to the country being in a heightened state of alert after September 11, and the anthrax postal attacks. Another reason, according to The New York Times, was "sheer good luck."

A map of SARS cases in the US in April 2003.
A map of SARS cases in the US in April 2003.
Anat Givon / AP

Sources: WHO, The New York Times, CDC

Toronto, Canada, wasn't so lucky. The city was declared SARS-free in May, but later cases emerged. In the end, 375 people were infected and 44 people died. Up to 80% of small Asian-owned businesses' income was estimated to be lost because of racist boycotting.

Ontario Health Minister Tony Clement, leaves the WHO headquarters, in Geneva, Switzerland,  after a meeting with WHO Director General Gro Harlem Brundtland to try to get the WHO to reconsider the SARS travel advisory on Toronto issued by WHO.
Ontario Health Minister Tony Clement, leaves the WHO headquarters, in Geneva, Switzerland, after a meeting with WHO Director General Gro Harlem Brundtland to try to get the WHO to reconsider the SARS travel advisory on Toronto issued by WHO.
Fabrice Coffrini / Keystone / AP

Sources: The New York Times, Washington Post, CNN

But in relative terms, Hong Kong got it the worst. Along with a recession due to the city coming to a standstill, 1,755 people were infected, and 299 people died.

Relatives of SARS victims hold death certificates of their loved ones at the start of a news conference in Hong Kong, Friday Oct. 3, 2003.
Relatives of SARS victims hold death certificates of their loved ones at the start of a news conference in Hong Kong, Friday Oct. 3, 2003.
Anat Givon / AP

Source: South China Morning Post

Since 2004, there have been no reported cases of SARS.

A woman plays with a protective mask at a shopping street in 2003 in Beijing.
A woman plays with a protective mask at a shopping street in 2003 in Beijing.
Eugene Hoshiko / AP

Sources: The New York Times, CDC, BBC

The final death toll was relatively low, considering the thousands who die from influenza every year. Yet SARS terrified the world — it was invisible, unknown, and the first pandemic of the globalized world.

Passengers wearing masks, walk out from a flight from Hong Kong at the Incheon International Airport, 50km (30 miles) west of Seoul, South Korea, Friday, April 4, 2003.
Passengers wearing masks, walk out from a flight from Hong Kong at the Incheon International Airport, 50km (30 miles) west of Seoul, South Korea, Friday, April 4, 2003.
Yun Jai-hyoung / AP

Sources: The New York Times, CDC, BBC

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