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Know your enemy!

Year: 2003
Setting: AsiaMedic clinic in Singapore
Position: Private general practitioner

SARS has struck Singapore and I am at the vortex of the epidemic frenzy. Schools call about the potential infectious threat posed by their drivers and cooks to the children, companies ask for advice on the safety of their employees and about strategies to address multiple issues, and ambassadors forward questions from their citizens. Panic causes some people to flee the city-state, abandoning their homes and leaving pets unattended; others refuse to venture outside of their residences. Usually vibrant malls are empty and the city has turned into a ghost town.

After meningitis in Brazil, Japanese encephalitis in China, dengue fever in New Caledonia, malaria in Africa and AIDS in France, I am witnessing again human behavior in times of an acute social health-related crisis and read intently the latest scientific news about the virus. Early on, it becomes obvious that this coronavirus is not highly contagious and that one has to be in close contact with a carrier to become infected. Based on this and because my patients were all screened for SARS symptoms and travels in epidemic countries, I decide not to wear a mask while examining patients, much to the amazement of my co-workers. During that time I visited a few of my colleagues who received me wearing masks, gloves, goggles and surgical garbs. Some continued that practice even after the restrictions and precautions had been lifted! Remarkably, at the end no SARS case was reported from the expatriate community.

Lesson for the doctor: In the midst of epidemics, base your advice and behavior primarily on science.

Yann Meunier, MD, is the health promotion manager for the Stanford Prevention Research Center. He formerly practiced medicine in developed and developing countries throughout Europe, Africa and Asia. Each week, he will share some of his experiences with patients in remote corners of the world.

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