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The Chinese Government discouraged its press from reporting on SARS, and they also delayed reporting the outbreak to the WHO. They even kept the news from other areas in China outside of Guangdong province. A WHO team that travelled to Beijing was not allowed to visit Guangdong province for several weeks.
On January 31, 2003, a fishmonger named Zhou Zuofen checked in to the Sun Yat-sen Memorial Hospital in Guangzhou, where he infected 30 nurses and doctors. The virus soon spread to nearby hospitals. Eventually over 8,000 people from 29 different countries and territories were infected, and at least 774 died worldwide. The World Health Organization declared that the virus was contained on July 5, 2003, but several SARS cases were reported up until May 2004.
On April 4, 2003, President George W. Bush issued Executive Order 13295 in which he added Severe Acute Respiratory Syndrome to the list of communicable diseases for which a person can be quarantined. The order noted that SARS, a disease first recognized in late 2002 in China, is "associated with fever and signs and symptoms of pneumonia or other respiratory illness, is transmitted from person to person predominantly by the aerosolized or droplet route, and, if spread in the population, would have severe public health consequences." President Bush's order noted that SARS was characterized by high fever and breathing difficulties, and that up to that time it had infected more than 2,270 people, killing 79, according to statistics provided by the WHO. It had spread to 16 countries, including the United States. No U.S. deaths had been reported and none would be.
A spokesman for the Centers for Disease Control and Prevention said the order should not be taken as any indication that the government intended to quarantine anyone and that while quarantines were not yet necessary, they could become necessary if the situation got worse. Earlier in the week, on April 1st, the U.S. government called back non-essential personnel in their consulate office in Hong Kong and Guangzhou. The government also advised US citizens not to travel to the region.
Bush's order read as follows:
REVISED LIST OF QUARANTINABLE COMMUNICABLE DISEASES By the authority vested in me as President by the Constitution and the laws of the United States of America, including section 361(b) of the Public Health Service Act (42 U.S.C. 264(b)), it is hereby ordered as follows:
Section 1. Based upon the recommendation of the Secretary of Health and Human Services (the "Secretary"), in consultation with the Surgeon General, and for the purpose of specifying certain communicable diseases for regulations providing for the apprehension, detention, or conditional release of individuals to prevent the introduction, transmission, or spread of suspected communicable diseases, the following communicable diseases are hereby specified pursuant to section 361(b) of the Public Health Service Act: (a) Cholera; Diphtheria; infectious Tuberculosis; Plague; Smallpox; Yellow Fever; and Viral Hemorrhagic Fevers (Lassa, Marburg, Ebola, Crimean-Congo, South American, and others not yet isolated or named). (b) Severe Acute Respiratory Syndrome (SARS), which is a disease associated with fever and signs and symptoms of pneumonia or other respiratory illness, is transmitted from person to person predominantly by the aerosolized or droplet route, and, if spread in the population, would have severe public health consequences.
Sec. 2. The Secretary, in the Secretary's discretion, shall determine whether a particular condition constitutes a communicable disease of the type specified in section 1 of this order.
Sec. 3. The functions of the President under sections 362 and 364(a) of the Public Health Service Act (42 U.S.C. 265 and 267(a)) are assigned to the Secretary.
Sec. 4. This order is not intended to, and does not, create any right or benefit enforceable at law or equity by any party against the United States, its departments, agencies, entities, officers, employees or agents, or any other person.
Sec. 5. Executive Order 12452 of December 22, 1983, is hereby revoked.
GEORGE W. BUSH
THE WHITE HOUSE,
April 4, 2003.
The Bush White House was described by the Washington Post as "taking aggressive steps to ensure it does not erupt into a major health or political problem domestically", using their best efforts in "preparing for a possible epidemic here without frightening the public." An economist Bush was reportedly aware and mindful not only of the health impact, but of the economic impact as well. Government analysts at the State Department and CIA prepared classified reports on the potential ramifications of SARS. Both the National Security Council and National Economic Council considered various aspects of the epidemic.
Dr. Anthony S. Fauci, a name familiar to those following Covid-19 news, and then the director of the National Institute of Allergy and Infectious Diseases, conferred with the White House at least two dozen times during the SARS crisis. Fauci was complimentary to the attention shown by the Bush administration. He told the media, "It's almost the diametrical opposite of China. The atmosphere has been not to panic but to take it very seriously." Fauci continued to brief the President about updates on the search for a vaccine and why the illness had the "potential of turning into something much more serious." Fauci reported that in their first meeting on April 4, the president had asked him a "whole range of questions," including whether the mysterious germ emanating from southeast China could be the work of bioterrorists. It was during that 50-minute meeting, which included Vice-President Cheney, and CDC Director Julie L. Gerberding, that Bush agreed to sign an executive order giving federal health authorities the power to quarantine SARS patients arriving from another country.
The 2003 SARS outbreak raised legal issues about whether the CDC has sufficient power to close hospitals and quarantine large numbers of people if needed. Several legal scholars were of the opinion that the nation's patchwork of 50 different state public health laws, many antiquated and possibly unconstitutional, raised serious doubts about the extent of the federal government's powers.
The Bush administration also requested an additional $16 million for SARS from Congress, and the President was also concerned about what steps had been taken to contain an outbreak of SARS in Toronto. Dr. Gerberding said she was pleasantly surprised by the White House focus on SARS. She said, "When SARS was evolving, we were engaged in the preliminaries to war, and there was a great deal of concern from the standpoint of homeland security and the safety and well-being of our troops. More recently, there have been a fair number of inquiries about the potential economic aspects of SARS."
Bush was concerned about the potential impact of SARS on the global and U.S. economies, especially given the sluggish conditions that existed at the time. Bush's economic council added SARS to the list of indicators it monitors regularly. A conference call was organized between White House staff and high-tech entrepreneurs who were "extremely worried about the impact of SARS."
The World Health Organization removed the United States and Britain from the list of countries affected by SARS. At that point, neither country had any reported cases spreading among residents for at least 20 days, which was double the estimated incubation time. As of April 30, the United States had reported 56 probable cases and 233 suspected cases, according to the CDC. All recent cases were travelers arriving from SARS "hot spots" such as Beijing. The list of SARS-affected countries were China, including Taiwan and Hong Kong, Canada, Mongolia and Singapore.
By May 2005, the New York Times reported: "Not a single case of the severe acute respiratory syndrome has been reported this year or in late 2004. It is the first winter without a case since the initial outbreak in late 2002. In addition, the epidemic strain of SARS that caused at least 774 deaths worldwide by June 2003 has not been seen outside of a laboratory since then."