AMANDA ARONCZYK: It's not always fear mongering, sometimes it's the real deal. For example, the 2003 SARS epidemic which killed hundreds of travelers so fast it all but shut down the Asian airline industry, as public worry turned into debilitating fear almost overnight. In a global world connected by air travel, authorities constantly face the difficulty of knowing the difference between a lethal threat and the sniffles. Fifteen years ago, there was an outbreak that dramatized just how hard it is to identify a disease, much less contain it.
HOE NAM LEONG: Hi ya.
AMANDA ARONCZYK: Is this Dr. Leong?
HOE NAM LEONG: Yeah this is, this is. The elusive Dr. Leong.
AMANDA ARONCZYK: With that in mind, let me tell you about a man who came to New York with a very deadly disease. Although, he didn't know it at the time. This is the story of Dr. Hoe Nam Leong.
HOE NAM LEONG: I was impressed that you found me. I thought it would have been buried in history forever.
AMANDA ARONCZYK: Dr. Leong Is an infectious disease specialist based in Singapore. It started in the spring of 2003, when he saw a new patient.
HOE NAM LEONG: I was consulted on this and usually pneumonia in a girl was just returned from travel.
AMANDA ARONCZYK: She'd been shopping in Hong Kong. He would check on her often in the hospital but she wasn't improving.
HOE NAM LEONG: We were very limited in our testing abilities then and we couldn't figure out what she had.
AMANDA ARONCZYK: It was still a mystery. When a few days later Dr Leong boarded a flight with his family to attend a conference in Manhattan.
HOE NAM LEONG: We landed early in the morning in New York and we said, 'we're going to keep awake so we're going to try to beat the jet lag.'
AMANDA ARONCZYK: They take a shuttle to the hotel, get changed, wander through Chinatown, eat at a restaurant. Then the conference was scheduled to start.
HOE NAM LEONG: So I went back to the hotel in the late afternoon. This is when I realized that something wasn't quite right. I had chills. I knew I was sick.
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AMANDA ARONCZYK: The next day, he went to the hospital. They didn't know what he had. This is one of several moments when Dr. Leong fell through the cracks. The hospital could have forbidden him from traveling but they didn't and he just wanted to go back to Singapore. Why did you think it would be easier to go home?
HOE NAM LEONG: I guess we are always terrified about the unnecessary costs of medicine in the US.
AMANDA ARONCZYK: A-ha.
HOE NAM LEONG: The bills can be quite exorbitant.
AMANDA ARONCZYK: So they cut their trip short and get back on a plane. They're halfway across the Atlantic when airline staff come looking for Dr. Leong.
HOE NAM LEONG: They quickly identified me. I say they have received instructions from the Ministry of Health in Singapore to quarantine us at the rear of the plane.
AMANDA ARONCZYK: The crew doesn't know why exactly but they've been told to quarantine Dr. Leong and his family.
HOE NAM LEONG: They moved everyone from the rear of the plane forward, leaving only three to four rows of seats at the rear.
AMANDA ARONCZYK: Then at the first stopover in Frankfurt, they took everyone off the plane. First the passengers followed by the staff and then they came to get me.
MALE CORRESPONDENT: The Centers for Disease Control today issued a health warning for Americans following a worldwide outbreak of a mysterious form of pneumonia. [END CLIP]
HOE NAM LEONG: News broke. A new virus was discovered in Hong Kong and they're naming it SARS.
AMANDA ARONCZYK: Severe acute respiratory syndrome.
HOE NAM LEONG: Then I started realizing that we may be at the brink of a new epidemic.
MALE CORRESPONDENT: Today, a surgeon is under quarantine in a German hospital. The doctor had treated a person with the disease in Singapore this week then flew to New York for a medical conference. [END CLIP]
AMANDA ARONCZYK: Dr. Leong was Singapore's patient number three. He'd caught the virus from that young woman, the one who had just returned from Hong Kong. He became very ill and he thought he might die.
FEMALE CORRESPONDENT: German health officials said today, the condition of a Singapore doctor believed to have been infected with the mysterious pneumonia like illness, has worsened. [END CLIP]
AMANDA ARONCZYK: In 2003, over eight thousand people worldwide contracted SARS. And it killed nearly one in ten of those infected. In traveling to that conference, Leong could have caused an outbreak in New York City. Who should have stopped you?Should it have been the airline? Should it have been the authorities in Singapore? Should it have been the authorities in New York?
HOE NAM LEONG: I think everyone has a role to play. His hospital in Singapore should have been more cautious. He should have been flagged by the doctors in New York. And he should have known not to fly. After all, he is a specialist in infectious disease. Now looking back at what you did, do you feel badly? Like, should you have stopped yourself?
HOE NAM LEONG: I feel stupid. I honestly feel stupid. I said I shouldn't have boarded the plane.
AMANDA ARONCZYK: He was not alone. SARS spread, in many cases by air travel to over 25 countries. Flash forward to September 5th of this year, when a pilot on a 14 hour flight from Dubai to New York called officials at JFK airport to say, 'there seemed to be a lot of sick people on this plane.
MALE CORRESPONDENT: --landed at JFK Wednesday morning to a cluster of flashing lights, paramedics and law enforcement waiting for them on the tarmac. [END CLIP]
AMANDA ARONCZYK: Dozens of emergency vehicles met the plane away from the terminal. The Centers for Disease Control wouldn't let anyone off.
FEMALE CORRESPONDENT: At first, people are really calm and patient. And then after 20 minutes of no information, no water, the bathrooms are unusable by the end, people got really frustrated. [END CLIP]
AMANDA ARONCZYK: Passengers told Fox 5 News, it was the flight from hell. There was coughing, sneezing, everyone had their temperature taken. After two and a half hours on the tarmac, they were finally released.
MALE CORRESPONDENT: Where they met their families and a mob of TV cameras.
FEMALE CORRESPONDENT: Good afternoon.
AMANDA ARONCZYK: Five hours later the Department of Health held a press conference.
This was a flight that had 521 passengers, a 106 of them presented with symptoms ranging from cough, fever, vomiting.
AMANDA ARONCZYK: But over the course of the day that number went down a lot. Just 11 people went to the hospital. Some had a minor flu, others just had a common cold. Mostly people thought they were sick. So what happened here?
AMESH ADALJA: It does, It doesn't make sense. Sometimes the symptoms themselves become contagious. We see it a lot like in high schools. One person vomits and on the rest of them start vomiting.
AMANDA ARONCZYK: Dr. Amesh Adalja is at the John Hopkins Center for Health Security. Basically, people got scared and freaked out.
AMESH ADALJA: Fear is contagious, so I guess that's what ends up happening. Which is tagline from Contagion, I think, right?
AMANDA ARONCZYK: It's actually nothing spreads like fear. The question is, did this fear cause the public health officials and the airline to overreact?
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AMESH ADALJA: And I do believe that what that pilot did on the Emirates flight was right.
AMANDA ARONCZYK: As inconvenient as this flight from hell was for the passengers. It's thanks to SARS that there are systems in place– sick passengers, alert pilot. The CDC awaiting the plane on the tarmac, now if only containing the fear was so easy.
BOB GARFIELD: Coming up, when life or death may hinge on who do you trust.
AMANDA ARONCZYK: This is On the Media.