Common sense can cure both SARS and our misplaced panic

SHOCKING? Awful? Reprehensible? Scandalous? Or just plain Silly Amateurish Ridiculous Shambles? Whatever way you look at SARS, it's been another bad week for the government, and especially for the increasingly hapless Minister for Health.

First things first. SARS is serious, or at least it could be. It is a potentially dangerous and worrying condition. So little is yet known about its causes and origins, how it spreads and what sort of damage it can do, that it has to be taken seriously.

But the Ebola virus it isn't. In the aftermath of the first world war, a flu outbreak killed more than ten million people around the world, and especially in Europe. Soldiers who had survived some of the most awful wartime conditions in history died in the train on the way home from flu. The undernourished people of Germany, Russia and the Balkans were worst hit.

By comparison, SARS is a pinprick. And we know a lot more nowadays than we did then about how to prevent the spread of disease and how to treat people affected, so even if they do get it they won't be condemned to death, as people were then.

As a matter of fact, SARS is a very minor condition by comparison with most diseases and with an awful lot of what one might call man-made conditions. Far more people will be killed in Europe tonight by drunk drivers than are likely to die from SARS in the whole world over the next two months. Far more people will die of cancer and heart disease caused by cigarette smoking than SARS will ever take.

And when you think of conditions such as AIDS, malaria, cholera, meningitis, whooping cough even conditions that we regard as long gone like leprosy, polio and diphtheria you can multiply the number of potential SARS victims by 1,000 and still fall far short of the casualty figure. Some of these conditions are out of control in parts of the world. Many of them, when they attack a house, routinely take the whole family. Many still have no known cure.

If you go to the World Health Organisation website (www.who.int/en) right now to find out about SARS, the first thing you'll see is this headline: "More than 3,000 children die each day due to malaria". That's right. There's plenty of information about SARS elsewhere on the site, of course, but on Friday last the WHO released the Africa malaria report to mark Africa Malaria Day 2003.

In a feature piece about the issue, they go on to say that in Africa, 30 million women living in malaria-endemic areas become pregnant each year. For these women, malaria is a threat both to themselves and to their babies, with up to 200,000 newborn deaths each year as a result of malaria in pregnancy. That's right a million babies every five years.

I wonder why that report didn't merit so much as a hundredth of the column inches and news bulletin minutes we have devoted to SARS. It couldn't be because that's Africa, and we don't get malaria here in our affluent country, could it? Furthermore, apart from the relative incidence of SARS compared to other diseases and conditions, prevention is not difficult. Even (say) Homer Simpson could follow the WHO guidelines on the matter. Don't go to certain countries unless you have to. If on return (or if you have been in close contact with someone who has been in one of the suspect countries) and you develop a high temperature and breathing difficulties, you might have SARS, and you need to see a doctor. The doctor will send you to hospital, where you'll be isolated and treated with plenty of liquids until you recover. That might sound a bit flip. But the truth is that common sense is one of the key requirements in defeating SARS.

If common sense is required, the first thing we need in relation to SARS is a sense of perspective. (Perhaps a normal sense of perspective, not to mention a bit of courtesy and decency, would stop people in the media placing a question mark around the Special Olympics every time the subject comes up. Before long, people with an intellectual disability are going to be treated as if they were all contagious.)

The second thing we need, of course, is normal sensible precautions, and a sense that someone is in charge. This is where a minister with the well-established public relations savvy of a Micheál Martin comes into his own. You'd think.

There is so little chance of SARS representing a serious problem in Ireland, if it is taken as seriously as it deserves and if all the sensible precautions are put in place, that our minister for health was presented with a glorious opportunity to be a hero. This is the minister, after all, who launches a new anti-smoking campaign every six months or so (or maybe it's the same one over and over again) in order to embellish his reputation as a campaigner and communicator. SARS, you'd think, would be a piece of cake.

Except that we now know that if a party or any other kind of affair needs to be organised in a brewery near you, send for almost anyone else you can think of. Our minister for Health couldn't be trusted to find sand if he fell off a camel.

Who does he need around him at a moment like this? The public health specialists, of course. They're responsible people, very hard-working ones too, who have been driven into a dispute by years and years of intransigence in their relations with their employer. He doesn't have to give in to them, but it would probably make sense to appeal to them, public and privately, to put aside their differences during the period of difficulty, in return for a promise of serious negotiation in due course.

Instead of that the minister goes to the IMO Conference and gratuitously insults the public health doctors, even singling out some very highly-regarded individuals for special mention. The result, naturally, is that the doctors close ranks, as they must, and the dispute shows all the signs of getting worse.

The aforementioned Homer Simpson could have told the minister that is not the way to conduct normal industrial relations. Of course the public health doctors should be at work. The vast majority of them want to be, and if the minister had given them a reason to believe their grievances were seen by him as legitimate they would be.

Instead he is forced to rely on advice from within the department that not even its best friends could describe as coherent, and on a flow of information from local health authorities that are already under huge strain. If you're getting letters from the Department of Health demanding that you live within very constrained budgets, while all the time the demand for services increases, you're hardly likely to put everything to one side when the department tells you they want SARS to be your first priority.

All in all, with this minister in charge, maybe we're lucky we only need to be protected from SARS.