The Politics of SARS - Rational Responses or Ambiguity, Symbols and Chaos?

The main focus in this article is on the SARS event as a political process, involving political leaders, administrators and health professionals. How can we understand the reactions to SARS of some of the main actors and institutions? What aspects were they preoccupied with and did their definition of what SARS was all about change during the process? A selection of jurisdictions is chosen - China, the Hong Kong SAR, Canada and the World Health Organization - to explore these questions. The starting point is a view that the reactions cannot primarily be seen as an instrumental, based on rational, standard-operating-procedures (SOPs) and technical expertise, but may be better understood by a garbage can-perspective. From a review of the events as publicly reported, we find, as suggested by garbage can theory, that politicians' and administrators' responses to the SARS outbreak were a combination of competing rationalities and overlapping agendas. Critical decisions were triggered by extraneous factors and administrative actions were shaped by dramatic switches from one set of standard operating procedures to another, as events unfolded. The public health issues constantly vied with other agendas and only when compelling alignments among them occurred did professional or technical rationales for "solving the problem" become dominant.