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China Syndrome: The True Story of the 21st Century's First Great Epidemic

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When the SARS virus broke out in China in January 2003, Karl Taro Greenfeld was the editor of Time Asia in Hong Kong, just a few miles from the epicenter of the outbreak. After vague, initial reports of terrified Chinese boiling vinegar to "purify" the air, Greenfeld and his staff soon found themselves immersed in the story of a lifetime.

Deftly tracking a mysterious viral killer from the bedside of one of the first victims to China's overwhelmed hospital wards—from cutting-edge labs where researchers struggle to identify the virus to the war rooms at the World Health Organization headquarters in Geneva—China Syndrome takes readers on a gripping ride that blows through the Chinese government's effort to cover up the disease . . . and sounds a clarion call warning of a catastrophe to come: a great viral storm potentially more deadly than any respiratory disease since the influenza of 1918.


First published April 1, 2006

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About the author

Karl Taro Greenfeld

21 books80 followers
I'm the author of six books, including the recent novel Triburbia, the story collection NowTrends, the memoir Boy Alone and the Japanese youth culture collection Speed Tribes

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Displaying 1 - 30 of 57 reviews
Profile Image for W.
1,185 reviews4 followers
March 15, 2020
The Corona virus outbreak reminds me of this book. It was penned by Time Asia's editor.

This is the story of the SARs epidemic,which was such a major scare in 2003. That too originated in China. Its impact was massive in Hong Kong with its high population density and housing consisting almost entirely of apartment blocks.

The author was right there. The book is a very readable combination of research,personal observations and stories of the victims.

Has the feel of a medical thriller,only this epidemic was for real,lots of people were dying,and alarm bells were ringing throughout the region. A terrifying book.
Profile Image for Bob Croft.
86 reviews4 followers
February 4, 2016
I own a commercial janitorial firm, with a focus on health, and write a blog. Here's one I drew from the book:
In the 2003 SARS outbreak,the biggest non-hospital outbreak in Hong Kong was at Amoy Gardens, a complex of eight-story apartment towers, and particularly in one of the towers. Much speculation involved how the virus, borne by various bodily fluids and by aerosols (think coughing or sneezing), spread quickly among residents, living on various floors and without much apparent contact.
What seems to have occurred involves diarrhea, experienced by most SARS victims, which involves many trips to the toilet, and much flushing. A crack in a pipe in the building's air-shaft produced a fine mist of virus bearing particles, available to anyone accessing the air-shaft. Perhaps more significantly, the
Fill floor drain p-trap
bathrooms in the tower were equipped with floor drains, with P-traps, many of which seem to have been dry. (The P-trap under a floor drain is similar to the one in the drain under your sink - it's designed to hold water, so as to provide a barrier between sewer and your bathroom.) Without water in the P-trap, the air in your bathroom or kitchen connects directly to the air in the sewer and the vent pipe.
The thinking is that each flush produced an aerosol plume, which traveled up the vent pipe into any other floor drains in the vicinity that had dry P-traps.
(For more details, check Karl Taro Greenfield's China Syndrome. Fascinating, if chilling read; I picked it up from an interest in China and pandemics, and stumbled across the P-trap bit.)
Now, in providing commercial janitorial service, we emphasize health; we're careful to train our folks to pour a bit of water (6 or 8 ounces is adequate), once per week, into any seldom used drains (think floor drains, common in commercial restrooms, or the slop sink back in the shop, or the drain in the never used (I hope) eyewash station in the manufacturing area. Filling the P-trap weekly seems adequate to counteract evaporation.
Profile Image for Chinmaya Behera.
30 reviews2 followers
April 23, 2020
Great book about the SARS epidemic, pretty much focused on the investigative work done by health professionals and journalists. A very relevant book for 2020, when the world is grappling with Covid-19. Highly recommend this book to anyone looking to understand how zoonotic viruses are spread from animals to humans and then humans to other humans. The underlying causes for SARS and Covid-19 are similar and the effects these had on Chinese economy or world economy have multiple parallels between 2003 and 2020. History repeats itself after 17 years !
Profile Image for Joshua.
14 reviews2 followers
February 6, 2020
When I read this book today as the Wuhan coronavirus outbreak is in its full swing, it feels that exactly the same event that had recoiled 17 years ago is now unfolding itself all over again. The history is repeating itself. An infectious disease is evolving into an epidemic in a global scale, by a novel virus of similar structure and function (but different), which jumped to human from wild species found in wet markets. The tragic drama again happens in China, even with same players: sluggish provincial Chinese officials, late but draconian reactions from the central government, outspoken physicians and virologists (Guan Yi and Zhong Nanshan are still around and active), dying patients and the panic public. It's just too surreal.
Profile Image for Chey.
332 reviews23 followers
March 26, 2020
“There would be another outbreak, if not SARS, then another emerging virus... this was common sense: too many people were living too close together with too many wild animals.

