TCS Daily

Europe's SARS 'Capital'?

By Dominic Standish - May 16, 2003 12:00 AM

As I boarded a plane from Treviso, Italy, to London on 8 May 2003, I spotted an official notice warning about Severe Acute Respiratory Syndrome (SARS). It brought back memories of the "foot-and-mouth" disease crisis in Europe two years ago when certain foods could not be brought through airports and shoes were disinfected if they had been worn in the British countryside.

Fearing additional checks and questioning may delay my departure, I pinched myself and remembered these were unlikely given there were no confirmed cases of SARS in Italy. Indeed, there were no questions or checks and I soon forgot about SARS and enjoyed my journey.

By my return on 10 May everything had changed politically, but little practically. On 6 May, European health ministers had held an extraordinary meeting about the SARS crisis. The Italian health minister, Girolamo Sirchia, called for SARS screening at all European entry points. This was rejected in favour of requiring passengers from SARS-affected areas to complete questionnaires. Fuming after this rebuff, Sirchia returned to Italy and on 9 May issued a government decree imposing compulsory screening for anyone arriving from countries affected by SARS. Passengers suspected of infection face quarantine. The measures will remain in place until the SARS emergency is over.

These controls will also apply for many passengers coming to Italy from within Europe, in case anyone has made a stopover from a SARS-affected country. Yet I witnessed no checks or questioning on 10 May during my return journey from London, a major European hub for connections from non-European countries. Guido Bertolaso, coordinator of Italy's anti-SARS operation as head of the Civil Protection Department, has explained that the controls only apply immediately at the main airports in Milan and Rome. He added that it would take a week to extend the restrictions to major airports in Naples, Genoa and Bologna. Experiments using infrared temperature detectors are expected to begin at the end of the month.

Health Minister Sirchia has raised the spectre that Europe is "faced with the possible nightmare scenario of an outbreak of SARS." If this is the case, then why are the restrictions being imposed in such a piecemeal fashion? Scaring people about the threat of SARS and then gradually introducing controls can only exasperate fear.

Italy's border controls are creating fear when no evidence of a health problem exists. At the time of writing (12 May), there have been nine "probable" SARS patients in Italy. Figures from the World Health Organisation (WHO) indicate all nine have recovered. "Suspected" SARS cases have been reported in many EU countries. But according to the BBC Online's "SARS: Global Update", there are no confirmed SARS cases anywhere in the European Union (EU). The suspected cases seem to be under control without border restrictions and no one has died of SARS in the EU. Uncharacteristically, the EU response to SARS has been relatively restrained.

The Italian reaction is a classic case of the "precautionary principle" of better safe than sorry. According to this principle, action should be taken to prevent health risks, even when there is no scientific evidence of a threat. Sirchia, a physician, has warned of the "terrible consequences and the responsibility that would lie with the health authorities if preventive measures are not taken." Is Signor Sirchia more concerned with public health or the reputation of his health authorities if there is an outbreak?

Italy's panicky response to SARS is creating problems that far outweigh any health risk. The decree ordering SARS checks means Italy has broken from European policy on SARS. This has created diplomatic tensions, but has also resulted in pressure on the rest of Europe to adopt similarly irrational measures. On 9 May, Minister Sirchia sent a letter to David Byrne, the EU's Health and Consumer Protection Commissioner. "More checks need to be introduced at the frontiers of all European countries," said Sirchia. "We're doing more than anyone else in Europe to optimise border controls."

In fact, Italy's SARS controls will violate the 1985 Schengen agreement on the free movement of peoples within EU borders. After the Iraqi war caused significant conflicts between European governments, will Italy's actions generate a new European rift over SARS?

For the people of Europe, new border controls for SARS can only add to post-9/11 travelling fears and restrictions. In Italy, checks focused on certain foreigners make it more likely that non-Italians will experience hostility. In Treviso, parents at a school demanded that the child of a Chinese mother who had recently returned from China be kept at home. So far such incidents have been rare, but pointing the finger at foreigners as a deadly health risk will not help.

Indeed, the Italian government may be stoking up more problems than it solves with the border controls. Only a serious outbreak would justify these restrictions. Will Italy become the European SARS 'capital' without one confirmed case or death?

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