We are at a mysterious fork in the road. One path leads to years, perhaps decades, of spread of a new type of influenza, occasionally making people sick and killing about 18 percent of them. It's not a pleasant route, strewn as it is with uncertainties, but no terror seems to lurk on its horizon. The other path, however, wrenches the gut with fear, as it brings worldwide transmission of a dangerous new form of flu that could spread unchecked throughout humanity, testing global solidarity, vaccine production, hospital systems and humanity's most basic family and community instincts.
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There may be some minor footpaths along the way, heading to other alternatives, but they can't be discerned at this moment. At this writing, 108 cases of H7N9 flu, as the new virus has been dubbed, have been confirmed, and one asymptomatic carrier of the virus has been identified. Twenty-two of the cases have proven fatal, and nine people have been cured of the new flu. The remainder are still hospitalized, many in severe condition suffering multiple organ failures. As the flu czar of the World Health Organization (WHO), Dr. Keiji Fukuda, tersely put it to reporters last week, "Anything can happen. We just don't know."
On this tenth anniversary of China's April 2003 admission that the SARS virus had spread across that country -- under cloak of official secrecy, spawning a pandemic of a previously unknown, often lethal disease -- Beijing finds itself once again in a terrible position via-a-vis the microbial and geopolitical worlds. In both the SARS and current H7N9 influenza cases, China watched the microbe's historic path unfold during a period of enormous political change. And the politics got in the way of appropriate threat assessment.
On Nov. 16, 2002, the first human case of SARS staggered in search of a doctor the very day that top Communist Party leaders were meeting behind closed doors, naming Hu Jintao and Wen Jiabao the new leaders of the world's most populous country. Determined to experience China's first peaceful transition of power in living memory, without public strife between political factions, the party leaders vowed that nothing could rock the ship of state until March of 2003, when the National People's Party Congress would convene and officially anoint Hu and Wen. In the meantime, "stability" was the nervous watchword. President Jiang Zemin and his close Shanghai allies were jockeying to maintain control of key assets, including the military, while Hu and his backers hoped to squash the Shanghai billionaire bloc that they felt had amassed too much wealth and power.
Fang Lin, a country bumpkin who had made his way to the Shenzhen metropolis near Hong Kong and found work in a restaurant that served exotic animal meats, was the first November SARS victim. By December 2002 that first case of a new, mysterious respiratory disease had expanded into a full-fledged epidemic in Guangdong province, and Dr. Zhong Nanshan and his colleagues at the Guangzhou Institute of Respiratory Diseases were overwhelmed. Amid health-care worker panic and great mystery regarding the cause of the outbreak, Zhong led a valiant clinical effort that was largely unknown to the outside world, even nearby Hong Kong. Indeed, Guangdong provincial and party authorities and their Guangzhou municipal counterparts did not even officially notify Beijing of their outbreak until Feb. 8, 2003, after it was winding down. One of the Guangzhou patients fled the province on Feb. 21, checked into the Hotel Metropole in Hong Kong's Kowloon district, and passed his virus onto a cluster of travelers staying on the same hotel floor. Those individuals, unknowingly infected, went on to spawn outbreaks in Hanoi, Singapore, Toronto, Hong Kong, China's Shanxi Province, and from there to Beijing.
Even as the WHO and health departments around the world struggled over the next five weeks to understand and control the new pandemic, the transitional government in Beijing was mum, denying any claims that SARS was of Chinese origin and that it lurked around the country, including in its capital. After retired People's Liberation Army surgeon Jiang Yanyong courageously leaked information to Western reporters about dying patients in a Beijing hospital, the fresh Hu/Wen regime, newly ratified by the People's Party Congress, secretly on April 17 decided to publicly attack the epidemic. Three days later the nation's minister of health -- a Jiang ally -- and Hu's colleague, the mayor of Beijing, were unceremoniously sacked, placing shared blame on both factions of the Communist Party. The government publicly acknowledged the epidemic, and the People's Republic set course on an all-out war against SARS.
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