Welcome, virus.”

It was eerie reading about the 2002 SARS outbreak while another coronavirus is shutting down the world. In many ways it’s sad that so many lessons learned during the SARS crisis went unheeded by the world this time around.

There are still a lot of questions unanswered about these coronaviruses, including how to stop them and why SARS puttered out when COVID19 seems to just be starting in many places?

This book had great structure by separating its 400 pages into four books on the four important questions about a virus:

- What is it?
- What does it do?
- Where does it come from?
- How do you kill it?

It was also told chronologically, so it felt like it was being rolled out in real time. Another uncanny parallel, COVID19 also seems to follow the same timeline, with an outbreak in South China in the winter leading up to Spring Festival.

My one critique is the author had an odd word choice method. Sometimes he would use vocabulary like adroitly or raconteuse when maybe simplified language would have made the book more accessible. I would also apply this critique to the way he used Chinese terms, as he seemingly used spellings that weren’t the pinyin system I’ve learned.
Profile Image for Sebastian Rotella.
Author 9 books27 followers
April 22, 2020
If you want to read just one book to understand today's nightmare, read this one. Brilliant, intrepid, grimly funny, beautifully written, and, of course, remarkably prescient. It is full of great scenes, characters and insights. A blistering indictment of a dictatorship. And a tribute to medical professionals from many countries, from renowned scientists who defeated the epidemic to a conscientious young doctor in a provincial hospital whom government thugs literally dragged out of the room while the author was interviewing him.
Profile Image for Ernest.
238 reviews56 followers
April 19, 2020
This book is the warning message in the bottle for the year 2020. Published in 2006, it tells the story of the first corona virus outbreak in China in 2003. The author documents the actions of that time period which were very similar to what has happened in 2020. The book covers such details as: the geometric expansion of the population infection, the severity of the pulmonary disease, the inadequate preparations of the hospital and public health system, the deaths of hospital workers due to lack of protective equipment, governmental mismanagement at the onset of the epidemic, political personalities and the failure of leadership, etc. A reader would think that this book is describing the current day actions toward COVID-19.

The value of the book is the George Santayana quote: "those who do not learn from history are doomed to repeat it." This book is proof that the world did not learn from the year 2003 due to the media domination of the Persian Gulf War story that occurred at the same time of the epidemic.
Profile Image for Kristin.
313 reviews13 followers
November 13, 2020
For information junkies like myself, an account of the SARS outbreak in 2002 qualifies as perfect pandemic reading. A lot of the content was fascinating, like the details about how zoonotic viruses jump from animals to humans, and just how horribly China handled the SARS outbreak. I did not love the writing style and found the organization of the content a little haphazard. Especially the attempts at cliffhanger endings on chapters... am I reading a spy thriller? Probably a book written by a virologist or epidemiologist probably would have suited my interests better (this was written by a journalist).
Profile Image for Karen.
559 reviews1 follower
March 21, 2020
Great book about SARS that's focused on the investigative work done by health professionals and journalists. I read somewhere that this is *the* book to read about SARS, and I agree. Very interesting read.
Profile Image for Morgan A Kelley.
187 reviews3 followers
October 27, 2021
I read this book for my infectious disease class. A detailed account of the SARS outbreak in 2003 and all those involved. This was an especially interesting read given that this book was written before the COVID-19 outbreak and included all the warning signs for the recent pandemic. A great read for anyone interesting in disease or how the politics in China that led to the failed containment of COVID-19 were in place long before 2020–as the book will discuss, we got lucky with SARS. Our luck just finally ran out.
Profile Image for Abhishek Dalal.
15 reviews13 followers
May 6, 2020
Fantastic book on SARS. Must read given the circumstances we find ourselves in-eerily similar. China’s prevarications then and now have led to untold damage to their people and the rest of the world.
67 reviews2 followers
July 26, 2021
Absolutely mind-blowing... And also the most terrifying non-fiction book I've ever read. Reading this book in the midst of COVID is also a painful reminder that we truly never ever learn from history :'(

