FRIDAY, FEBRUARY 22, 2008 SOUTH CHINA MORNING POST AFTER SARS
FIVE YEARS SINCE A KILLER VIRUS HIT, OUR FIVE-PART SERIES
LOOKS AT THE IMPACT OF THE DISEASE AND LESSONS LEARNED
PART 1 HONG KONG’S EXPERIENCE
Outbreak of fear The appearance of a mysterious virulent disease that no one knew how to treat or stop from spreading gripped a terrified city, writes Sarah Monks
It was the run on white vinegar, alert for some time but for a different index case for the chain of outbreaks in
crisis, civil society came to the fore.
disease – bird flu (the H5N1 virus). On
February 17, 2003, bird flu claimed its first
people died of the disease in 1997 – a 33-
year-old man who had visited relatives in
towards the end of March – spiking at more
than 100 new patients per day on March 24
staff to helping children of Sars victims and
planning activities that would speed Hong
Kong’s state of readiness. An associate
“It is a holocaust. It is a war with an
microbiology at Chinese University warned
vinegar to fumigate their homes. But by the
on February 20: “We are not prepared for
an epidemic.” With only a few isolation
disaster I have ever seen,” said Sydney
was flying off the shelves of supermarkets
wards, he said: “You cannot create them in
Development Council staged an extra trade
show in July to make up for the disrupted
unhappiness at the way mainland officials
challenged suggestions by health chief Dr
syndrome (Sars), the first severe infectious
Yeoh that the disease had not spread to the
went into high gear, aimed at “restoring
disease to emerge in the 21st century and
Guangdong. “We are worried that it is the
beginning of an epidemic,” he said.
the world”. The plan eventually included
countries or regions, with 8,098 cases and
that the isolation and evacuation of Amoy
Gardens Block E residents might have been
Sars. By the end of August, the number of
anti-viral drug ribavirin, used to treat the
passenger flights was nearly back to pre-
Sars levels. Hotel occupancy was up to 71
long-term side effects. A nervous populace
per cent by early July. Retail sales reached
their pre-outbreak levels by the end of July.
Kong would be treated like a “plague city”
Hospital in Sha Tin all went on sick leave.
August low point as homebuyers looked for
coronavirus identified as the cause of Sars
infected 1,755 individuals, including 386
former dean of medicine, Chinese University
was linked to wild civet cats, fear spread
health-care workers. Of the 299 people who
that household cats could carry the disease.
died, eight were health-care workers. Hong
and individual visits by mainland tourists.
Kong’s domestic economy was devastated.
streets and fear as it suffered its worst
Kong with his wife to attend a relative’s
officially declared over on June 23, when
deserted as people avoided public places,
the WHO removed the city from the list of
911 of the Metropole Hotel in Mong Kok.
stayed at home or spent their weekends in
areas with recent local Sars transmission.
the crisis unfolded and what was learned.
The following day – five years ago today –
outlying areas. April retail sales were down
With relief came much soul-searching.
At the time, Sars was a terrifying mystery.
15.2 per cent from the previous year. The
airport resembled a ghost town as visitor
chief executive Tung Chee-hwa reported its
Guangdong, a stance Beijing later changed.
severe pneumonia. He died on March 4.
May. Hotel occupancy rates collapsed from
79 per cent in March to 22 per cent in April
caused the pneumonia-like disease, how it
Guangdong’s fatal “atypical pneumonia”
extraordinary service, hard work, attention
infectious. There was no diagnostic test.
firmly held its ground. Despite disruption
headlines, including final preparations for
the war in Iraq and the proposed Article 23
response to the epidemic, particularly in
Then the onslaught began in earnest.
the early phase. “Lessons must be learnt,
welfare at the time, said on February 11 of
On March 12, the South China Morning
and there is much that needs to be done to
that year: “We understand … that there
Post ran a headline: “Ward isolated after
and Business Strategy at the University of
strengthen the public health function, to
hospital staff fall ill with mysterious flu”.
improve the co-ordination of the different
The article detailed the sudden illness of
parts of the health sector, to provide clarity
infections have been mild and there is no
in roles and responsibilities and to improve
need for people to worry and to panic.”
Wales Hospital. Contact-tracing connected
Guangzhou professor was identified as the
time in non-Sars affected countries. Some
report that at a time of crisis, Hong Kong
Sars cases in Hong Kong: how the epidemic spread
professional. “The experience gave Hong
uncertainty about how Hong Kong fits into
going should their offices be hit by Sars.
a rapidly modernising China,” wrote chief
executive officer Christine Loh Kung-wai.
along with mats soaked in disinfectant at
included the ability to question authority,
regular disinfection of lifts. Homes were
aired and thoroughly cleaned with bleach. Tomorrow How HK’s health
wearing of masks if unwell. Any unguarded
sneeze or cough drew accusing looks. A couple wear protective masks as fear grips Hong Kong during the Sars outbreak in March 2003. The epidemic lasted for three months and infected 1,755. Photo: Robert Ng Turbulent days from local rumour to international alert January 2003 26 United Christian Hospital admits 15
allowed, for up to 10 days. In total, 1,262 people
found in civet “cats”, Hong Kong suspends
23 Guangdong health officials produce an 4 The Guangzhou professor dies.
suspected Sars cases from seven households,
are confined; 34 develop the disease.
