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Breakfast with Frost


APRIL 27, 2003

Please note "BBC Breakfast with Frost" must be credited if any part of this transcript is used

DAVID FROST: And now to the boss man in this particular subject, chief medical officer, welcome back, Liam. First of all, do you think what we've just heard, in fact that Dr Bruntland does go too far in her warnings and in fact that adds, possibly, to the sense of panic?

LIAM DONALDSON: No, I think what the WHO have done is right, although we do see here the downside of precautionary public health advice. If we give our advice and take our public action without fear or favour, then the downside are some of the things that we've seen in Toronto, with the damage to the image of the city and the tourism and economic. But we can't let those factors influence our public health thinking, we have to do what's right to protect the health of the public.

DAVID FROST: But at this moment in time you don't think there's a case for it being notifiable. Why not? Because there have only been six cases and no fatalities?

LIAM DONALDSON: That's not the reason. We have a legal system of notifiable disease. It's a very traditional system, it's based on form-filling, aggregating quarterly returns, and it's suffered over the years from under-notification. Food poisoning is a notifiable disease, we only hear about five per cent of the notifications as actually occur. What we want with this disease is a very rapid form of notification with the bureaucracy of the statutory notification system, and that's how we've detected our cases so far. We want people to get on the telephone, to email, by word of mouth to let us know. In due course, in the long terms, it might be helpful to make it notifiable -

DAVID FROST: It might, it might be.

LIAM DONALDSON: It might be, but the main purpose of notification is to spot the disease early and we think at this stage we've got the best way of spotting the disease early and we don't want to take our eye off the ball.

DAVID FROST: What about though - it does seem odd not doing anything about people coming in from the Far East into our airports. Is there not, nothing that could be done there?

LIAM DONALDSON: Well we have the exit screening - you've got to remember there is no test for SARS - so the exit screening, all it really amounts to is asking people have they got a cough, have they got chest symptoms, have they got a temperature, and that's a pretty blunt instrument for detecting a disease. But people are screen detected, they're screen, they're, if they fall ill on the aeroplane they are detected as well, and it would really only be if people developed the disease while they were at the airport collecting their luggage from the carousel. A very difficult thing to detect and in all the six cases we've had so far, none of them would have been found at exit, on the plane or at entry. We found them by good detective work in Britain, and that's what we need to keep up, that good public health detective work.

DAVID FROST: Right we'll just take the news and we'll hopefully have a moment to have another word afterwards.


DAVID FROST: We're out of time but one last question - is there a comparison, which Dr Bruntland said - between SARS and Aids? Nothing like?

LIAM DONALDSON: No. Because the worst thing that could happen would be to have a disease that travelled and was very, very contagious. That isn't the case with this. It has a limited infectiousness.

DAVID FROST: Thank you very much indeed Liam.


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