PS: Be prepared to pick up loadsa new vocab. I'm a voracious reader and even then I came across at least 15 words I've never encountered before.
206 reviews13 followers
May 21, 2020
Very readable and informative about the fight against SARS. But the author also occasionally makes obnoxious off-color comments (saying a woman’s nose was too wide, making fun of an employee for wanting to home to Guangdong) that really detract. His characters seem somewhat cartoonish
20 reviews
May 23, 2020
Loved the book, a very interesting read especially in the current global pandemic times. The final words about China and the next outbreak after SARS were just bang on: “This was common sense: too many people were living too close together with too many wild animals. Welcome, virus.”
506 reviews40 followers
May 13, 2020
Read this and keep in mind it was published in 2006. Don't get bogged down in the middle - read all the way to the end.
Profile Image for Anita.
1,346 reviews7 followers
April 16, 2020
I started reading this book, about the SARS coronavirus outbreak which began in China's Guangdong province, just as news about the now-named Covid-19 (SARS-CoV-2) was gaining an infectious traction in Wuhan, China. Both started out being classified as atypical pneumonia (or pneumonia of unknown origins). Both have been traced to having their genesis (or spread) from live-animal markets.

This book is authored by a former editor of Time Asia magazine, based in Hong Kong. As such, he was in the unique position to report on the 2003 SARS epidemic as the contagion spread from mainland China to the former British colony. This book gives a very detailed timeline of the virus' deadly reach. It shines a spotlight on the glaring shortcomings of the Chinese Government, in the early days and even months afterwards, in downplaying the severity of the spread. This includes concealing news about the outbreak from other provinces, ordering hospitals to not reveal the number of cases and fatalities (a breach – the divulging of "state secrets" -- which is considered treasonous!), and lying about the actual numbers – lowballing them for public consumption. Fast forward to 2020: The doctor who blew the whistle on Covid-19 was initially censured. It’s the same ol' in China.

This is because the Government considers it a loss of face to not being able to get a grip on the health calamity, and so chose to deny medical samples to doctors and scientists for conducting tests, refusing to grant them permission to visit hospitals, and going so far as to move and hide patients. Health authorities from Hong Kong (which is part of China) and members of the World Health Organization were stonewalled at every turn. More than anything, the Chinese Government prioritized civil order above all else, and so chose not to reveal to their citizens that an epidemic was raging among them, allowing them to think that it was just another rampage of a bad flu season.

At the time of this writing, many countries in the world are facing their own battle with the Covid-19 pandemic. At this time, there is a blame-game going on, as to the virus' origin. This is futile in the quest to trace the virus' provenance – zoonotic, to be sure – but global cooperation is required to pool knowledge and resources to understand its epidemiology. A treatment, vaccine, and cure is great; but the root of the problem still needs to be understood as novel viruses seem to encroach closer and deadlier with each manifestation.

* Read for the '2020 Around the Year in 52 Books Challenge' task: A book inspired by a leading news story
Profile Image for Yates Buckley.
644 reviews23 followers
May 11, 2022
A journalist retells the story of the SARS outbreak in 2003. The book describes the banality of the factors that lead to spread, that block information sharing, that shape the background causes for future outbreaks and the lucky breaks that send it all away temporarily.

Perhaps a bit hard to separate some of the critiques of the Chinese gov from what would be the case in any government managing of difficult situations such as an outbreak. But also interesting that there are big limits on what the gov can do - it seems it can’t afford to indefinitely ban consumption of illegal wild animals. Eating culture is tougher then public health.

