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VOA-TV Interview With Dr. David Richardson - 2003-04-28

VOA-TV Host David Borgida talks with Dr. Michael Richardson, the Chief Medical Officer of the Washington, DC Department of Health.

And now joining us, Dr. Michael Richardson, the Chief Medical Officer of the Washington, D.C. Department of Health.

Dr. Richardson, thanks for joining us.

My pleasure.

Discussing a little bit about SARS and how you see all the efforts that are being undertaken in Beijing and Toronto, for example, I know that this is from afar, clearly, but is there anything that you would advise those at CDC, seeing how you have seen the anthrax situation here in Washington many months ago, anything you could advise them to do, or are they handling it about the right way?

They're handling it about the right way. I mean, all of us are learning at the moment.

What we learn about SARS and how it is spread and all these things is very much a work in progress. We have learned much more, as we saw from your piece.

People are using different masks, as we realize that the A-95 mask may be valuable for hospitals but a simple surgical mask is okay for family members, things like that. We realize that we still don't know very much about how SARS is spread, in that there are people who are obviously infected by a respiratory droplet; others we still worry are infected by fecal-oral contact or through the sewer system.

We worry sometimes that maybe the virus may live much longer on contaminated surfaces, and therefore information and education is certainly always the way that has to be done.

And what are you doing in the Washington, D.C. area, Doctor, to stem the spread and make sure it doesn't occur here? There have been no legitimate cases in the Washington area.

There have been no cases in the District [of Columbia] or in Maryland yet. We have obviously many potential cases, many pending cases, but nothing suspect or probable.

And what we have done very much is reach out to our emergency rooms and our hospitals, to tell them how to diagnose, how to look at this, to in fact inform our public and our physicians.

We have certainly done very much in terms of making sure we have isolation ability in our hospitals.

And we have been lucky, I think we have to say that, rather than that we have done anything particularly unique. But certainly what we have learned from our bioterrorism involvement is that telling the truth and making sure that we are ready, so that if something happens we can respond properly and quickly.

It probably doesn't hurt to take a moment, because we have a worldwide audience, to just go over, if you wouldn't mind, for 30 seconds or so the key symptoms of this. What distinguishes it from the flu or the cold that people have all the time?

Well, very little except in a couple of things. First of all, the symptoms. The symptoms are those of a viral illness.

And so a temperature, as defined, over 100.4 degrees Fahrenheit; some respiratory symptoms, which is cough, shortness of breath, difficulty breathing; and, most importantly, that you have been exposed to someone who has had SARS or you have traveled within the last 10 days from a country where SARS has been diagnosed.

Initially that was only about four or five countries; now it's up to about 20 countries where SARS has been diagnosed.

You also have in the WHO classification that you have a chest x-ray that has infiltrates on it. So, you see some evidence of a pneumonia.

And that's where the name "severe acute respiratory syndrome" comes from.

There is an irony, as we talk about it, isn't there, that as the Western world has been concerned about bio and chemical terrorism, that SARS enters the picture?

And one would presume that the medical profession and health professionals are learning more about how to handle these kinds of possibilities because we now are confronting a real problem, SARS.

Well, I think that SARS is providing for us the first salvo of the 21st century and telling us a couple of things.

First of all, that our public health system has got to be more robust. We have got to make sure we understand and have epidemiologists, we have abilities to isolate, we have people to inform and to teach us as well as to do outbreak investigation. I think the second thing we realize is that health really is international. We talk a lot about a global village for learning and teaching, but really, in terms of diseases, we have to realize that people travel and diseases know no borders, no country, and certainly no ethnic or racial disparity.

And thirdly, I think we have to realize that many of these emergent infections, as they are called, are going to be with us for some time.

SARS, quite likely, we now know it's a corona virus, a virus that has come from animals and certainly mutated into man. We may be able to get even a vaccination against it if we are lucky, although SARS is a corona virus, it seems to mutate very quickly, and therefore a vaccine may be difficult.

That's one of the things I wanted to ask you about. Is there a danger that this could mutate to a form that common antidotes and antibiotics and so on can't treat it?

Well, so far we can say a couple of things about the corona virus. And again, I must say that we are learning as we go, and so some of these things will change.

We certainly have realized that this is a natural, we think, change. We realize also that if the HIV virus is anything to go by, the fact that the corona virus can change its genetic structure so quickly means that vaccination may be difficult, but better diagnostic tests for it may be as soon as three or four weeks away. And so that will certainly help.

Treatment for viral infections, however, are somewhat more difficult, and therefore prevention is going to be far more important, good hygiene, hand washing, very definitely making sure that you know your contacts and what you have been doing, and then, if you we are very lucky, we may be able to contain the spread very much more.

Dr. Michael Richardson, the Chief Medical Officer of the Washington, D.C. Department of Health on a very serious subject, thanks for the information. We appreciate it.

DR. RICHARDSON: My pleasure, David. Thanks for having me.