internal report on cases of atypical pneumonia
10 Eleven health care staff go on sick leave from 11 Hong Kong and Guangdong agree on Sars- 28 The chief executive announces the setting up
in the province. Rumours of mystery killer
Ward 8A at Prince of Wales Hospital. The ward is
27 The chief executive announces emergency
isolated but visitors are allowed in, wearing
measures, among them a one-week closure of
12 The government starts releasing on a daily
management and control of the Sars outbreak.
basis the names of buildings with Sars patients
February 12 Hong Kong authorities alert WHO of the
admitted to hospitals within the past 10 days. 10 Hong Kong media start reporting on 29 All arriving passengers required to fill out 15 Hong Kong’s disease prevention law is 11 The last Sars case is confirmed and reported. 14 Health secretary Yeoh Eng-kiong says “this is
health forms. The WHO’s Dr Carlo Urbani, who
23 The WHO removes Hong Kong from its list of
officials unsuccessfully seek information from
still not an outbreak”. The man who will become
areas with recent local transmission of Sars,
the index case for the Amoy Gardens outbreak
international community, dies of the disease.
23 The government proposes a HK$11.8 billion 11 Beijing’s Ministry of Health informs WHO of
stays overnight at his brother’s flat in the
31 An isolation order is served on Block E of
300 cases of an acute respiratory syndrome in
24 Body temperature checks begin for transit 15 The WHO issues a rare emergency travel
fans attend the final of the Rugby Sevens.
and arriving passengers at the airport, and at
1 Forty-one Sars heroes are given awards in 13 The Hospital Authority begins notifying the
advisory in response to reported outbreaks in a
chief executive Tung Chee-hwa’s honours list.
director of health of suspected and confirmed
number of countries, names the illness severe
28 Secondary 1 and 2 students resume classes.
acute respiratory syndrome (Sars) and confirms
1 Government experts find evidence that
sewerage and drains might have been involved
2 The Sars Expert Committee reports its 17 A 33-year-old Hong Kong man dies of bird flu 17 Sydney Chung Sheung-chee, dean of
in the vertical spread of Sars in Amoy Gardens’
3 Experts from the Chinese Medicine Hospital of
after visiting Fujian. His nine-year-old son is also
medicine at Chinese University, tells media the
Block E. Residents are evacuated to holiday
Guangdong province arrive to advise on the use
17 Harbour Fest concerts begin at Tamar site,
government’s Sars numbers are leaving out
camps to continue their 10-day quarantine. The
of Chinese medicine in treating Sars patients.
ending with The Rolling Stones on November 9.
19 Hong Kong steps up public education on
eventual toll is 329 infected, with 42 deaths.
5 Chief secretary Donald Tsang Yam-kuen is 22 The University of Hong Kong announces that 2 The WHO revises its advice to international July 2004 21 A 64-year-old medical professor from
travellers, recommending postponing all but
7 Health secretary Yeoh Eng-kiong resigns after
Guangzhou checks into the Metropole Hotel in
essential travel to Hong Kong and Guangdong.
being blamed in a Legco report for not being
Mong Kok. He will become the index patient for
23 Hospital Authority chief executive William Ho 3 The government extends the suspension of
HK$1 billion is earmarked to promote Hong
sufficiently alert when Guangdong was hit by
the Sars outbreak in Hong Kong from where it
Shiu-wei is admitted with Sars. He recovers and
atypical pneumonia, and for sending confusing
Health workers deliver food and supplies 10 The government announces that all 12 Students in Primary 4 and up resume classes. 22 The Guangzhou professor is admitted to 25 A high-level Sars steering committee, to Amoy Gardens residents sealed inside
household contacts of confirmed Sars patients
23 The WHO lifts its travel advisory.
intensive care at Kwong Wah Hospital.
chaired by the chief executive, is established.
under quarantine. Photo: Robert Ng
will be quarantined at home, with no visitors
24 After reports that the coronavirus has been Sarah Monks
US: Researchers find evidence of banned antibiotics in poultry products 05.apr.12 Johns Hopkins University Bloomberg School of Public Health Chris Stevens In a joint study, researchers at the Johns Hopkins Bloomberg School of Public Health and Arizona State University found evidence suggesting that a class of antibiotics previously banned by the U.S. government for poultry production is sti
High altitude disease can be divided into acute mountain sickness(AMS), high altitude pulmonary edema (HAPE) and high altitudecerebral edema (HACE). AMS is essentially a benign and limiteddisease, while HAPE and HACE can be potentially lethal. The mostcommon form of altitude disease is acute mountain sickness. ACUTE MOUNTAIN SICKNESS The incidence of AMS is about 25% at 9,000 ft and 67%