Very well written, with lots of empathy for actors in difficult situations.
Profile Image for Chris Moen.
4 reviews
May 1, 2020
Excellent read, very comparable to the situation we’re seeing currently with the SARS-CoV-2 pandemic. If you want to learn more about how much Wet markets are to blame and the ruthless slaughter of live animals for bizarre reasons aside from meat, read this! One of my favorite nonfiction thrilling science books of all times.
Profile Image for Donna.
39 reviews
April 28, 2020
This is a must read if you want to get an in depth knowledge of emerging viruses, especially SARS Coronaviruses coming out of China in the 21st Century. The text is about the 2003 outbreak of SARS in Hong Kong and China. I read this during the Covid-19 pandemic and sheltering in place of March-April 2020 and was blown away by the parallels of the two pandemics. An excellent book, told in journalistic style as it was written by the former Editor of TIME Asia who was living in Hong Kong at the time of the 2003 SARS outbreak.
Profile Image for Diep Vu.
80 reviews9 followers
April 7, 2020
Can hardly describe in words how I got shivered by the author's workloads via this book pertaining to the outbreak of SARS epidemic in Hongkong and mainland China in 2003. After spending more than two months reading "China Syndrome" as of the blockade of Wuhan on 23.01, I see a lot of Greenfeld's efforts through figures and statistics laid down in each of his valuable chapter. To the readers, Greenfeld provided them with lots of knowledge not just in virology, microbiology and epidemiology in particular but also in politics, culture and sociology in general. The book is a true story with authenticated facts written by the journalist Greenfeld and his counterparts, and it's not a kind of easy-to-read book, I admit, since you have to familarize yourself with basic understanding on China and how such bureaucratic government handles with each risk to its communist regime. Thank to Greenfeld, he spent so much time as an expat working over there in order to expose to readers the nature of SARS and China through each thrilling page and I'm sure you will get surprised upon realization on how it reflected the same as the current medical crisis of this Covid-19 pandemic.
Profile Image for Meg.
171 reviews11 followers
January 9, 2015
This book is brilliant! Non-fiction, but written like a Grisham novel, it documents the 2003 SARS outbreak in Asia. Author Karl Greenfield was the editor of Time Asia and his journalistic skills are evident as he exposes the where, what, who and how of the outbreak. The cast of doctors, health workers, politicians and scientists who battle the virus, plus the victims infected by it, are described brilliantly - Greenfield really brings these folks to life. The story is told chronologically and unfolds like a thriller. Highly recommended to anyone who enjoys an interesting story with fascinating characters.
Profile Image for Kerri.
53 reviews4 followers
March 8, 2020
As the world stares down COVID-19, I wanted to understand what we learned from a different-but-similar coronavirus, SARS, and what that response looked like on the ground. This book delivered, in a well-sourced but very readable format from an author who was on the ground in China during the outbreak in 2003.
Capturing both the scientific race and some personal anecdotes of patients and families, this book is very well done and will have readers quickly drawing parallels to the current situation with COVID-19.
Profile Image for Kristine.
251 reviews8 followers
May 7, 2009
Two of my favorite subjects, China and pandemics unite in a terrific book. This is exciting and terrifying as the Hot Zone.

One star deducted because the writing faltered at times with lame humor-like comparing Jennifer Lopez to a virus.

Profile Image for Susan.
63 reviews3 followers
November 9, 2011
The book started off pretty exciting but then got very repetitive, telling variations of the same scenario over and over.
Profile Image for Shuey Mirkin.
14 reviews
March 22, 2020
Reads like a novel, but well-researched and informative. It's scary to think how long we've known about these issues and did basically nothing about them.
Profile Image for Shay.
703 reviews16 followers
June 5, 2020
“The season of SARS could be viewed as either an anachronism or a harbinger.”

There is a definite sense of eerie deja vu in reading this book right now, from the slowly escalating rumours, and mutters about biological warfare, to the runs on particular kinds of equipment and supplies, to the very timeline and symptoms of the illness itself. Yet perhaps the most eerie part is the unheeded warning that SARS now represents. As Greenfeld details, the Chinese government banned the sale of the animal found to be the reservoir of the virus, and seized and destroyed the existing stock. But the closure of the urban markets where live animals were sold was only temporary, and within months they were back in business, operating much the same as before, with thousands of diverse, defecating, bleeding, doomed animals trapped in close quarters with one another, and the people who sold, butchered, and consumed them. One threat was eliminated, but the conditions for another such zoonotic outbreak remained much as they ever were. more
2 reviews2 followers
June 28, 2020
A warning heeded too late

One cannot read this book today without marveling at the seemingly prescient predictions the author makes about the potential of a SARS2. He convincingly demonstrates how coverups in China slowed reactions, the era of wild flavor and strange meat markets allowed for Animal viruses to cross the species barrier with scary efficiency. You couldn’t create a better breeding ground for dangerous viruses. And yet even after SARS1 the meat markets opened back up quickly. We’re just not equipped to psychologically handle low risk high impact situations. Not to mention the free rider problem that one bad country actors actions will spread across the world in short order.
Profile Image for London Storm.
156 reviews3 followers
May 19, 2021
I wasn't expecting a book on SARS to be quite this gripping, giving the horror we've all just lived through, that many in the global south are still living through the worst of, especially considering SARS infected and killed countless legions fewer people.

Thanks to a fantastic storytelling structure and even better writing, Karl Taro Greenfeld succeeds where many others have failed miserably. China Syndrome tells a compelling story and doesn't shy away from uncomfortable facts about the unfolding of the situation.

This book is a must read for anybody into this kind of thing and a should read for everybody else.
95 reviews
June 8, 2020
Greenfeld's China Syndrome is a case study on how China denied the existence of SARS, downplayed it's threat, and chose political stability over public safety. The mistakes made by the Chinese government virtually parallels the mistakes made by Trump's regime during the SARS 2 pandemic. If you believe that we could not have been prepared for SARS 2, then I highly recommend you read this book. It is a lie that we could not have been prepared. As Greenfeld argues, "the first response to a pandemic is denial."
Displaying 1 - 30 of 57 reviews

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