The story of the 2002-2004 SARS mini-pandemic

In late 2002, a virus that normally infected animals such as bats and civets made the jump to humans, and sparked an outbreak in southern China. The outbreak quickly spread to Singapore, Canada and Vietnam, and later to more than twenty countries around the world.

The illness was called Severe Acute Respiratory Syndrome - SARS - and the virus that caused it was called SARS-CoV - the ‘CoV’ stands for ‘coronavirus’. In recent years they’ve become known as SARS1 and SARS-CoV-1.

SARS was a terrifying illness, similar to the worst cases of Covid-19 in unvaccinated people - it started as a flu and progressed to a respiratory infection that left the patient struggling to breathe. 10-20% of patients died. Like Covid-19, SARS spread through fomites, tiny moisture droplets in the breath.

For a few months in the first half of 2003 the whole world was terrified of SARS. People cancelled trips to affected areas, travel and tourism declined, and airlines laid off staff.

Meanwhile, governments and health services tackled SARS with tools and techniques that are familiar from the early stages of the Covid-19 pandemic: there was contact tracing, and infected people and those who had come into contact with them went into quarantine. In hospitals SARS patients were kept on separate wards, and were cared for by separate doctors, who lived and worked in permanent quarantine.

The measures worked. Infected people were isolated promptly and the virus ran out of opportunities to spread. The last recorded new case of SARS was in July 2003. About 8000 people had been infected, 20% of them healthcare workers, and around 800 had died.

By 2004, the world was ready to forget about SARS and move on. But the story has a little-known sequel: of the people who had SARS and recovered, 10-20% went on to develop a debilitating chronic illness, whose main symptoms included fatigue, sleep problems and memory problems, similar to ME, Long Covid, and other post-viral illnesses.

Further reading

The chronology of the 2002-2003 SARS mini pandemic - scientific article, 2004

SARS survivors struggle with symptoms years later, 2010

Ten years later, SARS still haunts survivors and health-care workers, 2013

SARS 10 years later: How are survivors faring now? 2013

The original Sars virus disappeared – here’s why coronavirus won’t do the same, 2020

Unexplained post-acute infection syndromes, Nature Medicine, 2022