Missing: the big picture

It's as inevitable as the retreat to the charming French gîte in June, the beau monde's supercilious, eye-rolling response to…

It's as inevitable as the retreat to the charming French gîte in June, the beau monde's supercilious, eye-rolling response to the reasonable fears of ordinary people, writes Kathy Sheridan

It reached its zenith with the senior Mater Hospital doctor who popped up on Monday's Questions and Answers to berate the Irish media for broadcasting the "details" of a woman's illness; details, he insisted, that were properly the domain of doctor-patient confidentiality.

In other words, the fact that a possible/probable/all clear/probable again/ummmaybe case of SARS had been wandering around Dublin city with a few masks in her pocket, while the Department of Health and the ERHA openly disputed her status and the director of the National Disease Surveillance Centre was manning a picket line, should have remained a private matter. The doctor, mark well, was speaking on the same day that The Irish Times had reported that GPs were threatening not to notify infectious disease outbreaks to the health boards.

Next day we had the Tánaiste using the same lofty tone as the one she employed to accuse anti-war protesters of being anti-American, to chide the people of Clonmel for being adult enough to weigh up the risks of importing a 63-strong Special Olympics team from SARS-blighted Hong Kong.

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Meanwhile her colleague, the Justice Minister, was assuring a Cork audience that the criticism of the Health Minister was the work of sensation-mongers. That was after the Health Minister himself was reported to be citing the confusion and lack of co-ordination over SARS as evidence of inadequate and inefficient structures in the health system.

Now compare this official response to that of say, Toronto, where the health minister used the media exposure to show people how to wash their hands. Or to that of the UK's chief medical officer, who admitted on Sunday that he remained uneasy and that more cases of SARS were inevitable there. And his answer to the critics who claimed that the panic was doing more damage than the disease? Protecting the public's health had to be the priority.

Up to Monday night, I would have been among the soothing folk playing down the lunk-headed, official bungling of the SARS scare here, emphasising the very high recovery rates and the need for common sense and calm.

But suddenly I found myself shouting very uncalmly at the television. No doubt the doctor - a comparatively youthful man to judge by his full head of dark hair - believed that he was speaking from a platform of timeless, ethical certitude. Instead, he seemed straight from an era when pompous doctors pronounced, and the peasantry pulled the forelock.

John Bowman turned to him to point out that this, after all, was a public health issue, of global concern, and that the woman had not been identified. The doctor remained unconvinced. If this is the view of one prominent medic in a big city hospital, it's a fair assumption that many of his colleagues share it.

What the beau monde bandwagon is missing once again is the big picture. Yes, we know there is a better chance of killing yourself falling down the stairs or abusing alcohol than of contracting SARS. But in those situations, the responsibility is our own. With infectious diseases, however, information is power and unspun information is pure gold. Most commentators residing in the distant, leafy suburbs will have little to fear from a suspect SARS cases wandering around the inner city.

What "details" precisely would the Mater doctor deny to those who might have strayed into the path of that hapless Chinese woman? Would he also withhold information on how the two Legionnaires victims contracted their fatal illness? How exactly does this attitude differ from the Chinese cover-up?

The fact is that the world is threatened with a relentless virus "with a large appetite for people", to quote a doctor at the epicentre of Toronto's outbreak. It fulfils all the myths that once surrounded HIV/AIDS; it can be contracted from a toilet seat, a phone, a handshake or a sneeze.

There is no foolproof test for it, no vaccination and no cure, except vigilance. It could kill between five and 15 per cent of those infected, according to one estimate.

In his diary for the Guardian, that Toronto doctor, Paul Caulford, described how, suddenly, colleagues and patients "were critically ill all around me, on ventilators in the intensive care unit when just a few days earlier they seemed so robust and well. Our hospital has had more than 80 SARS cases in health workers and patients, some still remain off work six weeks later, some who have died.

"I never expected to see anything like this in my lifetime as a doctor. We always talked about the pandemics of the past, but we believed in our vaccines . . . We couldn't believe how much this disease had changed what for so long we have taken for granted".

The last thing the people of Clonmel et al need right now is patronising cant from Government bunkers. They need someone who will take responsibility for the outcome, whatever that might be.