Acting on the lessons of SARS: what remains to be done?

On November 16, 2002, a man was admitted with a diagnosis of atypical pneumonia to People’s Hospital #1 in Foshan City, Guangdong Province, People’s Republic of China. Although it was not recognized at the time, he was the earliest known case of a new human infectious disease, Severe Acute Respiratory Syndrome, or SARS. Within 4 months SARS was global, eventually infecting 8,098 people in 29 countries on 6 continents and killing 774 of them. Even more concerning than these numbers is the fact that in many locations most of the victims were infected in hospitals and 21% of the victims were healthcare workers. At the time, SARS caused great alarm in the public health and medical preparedness communities. National and international guidance was issued, many health departments and hospitals created SARS plans, personal protective equipment was purchased, and healthcare workers were trained in respiratory precautions. In the months following the SARS pandemic, a number of conferences were held and reports issued on lessons learned from SARS. Now, from the vantage point of 8 years’ distance, what did we really learn? What are the remaining unanswered questions? What remains to be done?