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Is it too early to write an obituary for SARS? I don't think so. SARS still exists, and there may be more SARS related morbidity and death in existing cases. But the spectre of SARS as a world-wide pandemic is dead and buried. I almost pity the poor civet cats in Southern China. Not only will they continue to be bred in captivity as an exotic delicacy, but when the grant money start coming in, there may be more scientists and students studying the civet cats and taking blood and other samples than there are civet cats.

What will the legacy of SARS be? First the effect on public health authorities around the world has been profound, and I don't expect it to be reversed. The United States as part of the War on Terror had started implementing some systems to reduce the porousness of our boarders to biological attack. Some of that came in handy during the SARS scare. Systems that were slowly being implemented were slammed into place with almost indecent haste. They won't be withdrawn, instead they will be turned into the sort of unobtrusive scanning at airports and border crossings that should have been in place decades ago.

Of course, the US is not the only country to have been so affected. By this time next year it probably will simply not be possible to get on an airliner anywhere in China or the Pacific Rim with a temperature above 100 degrees F (38 C). This is already true at many of the major international airports, expect it to spread to national and regional hubs as well. Will this make flying more onerous? I don't think so. In fact, I think it will have the opposite effect. To the extent that public health agencies supplement or replace security forces in screening airline passengers, they will be more likely to treat people as potential patients, not possible criminals.

(Sort of off topic, but worth keeping in mind, is that right now most of the spending on airline security is misplaced. Yes, scanning luggage for explosives and checking passengers for concealed weapons is still worthwhile. But as the shoe bomb incident showed, the dynamics of airline hijackings has fundamentally changed. A potential hijacker has to consider all passengers and crew as armed, hostile, and very dangerous. So a lone hijacker on a crowded aircraft is simply not a credible threat. A half-dozen potential hijackers on an almost empty aircraft at least has the potential for being a threat.)

Will air travel recover? Yes, but two things will change, and airlines need to get with the program. People will be even less anxious to crowd themselves into a sardine can after spending hours getting to the airport and through security. And there is going to be a capacity glut for years. The airlines that do well in the next few years will be those that give the customer a bit more room for the price of his ticket.

Which is better, a 50% full plane that seats 210 passengers, or a 70% full flight that can only hold 160? The best trade-off may be a layout that provides 180 seats, or 140. But some airlines are finding the best seating arangements, and along the way making money.

If you are looking to make money investing in airlines, be careful. There are some basket cases out there that are way overpriced' such as American Airlines(AMR). I'm not sure about Delta(DAL), but right now I'd say that investing in any airline that isn't making money is pretty risky. (Clarification added when proofreading. Translate that about Delta as I am not sure that Delta belongs in the exact same basket as American.) Remember two major airlines UAL and TWA are now in bankrupcy, and others have been through bankruptcy in the past. Southwest(LUV) and Alaska (ALK) probably won't make you rich, but at least they won't put you in the poor house. There are some overseas airlines that are potentially decent investments, but if you are sophisticated enough to invest in foreign stocks, you should be able to do your own picking and choosing.

Will there be any long term effects outside of public health organizations and airlines? Yes, but I don't see much investment opportunity. I think the streets and alleys of Hong Kong and Bejing will be a lot cleaner, even a decade from now, than they were six months ago. And every major city mayor is going to think of the public health department as something other than a good source of patronage jobs.

I also think the medical system in Canada will get the thorough housecleaning and reorganization it has needed for ages. Will it get the funding it needs as well? Don't count on it. But spending more money on doctors and other health professionals, and less on bureaucrats might help. For those unfamiliar with the Canadian health care system, Health Canada combines the roles in the United States of the US Public Health Service (PHS), the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC), with managing the health insurance plans of the various provinces. Does that create a major conflict of interest? Sure does. The primary reason that SARS got out of control in Toronto was exactly that conflict. (The real irony was that Canada has some of the best public health experts in the world. But they were in Hong Kong, Vietnam, and China where they were allowed to do some good, instead of in Toronto, where they would have been unable to accomplish anything due to the structure of the health system in Canada.)

So when it is all over but the shouting, who knows, maybe even some mayors and governors will keep an eye on the public health and vital statistics when there isn't a medical crisis--but don't count on it. Washington, DC is already back to politics as usual, I suspect that Bejing is not far behind, and as for Ottawa (Canada)? The federal officials there are still too busy denying that there still is a SARS problem to actually do anything about future public health problems.
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The Spanish flu also disappeared in the Summer, only to re-emerge in a more deadly form in the Fall.

But I think that you are right; I think that this has been contained. It is too bad that the people of the world can't always work together as well as they did this time.
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But I think that you are right; I think that this has been contained. It is too bad that the people of the world can't always work together as well as they did this time.

It will take time, but I think that this was one of those events that, in retrospect will actually show up as one of the more important events of the decade. I think that, for example, the China that comes out of this will be a somewhat different country. And I think that there are a lot of countries what were involved only peripherally in SARS and in controlling it that will as a result participate more in international health organizations and programs.

Certainly the next new disease to come along will find an international air travel system much better prepared to cope. (That is if any of the airlines can survive the hit they took.)

Another example is that the campaign against AIDS in Africa that President Bush asked for in his State of the Union Address probably will get funded. Not much to begin with, but throwing too much money in to begin with would be a mistake.

It is one of those painful realities. A working, effective campaign to wipe out AIDS is going to have to start slowly. Other efforts to treat AIDS, or to make drugs wore widely available can occur in parallel. But the nature of bureaucracy is such that an effective international effort has got to work with other agencies and organizations. A new program that starts with too much money will form an organization devoted to spending that money. (Hopefully in an effective manner, but it may not.)
Once you have a bureaucracy that is organized to spend its own money the inherent conservatism of such organizations means that it will never put working with other organizations ahead of its 'own' programs.
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