According to a March 21st report by the Health Scout News, a simple sneeze may have set off a worldwide epidemic.  Health investigators probing the spread of the mysterious global respiratory illness called SARS, or Severe Acute Respiratory Syndrome, appear to know the exact spot that brought at least seven people to a deadly confluence in a Hong Kong hotel on February 21st.  The seven individuals were all waiting for an elevator on the ninth floor of the Metropole Hotel in the Kowloon peninsula.  International news reports state that a 64-year-old medical professor from the Chinese mainland province of Guangdong appears to have spread the respiratory illness to 11 countries, killing 15 and infecting more than 600.  The Guangdong province, adjacent to Hong Kong is the site of a respiratory illness that has infected more than 300 people and killed five since last November.

Much like other respiratory illnesses, SARS seems to be spread by close contact. For example, a person infected with SARS could cough or sneeze, contaminating the immediately surrounding air with tiny droplets of infected matter. Someone in close proximity of the infected person could then breathe in air that has been contaminated. Because the cause of the SARS infection is yet unknown, scientists are considering other possibilities of communication. According to the CDC, "it is possible that SARS can also spread more broadly through the air or by touching an object that has been contaminated." A recent update on the WHO Web site addresses some other possibilities:

The SARS outbreak in Hong Kong SAR has developed an unusual pattern of transmission. This pattern is different from what is being seen in the vast majority of other SARS outbreaks, and is not yet fully understood. The number of cases is continuing to increase significantly, and there is evidence that the disease has spread beyond the initial focus in hospitals.

These developments raise questions related to other routes of transmission, in addition to well documented face-to-face exposure to droplets released when an infected person coughs or sneezes. Epidemiologists are considering whether SARS is being transmitted in Hong Kong by some environmental means for which no satisfactory explanation has been found.

To illustrate the communicability of SARS, consider this: According to the New York Times, as of March 29th, 249 individual cases of SARS could all be traced to one man. That's an incredible amount of people infected by one person. Of those infected, 214 were medical personnel or health care workers.

Much more in-depth and up-to-date information is available at these web sites:   http://www.cdc.gov  and  http://www.who.org



Having explained briefly the rapid spread of SARS and international fear produced in such a short time period, I propose to instigate an immediate cultural trend in regards to the SARS virus.  Many times popular trends and fads spread rapidly, similar to a disease or epidemic.  All media I have seen coming from Asia regarding the SARS outbreak has been extremely visual and almost fashionable.  Any picture of the public on the street shows crowds wearing surgical masks, advertisements with women "happily" wearing their masks, and any Chinese newsprint is interlaced with the acronym SARS.  In light of the mass media's tactics for information delivery (scare tactics, sound bites, disinformation, and biased news coverage) I intend to see a rapid rise in San Francisco residents wearing surgical masks as a public statement, as well as a direct result from participation in this art project.

With the above scientific information readily available to the public, I propose the research and implementation of a public "health alert" installation to take place in downtown San Francisco.  The purpose of this project is to raise awareness of the severity of the recent outbreak of the SARS virus worldwide.  Downtown San Francisco is the selected area for the project because of the amount of people moving through the area daily, including many international tourists.  The project will be implemented as described below:

An aggressive street-level marketing company will be created in this project to keep the SARS subject fresh in everyone's conversation, contemplation, and concentration.  Printed and painted materials will be placed throughout the downtown San Francisco area including: BART and MUNI stations, large billboards overlooking Union Square, and stencils painted on the street and respective signs.  A strong street team seen below is responsible for daytime and nighttime SARS message delivery.  Daytime responsibilities include flyer distribution, outdoor public announcements, and mass mailings of surgical masks to large businesses considered inside the Financial District.  The street team is also to hand out surgical masks to the public at large, targeting the Union Square to Chinatown flow of traffic.  Most surgical masks will come in a variety of colors and will have printed on them catchy slogans such as: "BE SARS FREE" or "BREATHE SARS FREE" so the public will want to collect and wear more than one type.  Nighttime road blocks are set up similar to sobriety check points along high traffic areas near the 101, 280, and Highway 80 intersections to question drivers and ensure the public that SARS is a serious epidemic.  Other graffiti experts and flyer/poster deliverymen are responsible for the placement of current, true, SARS statistics from around the world, including new cases reported, updated death tolls, and updated international travel advisories.

New technologies will also be introduced in this public art project. A mobile SARS information trailer-type unit will be used to deliver up-to-date information about worldwide effects of the SARS virus.  This trailer-type unit is equipped with solar panels for self-sufficient power, wireless internet capabilities for live compilation of SARS related data and imagery, and a free-space projection system to integrate images of people from around the world wearing surgical masks into the flow of foot traffic specifically in the Union Square area.  Using 2-3 powerful computers, the free-space projection system will mirror on a one-to-one basis persons wearing masks to those not wearing masks here in San Francisco.  Using Track Them Colors technology, a motion detection plug-in available for the Macromedia Director computer program, one "unaffected" person walking through Union Square will see an image of an "affected" person walking along side them.  The free-space projection system will help remind locals and tourists alike that they are not completely safe from the virus and be encouraged to wear a surgical mask, readily available to them from the aggressive marketing campaign created with this project.

The purpose of this project is not to scare the public "to death" about the SARS virus, but to raise many valid points about society in general.  The fact that the next pop singer will sell millions, or the next reality TV show will captivate millions, or that the latest fashion will raise millions inspires me to create my own "trend".  This project utilizes only true information, but the way it is distributed will have great effect, down to a person-to-person level.  I contacted both the Center for Disease Control and the World Health Organization asking what they felt was the most effective way of notifying the public of a disease outbreak.  I unfortunately received only automated responses referring me to databases of current information; a whole plethora of information is available however from the sites listed below.

Bet you didn't know...

During a sneeze, millions of tiny droplets of water and mucus are expelled at about 200 miles per hour (100 metres per second). The droplets initially are about 10-100 micrometres diameter, but they dry rapidly to droplet nuclei of 1-4 micrometres, containing virus particles or bacteria. This is a major means of transmission of several diseases of humans.  Though sneezes and coughs shouldn't be inhibited, the spray expelled from them should be.  So often people will cover their mouth with their hand and continue spreading their germs with everything they touch.  A proper way of preventing such a huge spray of germs is to cough in the crease of your elbow, allowing for less chance of germ transmission.

Information Resources:

http://www.cdc.gov/ncidod/sars/ic-closecontacts.htm  (Interim guidance on infection Control Precautions for patients suspected with SARS)

http://www.cdc.gov/ncidod/sars/casedefinition.htm     (Case definition)

http://www.cdc.gov/ncidod/sars/faq.htm                      (SARS Frequently Asked Questions page)

http://www.cdc.gov/ncidod/sars                                   (Comprehensive overview of SARS, including telebriefing transcripts)

http://www.who.int/csr/sars/en/                                   (World Health Organization SARS site)

http://www.who.int/csr/sars/travel/en/                          (World Health Organization SARS travel site)

http://www.health.nsw.gov.au/index.html                    (More SARS information)